Worker’s Continuity Report (Form REO6) – WSIB in Ontario
The Worker’s Continuity Report (Form REO6) is essential for documenting any ongoing issues related to a worker’s original injury. This form helps track the worker’s current employment status, medical treatments, medications, and any work modifications due to the injury. It ensures accurate reporting to the Workplace Safety and Insurance Board (WSIB) and aids in planning for an early and safe return to work. The form must be completed in black ink and can be mailed or faxed to WSIB. Any false statements are considered an offence under the Workplace Safety and Insurance Act, 1997.
Filling this form out accurately is crucial for proper documentation and to ensure your claims are processed smoothly. Here is a step-by-step guide to help you complete the form:
Claim Number
- Write your claim number in the designated box.
Worker’s Name
- Enter your full name as it appears on your claim.
Employment Status
- Answer if you are still with the same employer as when you were originally injured. Check ‘yes’ or ‘no’.
- If ‘no’, provide the name and address of your new employer.
- Indicate if WSIB can contact your new employer by checking ‘yes’ or ‘no’.
Injury Details
- Original Date of Accident/Injury: Enter the date of your original injury.
- Date of Recurrence/Re-Injury: Enter the date when your condition worsened or re-injured.
Present Condition
- Indicate if you feel your current problems are a result of your original work injury. Check ‘yes’ or ‘no’.
- Describe any changes or details about why your condition has worsened.
Medical Treatment
- Indicate if you have had any medical treatment for your injury from the specified time periods. Check ‘yes’ or ‘no’.
- If ‘yes’, provide details of the healthcare providers and frequency of visits.
Medications and Devices
- List any drugs, medications, or assistive devices (e.g., braces) you have used due to the injury.
Work Changes
- Indicate if there have been any changes to your work due to the injury. Check ‘yes’ or ‘no’.
- Describe the changes if applicable.
Reporting Problems
- Indicate if you have reported or discussed any ongoing problems at work. Check ‘yes’ or ‘no’.
- Provide names and positions of people you talked to if applicable.
Time Missed from Work
- Indicate if you have missed any time from work due to your injury. Check ‘yes’ or ‘no’.
- List the dates if applicable.
Current Work Status
Choose one of the following options:
- Returned to regular work without losing time/pay.
- Returned to modified work without losing time/pay.
- Lost time/pay due to the recurrence.
- Provide dates and details for the option you selected.
Return to Work Discussions
- Indicate if you have talked to your employer and health professional about returning to work. Check ‘yes’ or ‘no’.
- Provide dates and names if applicable.
- Indicate if there is an anticipated return to work date.
Declaration
– Read the declaration carefully.
– Sign and date the form to confirm that all information provided is true.
Submission
Once completed, you can submit the form via mail or fax to WSIB at:
Mail To: 200 Front Street West
Toronto, ON M5V 3J1
Fax To: 416-344-4684 or 1-888-313-7373
By following this guide, you ensure that your Worker’s Continuity Report is filled out accurately and comprehensively, helping to expedite your claim process.