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.

Important Information
The online Employer's Report of Injury (an E1 form) is an interactive application that will guide you through the sections necessary to submit your report of injury.
Please provide the necessary information below and click NEXT to continue to the next section.
An * indicates a required field.

Do not use your browser back or next button. Please use the NEXT and BACK buttons at the bottom of the sections.
Move the mouse pointer over the        's below for help on the fields.

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.
Employer
  • -- Select province --
  • Alberta
  • British Columbia
  • Manitoba
  • New Brunswick
  • Newfoundland and Labrador
  • Northwest Territories
  • Nova Scotia
  • Nunavut
  • Ontario
  • Prince Edward Island
  • Québec
  • Saskatchewan
  • Yukon
  • USA
  • Canada
Terms and Conditions
The WCB advises that the email account you provide should be accessible, used, and viewed only by those persons necessary to enable you to fulfill the requirements of providing information to report workplace injuries and processing those claims. To protect the privacy of workers, we recommend the use of an email account that is dedicated to communicating and receiving correspondence with the WCB relating to workplace injury claims. This email account should be associated with an identifiable individual responsible for work injury claims in your business. In submitting this report of injury (E1), you acknowledge that the information provided is accurate to the best of your knowledge.

Do you agree to these terms and conditions?

 

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
Regina SK
S4P 4L1

Fax: 306.787.4311
Toll-Free Fax: 1.888.844.7773