Employer's Report of Injury (E1)
Register for an online account so you can submit employer's payroll statements, view account details, request clearances and manage your automatic clearances verification list. You can also view cost information, request letters of good standings, report injury and review forms you have submitted.
If you have problems completing this form or have questions, please call us at 1-800-787-9288.
To complete this form, you will need the worker's personal health number as well as the worker's personal information including name, address and details of the incident that resulted in injury.
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If you have problems completing this form or need questions answered, please call our Teleservice at 1.800.787.9288.
Once you have submitted the required information online, you will not be required to submit a paper copy. Upon submission of your form, you will receive an email with your claim number within one to two business days. Please use that number in all phone calls and emails with the WCB.
Submit by mail or fax
If you prefer to submit this form by mail or fax, please download the PDF below. Fill it out in pen and send a copy to:
WCB Regina Office
200-1881 Scarth Street
Toll-Free Fax: 1.888.844.7773