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  • 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).

  • Form 1 – Complaint
    Type: Workers
    Date: January 21, 2020
    Description:

    Under section 25 of the Occupational Health and Safety Act, an employee may file a complaint against an employer or union if the employer or union has taken, or threatens to take, a discriminatory action against the employee because the employee complied with the Act, the regulations or an order or because the employee sought the enforcement of the Act, the regulations or an order. 

  • Audiometric Report
    Type: Health Care
    Date: August 28, 2019
    Description:

    Audiometric testing of a worker’s hearing is important to the success of a hearing conservation program because it helps determine if occupational hearing loss is being prevented by the noise control measures.

  • Estimate of Required Dental Services
    Type: Health Care
    Date: June 27, 2019 Last Revised: June 27, 2019
    Description:

    Estimate of required dental services to be completed by attending dentist/denturist and forwarded promptly to WorkSafeNB.

  • Form 33 – Claimant Prescription Information
    Type: Health Care
    Date: January 11, 2011 Last Revised: November 8, 2018
    Description:

    This form is used for the reimbursement of items  or drugs purchased by an injured worker.

    Pharmacies my use this from to  direct bill WorkSafeNB for approved personal items purchased by the client for the compensable injury. 

    Out of Province pharmacies may also use this form for direct billing of approved drugs.  They do not have access to e-pay

  • Code of Practice – Fall Protection
    Type: Employers
    Date: August 2, 2018
    Description:

    This guide can help you comply with Section 50.2 of the General Regulation 91-191.
    NOTE: Not for use when a safety monitor is part of the fall protection system on a work site.

  • Form 67 – Report of Accident or Occupational Disease
    Type: Workers
    Date: March 1, 2018
    Description:

    This report must be submitted within three (3) days after the accident

  • Anaesthesia Billing Form for WorkSafeNB Claimants
    Type: Health Care
    Date: March 20, 2016
    Description:

    WorkSafeNB uses the Medicare Manual to guide its payment for surgical procedures.

  • Doctor's Account for Consultations and Procedures
    Type: Health Care
    Date: March 20, 2016
    Description:

    Under the Act, application for payment must be made within three months of the service rendered.

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