Just Ask Joe Form

WSIB Class Action Lawsuit Registration

CLAIMS FROM JANUARY 1, 1990 to DECEMBER 31, 1997
By completing this form, you are registering for the Class Action Lawsuit against the Workplace Safety & Insurance Board of Ontario Canada (WSIB), pertaining to its' "DEEMING" practice and unlawful application of Section 43 of the Workers' Compensation Act 1997 as amended and the Workplace Safety & Insurance Act "the Act".
Full Name*

First NameLast Name
Phone Number*
E-mail*
example@example.com
Date of birth*

MonthDayYear
Date
Date of injury or illness*

MonthDayYear
Date
Claim Number*
About your Future Economic Loss Benefit
When did you begin receiving your FEL benefit?*

MonthDayYear
Date
Did the WSIB base your FEL benefit on Deemed Earnings?*
Has the WSIB reduced or stopped your FEL benefit?*
Provide the reason the WSIB used to reduce or stop your FEL benefit.*

0/500
Do you receive Canada Pension Disability (CPP)*
Did the WSIB deduct (offset) any portion of your CPP Disability benefit from your FEL benefit?*
By signing this Class Action Lawsuit Registration Form, I agree to register for the Class Action Lawsuit against the Workplace Safety & Insurance Board ("the WSIB") and confirm that I have been prejudiced by the WSIB's application of its "Deeming Practices" insofar as my claim is concerned.

I also understand that by signing this Class Action Lawsuit Registration Form, I am not being provided with legal advice and have decided to participate in the Class Action Lawsuit of my accord. I also know that I can withdraw my registration at any given time.

I further agree that my WSIBSETTLEMENTS.COM SPECIAL CLASS ACTION LAWSUIT Membership only entitles me to participate in the Class Action Lawsuit and that should I wish to use the tools available in the OnePlan provided by WSIBSETTLEMTS.COM, I can do so by purchasing the OnePlan subscription.
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WSIB Class Action Lawsuit Registration

About your Future Economic Loss Benefit