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  • Decision Review Application
    Type: Workers
    Date: June 10, 2019 Last Revised: October 15, 2026
    Description:

    A decision review is the required first step in the appeals process. It takes a second look at your claims-related decision to ensure that it is compliant with legislation, policy, and individual merits of your claim. You need to request a decision review before making an appeal to the Workers’ Compensation Appeals Tribunal. 

  • Initial Psychological Assessment Report
    Type: Health Care
    Date: March 20, 2016 Last Revised: October 5, 2026
    Description:

    The report is due within 14 days of discharge. 

  • Ketamine Review
    Type: Health Care
    Date: August 16, 2024 Last Revised: June 15, 2026
  • Application for Compensation Benefits and Report of Injury or Illness – Electronic Form 67
    Type: Workers
    Date: April 22, 2026
    Description:

    The Electronic Form 67 is a convenient online method for employers to report a workplace injury claim 24 hours a day, seven days a week.

  • Surviving Spouse Questionnaire – Deaths Occurring on or After July 1, 2025
    Type: Workers
    Date: March 3, 2026
  • Contractors and Subcontractors Form
    Type: Employers
    Date: January 2, 2025 Last Revised: January 16, 2026
    Description:

    Form to report contractors and subcontractors must be completed and returned no later than February 28, 2025.

  • Mental Health Provider Report
    Type: Health Care
    Date: November 7, 2025 Last Revised: November 7, 2025
  • Medical Aid Request
    Type: Workers
    Date: November 1, 2022 Last Revised: May 28, 2025
    Description:

    Use this form if you had an approved claim that is now closed (you're no longer receiving any benefits from WorkSafeNB such as loss of earnings or medical aid) and require medical aid for your previously approved work-related (compensable) injury or illness. 

  • Surviving Spouse Questionnaire – Dependents
    Type: Workers
    Date: March 10, 2020 Last Revised: March 10, 2025
    Description:

    The benefits you receive from WorkSafeNB are reviewed annually on the anniversary of your spouse’s death and adjusted in accordance with the percentage increase established by WorkSafeNB.

  • Surviving Spouse Questionnaire – New Spouse
    Type: Workers
    Date: March 10, 2020 Last Revised: March 10, 2025
    Description:

    The benefits you receive from WorkSafeNB are reviewed annually on the anniversary of your spouse’s death and adjusted in accordance with the percentage increase established by WorkSafeNB.

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