Workers Compensation Board of Prince Edward Island
Worker's Report of Injury Form
The following errors occurred:

To file a claim with the WCB, you must complete and submit this form. A decision cannot be made without this form having been completed, and it must be submitted within six(6) months from the date of your accident. If you are unable to complete this form online, you can choose the appropriate PDF form by clicking here.

Step 1 of 8















If you have questions, please contact the WCB Claims and Compensation Division at 902-368-5680 or toll-free 1-800-237-5049 in Atlantic Canada.