Just Ask Joe Form

1
Full Name* This field is required.
First Name
Last Name
2
Phone Number
3
E-mail* This field is required.
example@example.com
4
Date of birth* This field is required.
Date
Month
Day
Year
5
Date of injury or illness* This field is required.
Date
Month
Day
Year
6
Claim Number* This field is required.
7
Provide a brief description of injury or illness (example; area of injury):
0/400
8
Do you currently receiving a Permanent Partial Disability (pension) for your injury or illness?* This field is required.
Yes
No
9
If yes, what is the percentage?
10
When did you begin receiving your pension?
Date
Month
Day
Year
11
Has your pension been reassessed since then?
Yes
No
12
If yes, what was the date of your last pension reassessment?
Date
Month
Day
Year
13
If your pension was increased at your last reassessment, what was the percentage?
14
If your pension was increased at your last reassessment, did you receive any arrears benefits?
Yes
No
15
If you were paid arrears, what was the date the WSIB used to pay your arrears?
Date
Month
Day
Year
16
Have you ever received a lump sum commutation of your pension?
Yes
No
17
Has your condition deteriorated since your last pension reassessment?
Yes
No
18
If yes, have you seen your health care provider regarding your deterioration?
Yes
No
19
Are you currently receiving a Section 147 (4) Supplement, also referred to as an older worker supplement?
Yes
No
20
If yes, when did you begin receiving the supplement?
Date
Month
Day
Year
21
Do you currently receive a Bill 165 Award, also known as Section 147(14) benefit?
Yes
No
22
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.
0/500
23
Click here to uploadYou may upload a document that is relevant to your question
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24
Terms and Conditions* This field is required.
25
WSIB Settlements
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Just Ask Joe Form