Just Ask Joe Form

Personal Information...
Hi there, If your injury or illness occurred before January 1, 1990, you've come to the right place. We want to give you the most accurate response possible and ensuring our answer to your question is based on the appropriate legislation is extremely important. Please be as thorough as possible with your responses to the questions in the questionnaire as this will impact the accuracy of our answers.

If you require additional time to complete your questionnaire, click the "Save to fill later" document icon at the bottom of the form and you will receive an email with a link to take you back to the form when you're ready to finish completing it.
Full Name *

First Name Last Name
Phone Number *

Area Code Phone Number
E-mail *
example@example.com
Date of birth *

Month Day Year
Date
Date of injury or illness *

Month Day Year
Date
Claim Number *
Provide a brief description of injury or illness (example; area of injury):

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This section deals with Permanent Partial Disability (Pension)...
Do you currently receiving a Permanent Partial Disability (pension) for your injury or illness? *
If yes, what is the percentage?
When did you begin receiving your pension?

Month Day Year
Date
Has your pension been reassessed since then?
If yes, what was the date of your last pension reassessment?

Month Day Year
Date
If your pension was increased at your last reassessment, what was the percentage?
If your pension was increased at your last reassessment, did you receive any arrears benefits?
If you were paid arrears, what was the date the WSIB used to pay your arrears?

Month Day Year
Date
Have you ever received a lump sum commutation of your pension?
Has your condition deteriorated since your last pension reassessment?
If yes, have you seen your health care provider regarding your deterioration?

This section deals with Section 147 Supplements...
Are you currently receiving a Section 147 (4) Supplement, also referred to as an older worker supplement?
If yes, when did you begin receiving the supplement?

Month Day Year
Date
Do you currently receive a Bill 165 Award, also known as Section 147(14) benefit?
Ask your question here. Please note that if you need to upload a document pertinent to your question for our review, such as a WSIB decision letter, you may do so in the following section.

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By signing this questionnaire, I agree and understand that I am not being provided with legal advice and that any opinions provided by any of our advisors in connection with my WSIB claim are solely based on his/her direct experiences derived from many years of providing paralegal services for injured and ill workers in Ontario. I also agree and understand that any opinions provided are solely based on the information and the accuracy of said information provided by me in this questionnaire.
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Claims before January 1, 1990