Worker's Report of Injury (W1)
Register for an Online Account so you can view your claim information and review forms you have submitted. You will also have the ability to view your payments, submit appeals and update personal information.
The following form is for workers who have been injured on the job. This should be the first form you complete and provide to WCB after a workplace injury. If you fill this form out, you will not need to provide a paper copy of the W1 form to WCB. If you have an active claim and need to appeal it or provide additional information this is not the form you need.
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 your provincial health number as well as your employer contact information and details of the incident that resulted in the injury.
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