The WSIAT created forms to collect the information needed to

• start an appeal
• prepare an appeal for hearing
• update a file
• make requests

Each form is available here in 2 formats depending on how you want to send it to us

1. Print and Mail (left side below)
2. E-File (right side below)

The WSIAT forms are available in PDF format. To view and print them, you must have Acrobat Reader software (version 4 or higher), a free utility created by Adobe. If you do not have the Adobe Acrobat or Acrobat Reader DC, you can download the version you need for your computer.

Requests for Accessible Formats and Communication Supports

Forms and information about our appeal process are available on this website. If you need forms or information in an accessible format, please contact the Call Centre or the Accessibility Coordinator.

E-File

Please complete the form electronically, save and name it, and E-File it to us.

Print and Mail

You may either complete the form electronically before printing it, or you may print it first and then complete it with a pen. Once complete, please send the form to us by courier, mail, or deliver it in person.

WSIAT Address:	Mailroom Workplace Safety and Insurance Appeals Tribunal 505 University Avenue 5th Floor Toronto, ON M5G 2P2

Starting an Appeal

Print and Mail	E-File
Notice of Appeal Form for Workers	Notice of Appeal Form for Workers
Notice of Appeal Form for Employers	Notice of Appeal Form for Employers

E-Share

Print and Mail	E-File
WSIAT E-Share Service Consent Form	WSIAT E-Share Service Consent Form

Responding to an Appeal

Print and Mail	E-File
Response Form for Workers	Response Form for Workers
Response Form for Employers	Response Form for Employers

Consent to Release Information

Print and Mail	E-File
Consent Form to Release a Worker’s Information	Consent Form to Release a Worker’s Information

Accommodation Requests

Print and Mail	E-File
Accommodation Request Form	Accommodation Request Form

Preparing an Appeal

Print and Mail	E-File
Hearing Ready Form for Oral Hearings	Hearing Ready Form for Oral Hearings
Hearing Ready Form for Hearings in Writing	Hearing Ready Form for Hearings in Writing
Agreed Statement of Facts (General)	Agreed Statement of Facts (General)
Not Ready for a Hearing Form	Not Ready for a Hearing Form

Address Change

Print and Mail	E-File
Worker Change of Address Form	Worker Change of Address Form
Representative and Employer Change of Address Form	Representative and Employer Change of Address Form

Authorizing a New Representative

Print and Mail	E-File
Worker Authorization to Represent	Worker Authorization to Represent
Employer Authorization to Represent	Employer Authorization to Represent

After the Hearing

Print and Mail	E-File
Hearing Expense Claim	Hearing Expense Claim
Hearing Expense for Teleconference and Videoconference Claim	Hearing Expense for Teleconference and Videoconference Claim
Application for Direct Deposit	Application for Direct Deposit
WSIAT Request Form for Audio Recordings	WSIAT Request Form for Audio Recordings

Right to Sue (section 31) Applications

Print and Mail	E-File
Right to Sue Application Form	Right to Sue Application Form
Right to Sue Participation Form	Right to Sue Participation Form
Agreed Statement of Facts (Right to Sue)	Agreed Statement of Facts (Right to Sue)
Draft Order and Consent (Right to Sue)	Draft Order and Consent (Right to Sue)

Reconsiderations and Clarifications of WSIAT Decisions

Print and Mail	E-File
Request for Reconsideration / Clarification	Request for Reconsideration / Clarification
Reconsideration / Clarification Response	Reconsideration / Clarification Response

If you have any questions about the WSIAT forms, please Contact Us.