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  • Medical Form 8-10
    Type: Health Care
    Date: August 20, 2019 Last Revised: February 26, 2021
    Description:

    The new Medical Form 8-10 requires physicians to provide functional abillities recommendations. Evidence shows workplace connection is good for mental, physical and emotional health. Even if a worker is able to work one hour per week, there are positive benefits. 

  • Employer Report of Injury or Illness
    Type: Employers
    Date: August 6, 2020 Last Revised: January 27, 2021
    Description:

    Complete this form if an employee experiences a work-related injury or illness. You must submit this to WorkSafeNB within three days of the: date of the accident if the injury or illness may entitle the worker and/or their dependent(s) to wage  replacement or medical treatment under New Brunswick’s Workers’ Compensation Act; date the employee is diagnosed with an occupational disease; or date you are notified of the accident/injury or illness by the employee.

  • Application for Workers' Compensation Benefits
    Type: Workers
    Date: August 6, 2020 Last Revised: January 27, 2021
    Description:

    Submit this form when applying for WorkSafeNB benefits, such as lost wages and/or medical treatment (physiotherapy, medication, etc.), due to a workplace injury or illness. You must complete this form and send it to WorkSafeNB within one year from the date of the accident/injury or illness.

  • Application for Alternative Assessment Procedure for Inter-Jurisdictional Trucking
    Type: Employers
    Date: January 12, 2021
    Description:

    Application for the Alternative Assessment Procedure (AAP) for Interjurisdictional Trucking and Transport.

  • Application for Optional Personal Coverage
    Type: Employers
    Date: January 12, 2021
    Description:

    Proprietors, partners and spouses of non-incorporated businesses and non-salaried officers of limited or incorporated companies are not automatically covered for compensation purposes under the Workers’ Compensation Act of New Brunswick. To obtain coverage for these individuals, optional personal coverage must be purchased from WorkSafeNB. Please read the Terms and Conditions of Optional Personal Coverage before completing the application.

  • Instructions for completing Form 100
    Type: Employers
    Date: January 12, 2021
    Description:

    The pre-printed Form 100 must be completed (even if the employer ceased operating) and returned no later than February 28, 2021. Any Form 100 received after this deadline will be subject to a late filing penalty.

  • Report contractors and subcontractors Form
    Type: Employers
    Date: January 12, 2021
    Description:

    Form to report contractors and subcontractors must be completed and returned no later than February 28, 2021.

  • Decision Review Form
    Type: Workers
    Date: June 10, 2019 Last Revised: January 1, 2021
    Description:

    The Decision Review Office is here to review WorkSafeNB decisions if you disagree with the original decision.  Injured workers, employers or their representatives can request a review. You can request a review by completing the Decision Review form and forwarding it to the Decision Review Office

     

  • Travel Expense Form
    Type: Workers
    Date: March 20, 2016 Last Revised: January 1, 2021
    Description:

    Medical expense related travel is any visit to a medical professional such as visits to physicians, physiotherapists, chiropractors and any other treatment provided to help you recover from your workplace injury.

    Non-medical expense related travel may include appointments with WorkSafeNB staff, at the staff members’ request, appointments for vocational testing or training and WCAT hearings.

  • Discomfort Survey
    Type: Workers
    Date: December 16, 2020
    Description:

    To help determine whether your computer workstation requires adjustments

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