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  • Form 67 – Report of Accident or Occupational Disease
    Type: Workers
    Date: March 1, 2018
    Description:

    This report must be submitted within three (3) days after the accident

  • Anaesthesia Billing Form for WorkSafeNB Claimants
    Type: Health Care
    Date: March 20, 2016
    Description:

    WorkSafeNB uses the Medicare Manual to guide its payment for surgical procedures.

  • Doctor's Account for Consultations and Procedures
    Type: Health Care
    Date: March 20, 2016
    Description:

    Under the Act, application for payment must be made within three months of the service rendered.

  • Employer Registration – Application for New Coverage – Online
    Type: Employers
    Date: March 20, 2016
    Description:

    Employers having three or more workers, full or part-time, must register for coverage. The only exception is the fishing industry, which must register when 25 or more workers are employed.

  • Form HA-01 – Hearing Aid Fitting and Service Report
    Type: Health Care
    Date: March 20, 2016
    Description:

    Hearing services providers must complete and submit the WorkSafeNB Form HA-01 – Hearing Aid Fitting and Service Report each time they deliver services to an injured worker, under their contract with WorkSafeNB. This form must be submitted even when the service provided does not result in a new invoice to WorkSafeNB. Submission of HA-01 forms, by hearing services providers, for all services to WorkSafeNB clients are necessary for comprehensive client hearing health files and to establish travel benefits, which may be claimed.

  • Form HA-02 – Exception Report
    Type: Health Care
    Date: March 20, 2016
    Description:

    The hearing services provider must submit Form HA-02 – Exception Report any time WorkSafeNB approval is required before service delivery, such as when the service falls outside of the standard fee schedule and or outside the Standing Offer Price list. Form HA-02 – Exception Report must be submitted for WorkSafeNB approval whenever the delivery of a replacement hearing aid device(s) or manufacturer repair is requested.

  • Psychology Discharge Report
    Type: Health Care
    Date: March 20, 2016
    Description:

    The report is due within 14 days of discharge. 

  • Psychology Initial Assessment Report
    Type: Health Care
    Date: March 20, 2016
    Description:

    The report is due within 14 days of discharge. 

  • Psychology Progress Report
    Type: Health Care
    Date: March 20, 2016
    Description:

    To be completed and submitted every 4-6 sessions unless agreed otherwise with WorkSafeNB.

  • Physiotherapy Progress Report
    Type: Health Care
    Date: March 20, 2016

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