Only use this form if you want to assign someone to act as your representative. You are not required to have one. This form authorizes the Workers’ Compensation Appeal Tribunal (WCAT) and WorkSafeBC (including the Review Division), to give confidential information about you or your business to your representative. It takes about 5 to 10 minutes to complete.
Questions marked with the * are required for WCAT to complete the authorization.
Collection and use of personal information: Personal information on this form is collected for the processing and adjudication of a WCAT matter under the Workers Compensation Act and the Freedom of Information and Protection of Privacy Act. Contact the Freedom of Information Coordinator at WCAT if you have questions.
If you’d prefer to mail or fax a printed copy, use this version: Authorize a representative (PDF, 83KB).