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WSIB Form 7 — Employer's Report of Injury (Ontario)

WSIB Form 7 — Employer's Report of Injury/Disease (Ontario)

WSIB FORM 7 — EMPLOYER'S REPORT OF INJURY / DISEASE

Workplace Safety and Insurance Board (WSIB) — Province of Ontario

Authority: Workplace Safety and Insurance Act, 1997 (WSIA), S.O. 1997, c. 16, Sched. A, ss. 21-22. Employers must submit this report within three calendar days of learning of an injury requiring medical attention or causing time away from work.

PART A — EMPLOYER INFORMATION

Employer Legal Name: [Employer Legal Name]

WSIB Account Number: [WSIB Account Number]

Business Address: [Employer Address]

Telephone: [Employer Phone]

Contact Person: [Employer Contact]

NAICS Industry Code: [NAICS Code]

PART B — INJURED WORKER INFORMATION

Worker's Full Name: [Worker First Name] [Worker Last Name]

Date of Birth: [Worker Date of Birth]

Social Insurance Number (last 3 digits): [Worker SIN — last 3 digits]

Home Address: [Worker Address]

Telephone: [Worker Phone]

Occupation / Job Title: [Worker Occupation]

Date of Hire: [Worker Hire Date]

Employment Status: [Employment Status]

PART C — ACCIDENT / INJURY DETAILS

Date of Accident: [Accident Date]

Time of Accident: [Accident Time]

Location of Accident: [Accident Location]

Description of How Accident Occurred: [Accident Description]

Nature of Injury / Disease: [Nature of Injury]

Body Part(s) Injured: [Body Part Injured]

Witness Name(s): [Witness Name(s)]

PART D — MEDICAL TREATMENT

Medical Treatment Sought: [Medical Treatment]

Health Care Provider / Hospital: [Healthcare Provider]

Date of First Treatment: [First Treatment Date]

PART E — LOST TIME AND WAGES

Worker Lost Time From Work: [Lost Time]

First Day Absent: [First Day Absent]

Regular Gross Earnings: [Regular Earnings]

Regular Hours Per Week: [Regular Hours Per Week]

PART F — EMPLOYER DECLARATION

I, [Declarant Name], [Declarant Title], of [Employer Legal Name], certify that the information contained in this Employer's Report of Injury/Disease is true and accurate to the best of my knowledge. I understand that under WSIA s.21, failure to report a workplace injury within three calendar days is an offence and may result in penalties. I acknowledge that the WSIB may investigate this claim and request additional information.

Signature: _______________________________ Date: [Report Date]

LEGAL NOTICES AND OBLIGATIONS

Reporting Obligation: Under WSIA s.21, an employer who learns of a workplace injury that requires medical attention beyond first aid or that causes a worker to be absent from work must report to the WSIB within three (3) calendar days. Failure to report is an offence under WSIA s.149.

Duty to Cooperate: Under WSIA s.40, the employer has a duty to cooperate in the worker's return to work. This includes providing suitable modified or transitional work where possible, maintaining benefit coverage, and communicating with WSIB and the worker throughout the claim process.

Collective Agreement: If the worker is covered by a collective agreement, return-to-work obligations under WSIA operate alongside (and do not replace) the grievance provisions of the collective agreement.

Privacy Notice: Information collected on this form is used solely for administering the WSIA and is protected under the Freedom of Information and Protection of Privacy Act (Ontario) and WSIB privacy policies.

Applicant

________________

Signature

Date: ________________

Maintained by Vladislav Sergienko, Founder·Template last modified: ·Report an error

What Is a WSIB Form 7 — Employer's Report of Injury (Ontario)?

A WSIB Form 7 — Employer's Report of Injury (Ontario) in Canada reports a workplace injury to Ontario’s Workplace Safety and Insurance Board as the employer’s report of injury, governed primarily by Ontario’s Workplace Safety and Insurance Act, 1997 (S.O. 1997, c. 16).

