Employer Notice of Intention to Participate

Worker Name:	WCAT No.

WCB Claim No(s):

If you wish to participate in the worker's appeal of the hearing officer decision, you must notify the Tribunal of your intention by the deadline set out in the letter accompanying this form. Please read this form carefully. If you have any questions or concerns, please contact the Tribunal.

If you do not return a completed Notice of Intention to Participate by the date set by the Tribunal, we will assume that you do not wish to participate in the appeal. The appeal will be resolved without further notice to you, but you will receive a copy of the appeal decision.

By indicating that you wish to participate, you will be entitled to receive copies of all relevant documents and correspondence in the appeal, and will be notified by the Tribunal of any procedural matters which may arise during the course of the appeal. You will also have the opportunity to make written submissions, tender evidence and, if the Tribunal holds an oral hearing, attend and give evidence or observe the hearing. If you indicate that you wish to participate and later decide that you do not wish to participate, please let us know.

Yes, the Employer will participate in the worker's appeal.

By indicating that you do not wish to participate, you are indicating that you do not wish to be kept involved in the progress of the appeal. The Tribunal will resolve the appeal without further notice to you. You will not be offered any opportunity to provide submissions/evidence or to receive the submissions/evidence provided to the Tribunal by the other participants. You will receive a copy of the decision of the Tribunal resolving the appeal. At any time you may change your status to participate in the appeal.

No, the Employer will not participate in the worker's appeal.

Name and Title (Please Print)	Date	Signature

Civic Address	Telephone No.	Fax No.

MUST BE COMPLETED

Please check boxes indicating you have copied this form to the following:

Copy sent to the WCB Legal Department (c/o: Madeleine Hearns, via fax: 902-491-8916)

Copy sent to the Tribunal (c/o: Registrar, via fax: 902-424-2321)

Copy sent to the Workers' Representative

(Workers' Advisers Program can be reached via fax: 902-424-0530)

Request for Access to Documents or Records

Worker's Name:

WCB Claim No(s):

WCAT No:

Check One: Initial Request

Update Required (documents not previously obtained from the WCB)

The Employer would like a copy of the following documents or records from the Tribunal:

Copy of Complete WCB Claim File(s) and Tribunal Appeal file

Copy of Medical Reports Only

Copy of the Following Documents/Records Only (Please Be Specific):

I understand and agree on behalf of the Employer to the following conditions regarding the Tribunal's release of documents or records to the Employer:

a.	the documents or records will be kept confidential and secure by the Employer;

b.	the documents or records will be used by the Employer to pursue or respond to the appeal only; and

c.	the Employer will comply with any other conditions or restrictions the Tribunal may impose regarding the use and disclosure of the documents or records.

Name and Title (Please Print)	Date	Signature

Telephone No.