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.
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.
Administer this form to workers participating in the SUCCEED program within one week of starting treatment. Re-administer at the end of treatment.
Complete and submit this form within one week of treatment end date.
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
Use this receipt template for recording informal home care services performed for a worker (the client) receiving WorkSafeNB benefits.
Complete this disclosure statement if you plan to perform informal home care services for a worker (the client) receiving WorkSafeNB benefits.
Use this form to appeal an order, advice or administrative penalty (AP) issued under New Brunswick’s Occupational Health and Safety Act or its regulations. The notice of appeal must be filed within 14 calendar days of receiving the order, advice or administrative penalty.
WorkSafeNB has streamlined reporting for chiropractors by combining the Form 8C, Chiropractor’s First Report of Accident and the Form 10C Chiropractor’s Progress Report into one form, the Chiropractic Form 8-10. It is for both initial visits and follow-up (progress) reports.
