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Electronic Form 67

FOR EMPLOYER USE ONLY

What is an Electronic Form 67?

It is a convenient online method for employers to report a workplace injury claim 24 hours a day, seven days a week.

Are you an injured worker?

If so, you must fill out a printable Form 67.

Why should the employer submit a claim online?

  • The claim is received instantly by WorkSafeNB.
  • Reduces paperwork.
  • Only completed forms can be submitted, eliminating the need for follow-up phone calls.
  • Claims can be processed faster. The sooner a report gets to WorkSafeNB, the sooner it can be processed and the sooner we can get an injured worker back to health and work.

An employer representative must register first before they can submit a claim.

Before submitting a claim, an employer representative must register below by sending an email with their name, position within the company, company name, their contact information and a company email address to receive submission confirmations.

Employers can submit a claim online using one of two ways:

Employers now have two convenient online methods to report a workplace injury. Each method – one through WorkSafeNB’s website, the other through Service New Brunswick’s website – has its advantages. To determine which one works best for you, read below.

 

Submit through WorkSafeNB
  • Better suited for employers with a lower injury frequency.
  • No password requirement.
  • Account will never be deactivated due to inactivity.
Please email us to register before submitting a claim.

         
Submit through SNB
  • Better suited for employers with an injury frequency greater than 12 claims a year.
  • Ability for different company departments to complete relevant sections of the form (payroll for salary information, supervisor for accident details, etc.).
  • Ability to update a previous no-time loss claim should the injured worker’s status change.
Please email us to register before submitting a claim.

            

 







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