Form 7 serves as the employer's official notification to the WSIB that a workplace injury has occurred. It provides the WSIB with the information needed to open a claim, assign a claims adjudicator, assess entitlement, and calculate the worker's loss-of-earnings (LOE) benefit. The form captures the employer's WSIB account number and NAICS industry classification, the injured worker's personal information and employment history, a detailed description of how and where the accident occurred, the nature of the injury and body part affected, information about medical treatment received, and the worker's regular earnings — which form the basis for calculating LOE benefits at 85% of net average earnings under WSIA s.43.

In Ontario, almost all employers are covered under Schedule 1 (mandatory insurance) or Schedule 2 (self-insured) of the WSIA. Approximately 300,000 Ontario employers are registered with WSIB, covering some 5 million workers. WSIB annually processes over 200,000 lost-time and no-lost-time claims. The WSIB is funded through employer premiums based on industry classification and experience rating — meaning an employer's claims history directly affects its premium rate under the NEER (New Experimental Experience Rating) program.

The legal framework governing the WSIB Form 7 — Employer's Report of Injury (Ontario) in Canada draws on several key statutes and regulatory bodies. Under the Canada Labour Code (R.S.C. 1985, c. L-2), the Canada Industrial Relations Board adjudicates federal workplace disputes. Provincial employment standards legislation — including Ontario's Employment Standards Act 2000 and British Columbia's Employment Standards Act (RSBC 1996) — governs minimum employment terms. The Personal Information Protection and Electronic Documents Act (PIPEDA) governs private-sector data handling. The Canada Revenue Agency (CRA) administers source deductions and Canada Pension Plan (CPP) contributions. Parties executing a WSIB Form 7 — Employer's Report of Injury (Ontario) in Canada should confirm the document reflects current law, including any amendments enacted since the original drafting date. The Canada Labour Code (R.S.C. 1985, c. L-2) sets the foundational requirements.

When Do You Need a WSIB Form 7 — Employer's Report of Injury (Ontario)?

An Ontario employer must complete and submit WSIB Form 7 within three (3) calendar days of learning that a workplace injury or occupational disease requires medical attention beyond first aid or has caused the worker to be absent from work. This three-day reporting obligation applies whether the worker is full-time, part-time, seasonal, casual, or temporary — and regardless of whether the employer believes the injury is work-related or whether the employer disputes the worker's account of the accident.

Form 7 is required in the following circumstances: when a worker visits a physician, walk-in clinic, hospital emergency department, or physiotherapist for a workplace injury; when a worker is prescribed medication for a workplace injury; when a worker is absent from work for any part of a day following a workplace incident; when a worker returns to work on modified duties at reduced earnings after an injury; and when a worker develops an occupational disease (such as occupational asthma, repetitive strain injury, or noise-induced hearing loss) linked to workplace exposures.

Form 7 is not required for incidents that require only first aid administered on-site (e.g., a bandage or ice pack) and that do not result in any time away from work or medical consultation. However, employers are strongly advised to document all workplace incidents in an internal accident register, because a minor injury may later develop into a more serious condition requiring a WSIB claim, and early documentation protects the employer against late or exaggerated claims.

Employers who fail to file Form 7 within three calendar days may face WSIB surcharges, prosecution under WSIA s.149, and difficulty managing the claim. WSIB adjudicators draw negative inferences from late employer reports, and delays in reporting can result in the WSIB making entitlement decisions based solely on the worker's Form 6 report.

Under the Canada Labour Code (R.S.C. 1985, c. L-2), the Canada Industrial Relations Board adjudicates federal workplace disputes. Provincial employment standards legislation — including Ontario's Employment Standards Act 2000 and British Columbia's Employment Standards Act (RSBC 1996) — governs minimum employment terms. The Personal Information Protection and Electronic Documents Act (PIPEDA) governs private-sector data handling. The Canada Revenue Agency (CRA) administers source deductions and Canada Pension Plan (CPP) contributions.

