Wage Loss Form
Definition
Injured workers who lose time from work to attend in-person or teleconference hearings are entitled to claim lost wages due to their attendance at the hearing.
In order to receive payment for lost wages, a Wage Loss form must
be filled out and submitted to the Customer Service Department at
the Workers’ Compensation Board (not the Appeals Commission).
The current employer of the injured worker (who is currently employed at the time of the hearing) is responsible for filling out this form and submitting it to WCB.
Although Wage Loss forms are normally given to injured workers at the hearing,
if you have lost or forgotten your form, you may print off a copy
from our web site, have your employer complete it and mail it to
the Claims Department at the WCB.
To submit your Wage Loss Form:
- Print the Wage Loss Form by clicking on the icon below
- Fill in the required information
- Mail to:
Workers' Compensation Board - Alberta
P.O. Box 2415
Edmonton, Alberta T5J 9Z9
| 
