Publications and forms

Worker publications

• Worker Handbook (includes injury reporting form, Automobile accident report form, and Information release form) (pdf, 635KB)
• Worker fact sheets
• 2012 pension payment calendar (pdf, 199KB)
• 2011 pension payment calendar (pdf, 152KB)
• Back to basics (pdf, 82KB) This booklet will help you get to know your back better, to understand why back pain occurs, how to manage it and how to maintain good back health.
  • Back to basics French (pdf, 114KB)
• Working safely behind the wheel (pdf, 470KB) - Keeping Alberta streets and highways safe is everyone’s responsibility. Working Safely Behind the Wheel is designed to get drivers thinking about their driving habits and the consequences of bad driving.

Worker injury reporting form

• Report of Injury or occupational disease form with instructions - C060 (pdf, 134KB)
• Progressive Questionnaire form - C504 (pdf, 15KB) Injuries that occur over time require more information. Complete this form along with your report of injury or occupational disease form.

Worker forms (A - Z)

• Asbestosis exposure claim forms (pdf, 287KB) This package includes the Workers Report of Injury or Occupational Disease C060, Pulmonary history questionnaire C013, Workers employment record (chemical exposure) C117, Assignment of damages agreement C847.
• Assignment of Compensation form - C140 (pdf, 49KB) Use this form when your employer has kept you on full pay through your period of temporary disablement.
• Authorize a Worker Representative / Information Release form - C622 (pdf, 36KB) Use this form to authorize another party to act on your behalf on your claim.
• Automobile Accident Report form - L054 (pdf, 49KB) Work-related motor-vehicle accidents require completion of this form along with your report of injury or occupational disease.
• Damaged eye glasses form- C697 (pdf, 47KB) Use this form when only eyeglasses have been damaged (an eye injury has not been sustained).
• Direct Deposit Request form - C078 (pdf, 26KB) Use this form to sign up to have your benefit payments deposited directly into your designated bank account.
• Election to Claim Fatality form - C876 (pdf, 51KB) Use this form to elect to claim a work-related fatality in Alberta when the accident occurred outside the province.
• Election to Claim under the Alberta WCB - C1040 (pdf, 19KB) Use this form if you reside outside the province of Alberta but were injured in Alberta, in a work-related accident and would like to submit a claim for compensation in Alberta.
• Emotional Injuries - General Information Questionnaire (pdf, 33KB)
• Employment Record - Chemical Exposure form - C117 (pdf, 35KB)
• Employment Record - Noise Induced Hearing Loss form - C131 (pdf, 17KB)
• FOIP - Request to access information (pdf, 590KB)
• FOIP - Request to correct personal information (pdf, 593KB)
• Hearing loss forms package (pdf, 58KB) Use this form if you have sustained a work-related hearing loss.
• Information Release form / Authorize a Worker Representative - C622 (pdf, 36KB) Use this form to authorize another party to act on your behalf on your claim.
• Interjurisdictional trucking application - A596 (pdf, 24KB)
• Medical Release form - C463 (pdf, 17KB) Use this form to authorize the release of medical information relevant to your claim to WCB by health care practitioners.
• Personal Attendant's Wage Loss form - C936 (pdf, 20KB) Use this form to request payment assistance for a personal attendant who was required to assist you and has suffered a wage loss.
• Progressive Questionnaire form - C504 (pdf, 29KB) Injuries that occur over time require more information. Complete this form along with your report of injury or occupational disease form.
• Pulmonary History Questionnaire - C013 (pdf, 27KB)
• Report of Injury or occupational disease form only - C060 (pdf, 86KB)
• Report of Injury or occupational disease form with instructions - C060 (pdf, 134KB)
• Request for Review form - G040 (pdf, 35KB) Complete this form if you require a review of a customer service decision.
• Right of election form - C169 (pdf, 92KB) Use this form if you were injured outside of Alberta but normally live or work in Alberta and would like to claim compensation in Alberta.
• Translation and Interpretation Services Use these forms if you require translation or interpretation help.
• Travel and Expense Record form- C688 (pdf, 24KB) Use this form to claim expenses for work-injury related travel. Discuss travel payment available with your case manager or adjudicator prior to travel.
• Wage Loss form - C394 (pdf, 20KB) Use this form to claim wages lost due to attendance at a claim-related appointment.

You can order WCB publications and forms online and have them mailed to you.
Please note: The minimum order for any single type of publication or form is ten (with the exception of Worker Handbook). You can also print a pdf of the publications and forms.