What to Include in Your WSIB Form 7 — Employer's Report of Injury (Ontario)

A complete and accurate WSIB Form 7 must include the following elements to confirm prompt claim processing and protect the employer's interests in the WSIB claim process.

Part A — Employer Information: The employer's full legal name exactly as registered with WSIB, the WSIB firm account number (found on WSIB correspondence and premium statements), the full business address including postal code, a direct telephone number, and the name and title of the contact person who will manage the claim. Providing the NAICS industry classification code helps WSIB verify premium rates.

Part B — Injured Worker Information: The worker's full legal name, date of birth, Social Insurance Number (the last three digits are sufficient for identification purposes), home address and telephone number, job title and department, date of hire, and employment status. The hire date and employment status affect entitlement calculations for long-term disability benefits.

Part C — Accident Description: The exact date, time, and location of the accident. A clear, factual, and objective description of what the worker was doing at the time of the injury, what happened, and what caused the injury. Describe the specific workplace activity, any equipment or materials involved, and any environmental factors (wet floor, poor lighting, excessive weight). Avoid conclusions, blame language, or opinions. Identify any witnesses by name and position.

Part D — Medical Treatment: Whether the worker sought medical attention beyond first aid, the name of the healthcare provider or hospital, and the date of first medical treatment. If the employer has a designated healthcare provider under a workplace health program, note this.

Part E — Lost Time and Wages: Whether the worker lost any time from regular work (even for part of a day), the first date the worker was absent, the worker's regular gross earnings stated as a weekly or hourly amount in Canadian dollars, and the worker's regular hours per week. Accurate wage information is critical because WSIB calculates LOE benefits at 85% of net average earnings.

Part F — Employer Declaration: The name and title of the authorized person completing the report, their signature, and the date the report was prepared. The declaration certifies the accuracy of the information under the WSIA.

Additional compliance elements for a WSIB Form 7 — Employer's Report of Injury (Ontario) used in Canada include: Under the Canada Labour Code (R.S.C. 1985, c. L-2), the Canada Industrial Relations Board adjudicates federal workplace disputes. Provincial employment standards legislation — including Ontario's Employment Standards Act 2000 and British Columbia's Employment Standards Act (RSBC 1996) — governs minimum employment terms. The Personal Information Protection and Electronic Documents Act (PIPEDA) governs private-sector data handling. The Canada Revenue Agency (CRA) administers source deductions and Canada Pension Plan (CPP) contributions. Forms-legal.com provides this template as a starting point for Canada-compliant documentation.

Sources & Citations

Statutory citations link to official government sources.

  1. R.S.C. 1985, c. L-2CA official

Cite this page

Reference this free template in an article, syllabus, or research note:

APA

Forms Legal. (2026). WSIB Form 7 — Employer's Report of Injury (Ontario) (Canada) [Legal document template]. Forms Legal. https://forms-legal.com/canada/employment/forms/wsib-form-7-employer-report-injury-ontario

MLA

"WSIB Form 7 — Employer's Report of Injury (Ontario) (Canada)." Forms Legal, 2026, https://forms-legal.com/canada/employment/forms/wsib-form-7-employer-report-injury-ontario.

BibTeX
@misc{formslegal-wsib-form-7-employer-report-injury-ontario,
  author       = {{Forms Legal}},
  title        = {WSIB Form 7 — Employer's Report of Injury (Ontario) (Canada)},
  year         = {2026},
  howpublished = {\url{https://forms-legal.com/canada/employment/forms/wsib-form-7-employer-report-injury-ontario}},
  note         = {Free legal document template. Based on Canada Labour Code (R.S.C. 1985, c. L-2)}
}

Frequently Asked Questions

Based on Canada Labour Code (R.S.C. 1985, c. L-2) — Template last modified June 2026Verify the source →

This template is provided for informational purposes only and does not constitute legal advice. Laws vary by jurisdiction and change over time. Consult a qualified attorney for advice specific to your situation.Full disclaimer

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