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Accident Benefits Application Forms

Don’t delay discussing your matter with us to find out how to build a winning case.

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Accident Benefits Application Forms

Don’t delay discussing your matter with us to find out how to build a winning case.

You don’t pay us unless we win your case. No Out of pocket expenses required.

Note: Your Privacy is Safe with us. We will never disclose your information to external parties.

After an accident, there are many things you need to do on a very specific timeline. In particular, there are several forms that need to be completed quickly. Ideally, you will work with a personal injury lawyer who can consult with you and help you complete these forms to maximize your settlement. Still, it’s a good idea to have a strong understanding of which forms you’ll need to complete in advance.

As you submit these forms, always make sure you make a copy of the form and any materials you must submit along with it. Keep the copies in a safe place in case you need them again.

Below, you’ll learn more about the key accident benefits application forms you may need to complete.

Application for Accident Benefits (OCF-1)

This is the basic and primary form you will need to complete after your accident. You will receive a package with the Application for Accident Benefits form in the mail which you must complete within 30 days of receipt. If you cannot complete it within 30 days, you should still submit the completed form to your insurance company along with an explanation of why you could not complete it on time.

Employer’s Confirmation of Income (OCF-2)

If you are claiming Income Replacement Benefits, you will need to complete the Employer’s Confirmation of Income form. You are eligible for these benefits if you were employed for a minimum of 26 weeks during the year before your accident occurred. You can only apply for these benefits if you cannot return to work for more than one week after the date of the accident.

Disability Certificate (OCF-3)

If you have become disabled because of your accident, the Disability Certificate is a crucial form to complete as it shows that a medical professional has diagnosed you with a disability. You must complete it with your doctor and any other health care practitioners you have seen. These may include chiropractors, occupational therapists, optometrists, speech language pathologists, psychologists, dentists, nurse practitioners, physiotherapists and others.

Permission to Disclose Health Information (OCF-5)

The Permission to Disclose Health Information is a form that you should only complete if the adjuster in charge of your claim requests it. This form allows the insurance company to review your personal medical records. Before agreeing to complete this form, make sure you find out which records the adjuster is requesting and why they are being requested. Also make a note on the form that you are only agreeing to allow the insurance company access to records for visits that occurred on specific dates.

Pre-approved Framework Treatment Confirmation Form (OCF-23)

The Pre-approved Framework Treatment Confirmation Form should also only be completed if requested by your insurance company. It is only for certain categories of injuries, so you do not need to worry about this form unless you hear from your insurer.

Election of Income Replacement, Non-Earner, or Caregiver Benefit (OCF-10)

It’s important to understand that while you may be eligible for both the Income Replacement Benefit and the Non-Earner Benefit and the Caregiver Benefit, you are only allowed to apply for and receive one of these. A lawyer can help you better understand which benefit you should apply for. You will need to submit this form within 30 days of the date you received it.

Application for Expenses (OCF-6)

The Application for Expenses is for any medical or personal expenses you incurred because of your accident. They may include medication, massage, physiotherapy, and other insurance-approved treatments. In addition, you can include babysitting or attendant care, housekeeping, transportation, and even any clothing or other personal items that were destroyed during the accident. It is imperative that you keep all receipts for these expenses, as they must be submitted along with the form. Make sure babysitters or other non-professionals create detailed receipts for their services so you are able to submit them.

Activities of Normal Life (OCF-12)

If your insurance company thinks you are entitled to attendant care, housekeeping, or non-earner benefits, they will request that you fill out the Activities of Normal Life form. In this form, you will describe any activities you could do prior to your accident that you can no longer do.

Declaration of Post-Accident Income and Benefits (OCF-13)

The Declaration of Post-Accident Income and Benefits form should be completed if you can work after your accident, but cannot work at your regular job or regular hours. It should also be completed if you are able to get disability benefits for your work. Completing this form will assist your insurer in determining your Income Replacement Benefit.

