Full Service: An Employer’s Guide and Toolkit for Workplace Injury Management in BC Food and Beverage Operations

This guide describes the key components of an injury management/return-to-work program.

Note: WorkSafeBC forms are not customizable because they are official forms.

• Form A – Early and Safe Return-to-Work Letter
• Form A (alt) – Employee Return-to-Work Checklist
• Form B1 – Letter to Physician
• Form B2 – Letter to Physician — Modified Work
• Form C – Physician Assessment — Return-to-Work Planning
• Form D – Modified Work Offer
• Form E: Witness Statement
• Form F: No Time Loss and No Medical Aid Checklist (Non-Reportable Incidents)
• Form G: Time Loss and Medical Aid Checklist (Reportable Incidents)
• Form H: Manager/Supervisor Communication Log
• Form I: Return-to-Work Plan
• Form J: Modified Work List
• Form K: Employee Orientation Checklist
• WorkSafeBC Form 52E40 — Incident Investigation Report
• WorkSafeBC Form 55B23 — First Aid Record
• WorkSafeBC Form 6 – Application for Compensation and Report of Injury or Occupational Disease
• WorkSafeBC Form 6 Reference Guide
• WorkSafeBC Form 63M4 — WorkSafeBC Authorization of Representative
• WorkSafeBC Form 7 — Employer’s Report of Injury or Occupational Disease
• WorkSafeBC Form 7 Reference Guide
• WorkSafeBC Form 9 — Employer’s Statement of Return to Work

Publish Date: July 31, 2017