Workers

Injury & Claims

• Application for Compensation Benefits

• Employer's report of injury or illness

• Immediate incident reporting for the worker

• Request to reactivate claim

Hearing Loss

• Application for Compensation Benefits - Hearing Loss (E)

• Prior approval request (Hearing claims)

• Schedule A - Fee Structure (Hearing claims)

• Service provider report (hearing claims)

Wage Loss

• Wage Loss - Verification of Information

• Wage Loss - Annual Medical Report for Psychological Injuries

• Wage Loss - Annual Medical Report for Physical Injuries

Other Requests

• Request for Disclosure of Claim Information

• Email Authorization

• Direct deposit authorization

• Photo Release

• Reprisal Complaint

Employers

Registration & Coverage

• Application for Registration

• Application for Coverage Outside

• Application for Optional Coverage

• Director Exemption Application Form

• Optional Coverage Cancellation Form

• Application for AAP for interjurisdictional trucking and transport

Payroll & Reporting

• Employer Payroll Report 2024

Permits & Safety

• Application for explosives magazine storage and use permit

• Application for blasting permit

• Application for mine rescue certification

• Application for variance of a WHS regulation

• Application to operate a diesel engine underground

• Asbestos control pre-project safety meeting

• Notification of ownership of radiation equipment - Form A

Health Care Providers

Initial Reports

• Doctor's first report

• Chiropractor's first report and assessment

• Physiotherapy initial assessment report

• Dentist's first report

• Psychological initial assessment report

Progress & Discharge

• Doctor's progress report

• Chiropractor progress report

• Chiropractor discharge report

• Psychological progress report

• Physiotherapy Extension and Discharge Report

Functional Abilities & requests

• Functional abilities form

• Psychological functional abilities form

• Assistive device request

• Appendix 1 - Barriers to return to work

Other Forms & Reports

• Yukon Health Care Provider Application

• Massage Therapy Report

Reconsiderations & Appeals

• Request for Reconsideration

• Withdrawal of Reconsideration Request

• Authorization of a representative

• Request for disclosure (general)

  • Request for Disclosure of Claim Information

  • Request for Disclosure of Employer Assessment Decision / Administrative Penalty

  • Workplace Health & Safety Decisions / Orders / Administrative Penalty