What is an Electronic Form 67?
It is a convenient online method for employers to report a workplace injury claim 24 hours a day, seven days a week.
Why should the employer submit a claim online?
- The claim is received instantly by WorkSafeNB.
- Reduces rework that can delay decisions and payments.
- Improves injury reporting and benefit application by receiving required information earlier.
- Submitting a report to WorkSafeNB promptly allows for faster processing, helping injured workers return to health and work as quickly as possible.
Are you an injured worker?
When a workplace injury occurs, both employers and workers play a critical role in initiating the claim process. Employers must submit the Employer's Report of Injury or Illness, while workers submit the Application for Compensation Benefits when compensation benefits are required. When both documents are submitted together by using the E67, information is received earlier, more and with greater accuracy allowing for faster decisions and quicker access to benefits.
We recommend completing the form with your employer. If that’s not possible, you may complete the online form on your own.
Before submitting a claim, an employer representative must register below by sending an email with their name, position within the company, company name, their contact information and a company email address to receive submission confirmations.
Employers can submit a claim online using one of three ways:
Employers now have three convenient online methods to report a workplace injury. Each method has its advantages. To determine which one works best for you, read below.
Submit through MyServices
- Better suited for employers who want access to a website application to view current employer balances, claim information, and communicate securely with WorkSafeNB. It is practical for employers with low injury frequency.
- An employer representative must register before they can submit a claim by providing their name, position within the company, company name, their contact information and a company email address to receive submission confirmations.
Submit through WorkSafeNB
- Better suited for employers with a low injury frequency.
- No password requirement.
Submit through Service New Brunswick
- Better suited for employers with a high injury frequency.
- Ability for different company departments to complete relevant sections of the form (payroll for salary information, supervisor for accident details, etc.).
- Ability to update a previous no-time loss claim should the injured worker’s status change.
Please
email us to register before submitting a claim.
