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  • Psychology Forms – General Information
    Type: Health Care
    Date: August 14, 2020
    Description:

    WorkSafeNB, in consultation with psychologists from across New Brunswick, has updated the three psychology forms to align them with significant changes in diagnostic criteria, the development of new empirically supported treatments and changes to the Worker’s Compensation Act.

  • Initial Psychological Assessment Report – Instructions
    Type: Health Care
    Date: August 13, 2020
  • Employer Report of Injury or Illness
    Type: Employers
    Date: August 6, 2020
    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: August 6, 2020
    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.

  • Initial Psychology Assessment Report (IPAR) | Excel Version | Word Version
    Type: Health Care
    Date: June 18, 2020 Last Revised: June 18, 2020
    Description:

    The Initial Psychological Assessment Report (IPAR) asks for information necessary for WorkSafeNB to make an acceptance decision on a claim. WorkSafeNB must determine whether the worker’s injury meets requirements for acceptance under the Workers’ Compensation Act.

  • Psychology Progress Report | Word Version
    Type: Health Care
    Date: June 18, 2020
    Description:

    The Psychology Progress Report (PPR) asks for information necessary to help us understand a worker’s recovery, accommodation options and more. This helps us review progress and opportunities for additional support.

  • Psychology Discharge Report | Word Version
    Type: Health Care
    Date: June 18, 2020
    Description:

    The Psychology Discharge Report (PDR) asks for information necessary to close a course of treatment. It helps us understand the outcomes of that treatment and review overall improvement and possible need for additional support. 

  • Direct Deposit Enrolment Form - Worker
    Type: Workers
    Date: April 8, 2020 Last Revised: April 8, 2020
    Description:

    We encourage clients to sign up for direct deposit if they haven’t already done so. Registration is simple and quick.

  • Direct Deposit Enrolment Form: Provider
    Type: Health Care
    Date: April 8, 2020 Last Revised: April 8, 2020
    Description:

    Sign up for direct deposit (health care providers).

  • Long-term Disability Questionnaire
    Type: Workers
    Date: March 10, 2020 Last Revised: March 10, 2020
    Description:

    In accordance with the Workers' Compensation Act, adjustments to Long-Term Disability (LTD) benefits are made on the anniversary month of your injury or recurrence of injury.

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