Online Inquiry For Injured Workers

If you are an injured worker and feel that you might benefit from our services and would like to learn more, please fill out the online inquiry form below for your FREE case assessment. 

Once your inquiry has been received our licensed Paralegal specialized in W.S.I.B. claims (who is also an injured worker) will be in contact with you within 48 hours. 

Please note that our offices are not open for business during the weekend and any inquiries that are received during that time will be replied to within 48 hours of the commencement of business hours following the weekend when the inquiry was received.

* All fields are required to be filled in to enable us to better assist you and assess your case.

Name:

Address: 

City: 

Province: 

Postal Code: 

Phone Number: 

What time is best to reach you?    Please fill in specific time if selected:

Email Address: 

Date of Workplace Injury: 

Do you have multiple claim numbers for more than one injury:  Yes  No

Type of injury or injuries: 

How did this injury or injuries occur?  Please explain: 

 

Have you returned to work after your injury / injuries:  Yes  No

Have you participated in a Labour Market Re-Entry (LMR) plan:  Yes  No

Have you received Loss of Earnings (L.O.E.) benefits:  Yes  No

Have you been awarded NELS or FELS:  Yes  No

Are you appealing a decision made by the Board:  Yes  No

What would you like to see Injured Worker's Advocate & Paralegal Services do for you?  Please explain: 

How did you hear about us: 

Thank you!  A representative will be in contact with you soon.