Application for Accident Benefits

If your insurance company will not pay a specific benefit you’ve applied for but you think you are eligible for it, you should complete an Application to the Safety, Licensing Appeals and Standards Tribunals Ontario (SLASTO). This form will initiate a mediation and potential hearing process.

Now that you have a clearer understanding of the forms you may be required to complete for your personal injury case, you will be more prepared throughout the process. Because it can be difficult to keep track of many forms and deadlines, it may be a good idea to contact a personal injury lawyer for assistance.

If you or a loved one has been injured in an accident, consult with an accident benefits lawyer as soon as possible to better understand your rights and maximize your claim.

Disclaimer: The content of this article is a general guideline made available for educational purposes only and is not intended to be used as legal advice for the reader’s specific situation nor in general. By reading our blog and website content, the reader acknowledges the above and understands there is no lawyer-client relationship created between you and Himelfarb Proszanski through this content. To get specific legal advice, we encourage you to book a free consultation with one of our lawyers to clarify the legal aspects of your situation.

Timing is Critical. Help is Free.

Don’t delay discussing your matter with us to find out how to build a winning case.

You don’t pay us unless we win your case. No Out of pocket expenses required.

Note: Your Privacy is Safe with us. We will never disclose your information to external parties.

Timing is Critical. Help is Free.

Don’t delay discussing your matter with us to find out how to build a winning case.

You don’t pay us unless we win your case. No Out of pocket expenses required.

Note: Your Privacy is Safe with us. We will never disclose your information to external parties.

