Direction of Authorization – Claims (Form 1824A) – WSIB in Ontario
The “Direction of Authorization – Claims” (Form 1824A) is used to authorize a legal representative or organization to access and manage claim-related information on behalf of a worker or employer with the Workplace Safety and Insurance Board (WSIB). This form ensures that authorized representatives have the necessary permissions to act on behalf of a worker or employer concerning WSIB claims.
Follow these step-by-step instructions to complete this form. This form authorizes a legal representative or organization to access and manage claim-related information with the Workplace Safety and Insurance Board (WSIB).
Section-by-Section Instructions
Contact Information
- WSIB Contact: If you need this form in an alternative format, email accessibility@wsib.on.ca or visit the WSIB website at wsib.ca.
Claim Information
- Claim Numbers: Enter the relevant claim numbers associated with the worker.
- Worker Details: Provide the worker’s name and date of birth in the format (dd/mmm/yy).
Part A – Worker or Employer Directing Authorization
- Name: Enter the full name of the worker or employer directing the authorization.
- Employer/Company Name: Enter the name of the employer or company, if applicable.
- Contact Information: Fill in the address, city/town, postal code, telephone number, and fax number.
- Language: Indicate the preferred language (English, French, or other).
Part B – Representative Information
- Name of Authorized Person/Organization: Enter the name of the person or organization being authorized.
- Contact Information: Fill in the address, city/town, postal code, telephone number, and fax number.
- Signature: The authorized representative must sign this section.
Licensing Information
- Option 1: If the representative has a Law Society of Upper Canada or Application ID number, enter it here.
- Option 2: If the representative is exempt from the paralegal licensing requirement, check the appropriate exemption box:
- In-house legal services provider or paralegal
- Student legal aid services society
- Acting for family or friend
- Office of the Worker Adviser
- Articling student
- Legal clinic
- Constituency assistant
- Office of the Employer Adviser
- Trade union
- Other profession or occupation (specify)
- Option 3: If the representative is excluded from the paralegal licensing requirements, provide an explanation.
Part C – Extent of Authorization and Expiration
- Authorization Scope: This section confirms that the representative is authorized to access and manage all WSIB claim-related information.
- Effective Period: The authorization is effective indefinitely until revoked in writing or upon the death of the worker.
Part D – Approval by Worker or Employer
- Approval: The worker or employer must sign this section to validate the authorization.
- Details: Provide the name, position/title (if applicable), and date of signing (dd/mmm/yy).
Additional Information
- Cancelling or Changing Authorization: To change an authorization, complete a new Direction of Authorization form. To cancel an authorization, send a written request or fax to the Claims Adjudicator responsible for the claim.
- Code of Conduct for Representatives: Visit wsib.ca/repconduct for more information on the expected standards of behavior.
- Additional Space: If additional space is needed, add a note on page 1 and attach the extra pages to the form.
Submission Instructions
- Mail: Send the completed form to Workplace Safety and Insurance Board, 200 Front Street West, Toronto, Ontario M5V 3J1.
- Fax: Send to 416-344-4684 or 1-888-313-7373.
Ensure all sections are completed accurately and print in black ink to avoid delays in processing. If you need assistance, contact the Claims Adjudicator responsible for the claim.