Applying for benefits

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Learn how to apply for benefits using the Statutory Declaration – Spouse form once the WCB has determined the death is a result of a workplace injury.

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Once the WCB has determined the death is a result of a work-related injury, you can apply for benefits by:

  • Filling out the Statutory Declaration – Spouse (D34f) form.
  • Attaching to the form a copy of:
    • the death certificate.
    • your marriage certificate or confirmation of common-law relationship over one year previous to date of death.
    • the birth certificate for yourself and any dependent children.
    • your Social Insurance Number (SIN), and the SIN of any dependent children.

To ensure that you receive statements and information concerning your benefits, please notify the WCB of any changes to your address or telephone numbers.


Contact information

The WCB is committed to helping you. We are available to answer your questions.

Extended services unit