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Carl Herteis
2 days ago
In late May 2024, I retained the law firm, HIMPRO, for legal counsel after being hit by a car while crossing a street and suffering a shoulder replacement. Silene Malhao was assigned to my case and would ultimately represent me in a lawsuit for pain and suffering. This required two meetings to be held: a Discovery meeting was held in December 2025, followed by a Mediation meeting in July 2026. In both cases Silene held a preparation session with me to provide a purpose for each meeting, the attendees and what my involvement would be. These meetings were of a great benefit to me as they reduced my stress on me due to not being familiar with the court process. The purpose of the Mediation meeting was to get an agreement from the two parties for a settlement and remove the need to proceed to court. The defendant opened with an offer and Silene explained the pros and cons of the offer and told me that I could either accept the offer or make a counter-offer. She asked if I understood the options and their ramifications and asked for my decision. I chose to not accept the offer and make a counter-offer. She suggested an amount and why it was reasonable. This activity of an offer/counter-offer occurred several times and ultimately the defendant made a final offer which I accepted. I felt that the preparation for the two meetings by Silene were very helpful to me for lowering my stress level, for giving me an understanding of the process and ultimately reach a settlement. I felt very confident throughout the process. Silene's experience in this regard showed through to me and I am very satisfied. A very professional job.
Lejaun Salmon
2 weeks ago
I couldn’t have asked for a better team to represent me. David and Mena at Himelfarb Proszanski were absolutely amazing throughout the entire process. They were great communicators, always kept me informed, answered my questions, and made sure I understood what was happening every step of the way. The process was long, but having a team that truly advocated for me made all the difference. David fought hard for me and made sure everything possible was done to ensure I received the maximum amount I was entitled to. Mena was also incredibly helpful, responsive, and supportive throughout the process. I’m extremely grateful for their hard work, dedication, and professionalism. If you’re looking for a team that genuinely cares about their clients and will fight for you, I highly recommend Himelfarb Proszanski, David, and Mena!
Ellis St Croix
2 months ago
⭐⭐⭐⭐⭐ — Himelfarb Proszanski (HimPro) I came to HimPro after being wrongfully cut off my Long Term Disability benefits by Sun Life Financial — one of the most stressful and overwhelming experiences of my life. From the moment I signed my retainer, I felt like I actually had people in my corner. David Himelfarb is the real deal. His experience and strategic clarity gave me confidence at every stage. He told me the truth — even when it was hard to hear — and that honesty is what helped me make good decisions, including accepting the mediation outcome. He never oversold anything and he never let me down. Mena Brar was absolutely exceptional. She handled my documentation with professionalism, patience, and precision. I had an enormous amount of paperwork and she kept everything organized and on track. She genuinely cared about the outcome and it showed in every interaction. Selene — incredible communication and follow-through. Always responsive, always on point. She made sure I was never left in the dark. This team went up against a major insurance company and a complicated situation that they made easy they delivered. If you're dealing with a disability claim denial in Ontario, don't wait — call HimPro. I'm grateful to all three of them. — Ellis St. Croix
Ellis St Croix
2 months ago
Dear David, I just wanted to take a moment to say thank you — sincerely, and from the deepest part of my heart. When I came to you, I was worn down. The longest year of fighting a system that seemed designed to make people quit had taken everything out of me. I had the truth on my side, but I didn't know if that would ever be enough. You made it enough! You took my case, you believed in it, and over the course of a year you saw it through to the end with a level of care and skill that I will never forget. It has been a long year — but the right kind of long. The kind where you know the work being done matters. The settlement we reached means I can finally breathe again. I can clear the slate, rebuild, and step into something new and re invent myself — a life I can actually look forward to. That door would not have opened without you, and I want you to know that I understood that every single step of the way. You are genuinely exceptional at what you do. But more than that, you handled everything with integrity, with patience, and with real human decency. In my experience, that combination is rare. I was lucky to have you in my corner!! Thank you so very much, David. From the bottom of my heart — truly. With deep gratitude and respect, Ellis St. Croix
Ramzi Alkhouri
6 months ago
This had been an amazing service, they know what they are doing. They got me what I deserve, they have the experience and I was very satisfied with the results. I highly recommend my family and friends to HIMPRO.
Bryan Pilon
6 months ago
HIMPRO recently represented me for an insurance claim. They are a great firm, and more importantly, genuinely good people. I highly recommend them. From the beginning, they handled my case professionally and compassionately. Mena was amazing, her attention to detail and understanding made the process so much better. David and Silene also worked on my file and they were both honest, and highly knowledgeable lawyers. I felt fully informed and I was able to trust their judgement completely. My case was resolved in a very reasonable time given my circumstances. In my opinion, you will not be able to find a better group of people to handle your legal issues.
She Silva
7 months ago
I’m very happy with David and his team. Very professional and knowledgeable. Reputable law firm.
Patricia Gooden
7 months ago
Excellent communication skills from the Receptionists to my Lawyer and the Clerks. I will always appreciate all the support and good work that they are doing i am very grateful to have them supporting me, especially Dan Holland a very patience and professional person. Thank you.
Yoav Gurevich
7 months ago
Lauren and Alisha provided prompt and honest feedback when reviewing the terms of my employment contract. They consistently prioritized my what's best for my situation throughout the entire process. Highly recommended.
Phillip Dimopoulos
7 months ago
I am so grateful to have had this incredible team on my side after my wrist was broken in in a car accident, They guided me through the complex legal process and assured I received the maximum settlement possible. I discovered first hand that our legal system demands victims have experts guide and advise them if they have any hope for a fair resolution. A huge thank you to Silene, Ingrid, Spencer and the rest of the awesome team for all their support. Phillip

HIMPRO BY HIMELFARB PROSZANSKI

HIMPRO is a leading law firm with full service personal injury and disability insurance lawyers. We have been recognized by Best Lawyers and assigned the highest rating, AV Preeminent, from Martindale-Hubbell. We provide a combined century of trial experience which has led to the successful settlement of over 10,000 cases with combined settlement value in excess of ¾ billion dollars. Our mission is to win your case. At HIMPRO by Himelfarb Proszanski we build winning cases. That’s the HIMPRO Advantage™.

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