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WSIB Form 8D2 (0353A): Report on Skin Disease

When a patient reports a work-related skin condition, the WSIB sends out this physician's report, which you complete and return to the WSIB. The WSIB adjudicates all dermatitis claims, including latex sensitization and chemical burns, in its Occupational Disease and Survivor Benefits Program. The form is not posted with the WSIB's downloadable provider forms, so work from the copy the WSIB supplies.

Who completes it

The physician completes the whole form. The worker's claim (Form 6) and the employer's report (Form 7) are filed separately, and the WSIB may ask the worker to sign a permission form so it can obtain a specialist's report.

Submitting and payment

How to submit it
Complete the copy the WSIB supplies and return it to the WSIB; if you fax it, the physician fee schedule says not to also send the original.
Who pays
Bill the WSIB directly under physician fee code M655, the code for the physician's report on skin disease.

Good to know

  • The WSIB's list of conditions handled by its Occupational Disease and Survivor Benefits Program includes all dermatitis claims, including latex sensitization and chemical burns.
  • The WSIB notes that a medical specialist often needs to diagnose an occupational disease, and it may ask the patient to sign a permission form to obtain the specialist's report.
  • The WSIB states there is no time limit for submitting an occupational disease claim; the patient can file through their employer, doctor, union or a representative, or on their own.
  • Other occupational illnesses use different WSIB physician reports: Form 8D (0307A) for occupational disease generally, Form 8S (0407A) for chest disease and Form 8W (0425A) for vibration white finger.

Get the official form

Download the current version from the source each time; forms change without notice.

Physician's report on skin disease (Form 8D2)

Official page

Fill it with Vero

If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

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How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms change without notice, so download the current version from the official page before you fill it in.

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Frequently asked questions

Which skin conditions does the WSIB treat as occupational disease claims?

The WSIB's list of occupational diseases adjudicated in its Occupational Disease and Survivor Benefits Program names dermatitis and says it covers all dermatitis claims, including latex sensitization and chemical burns. When a patient reports a work-related skin condition, the WSIB sends Form 8D2 for the treating physician to complete and return.

What billing code applies to WSIB Form 8D2?

Physician fee code M655. The WSIB physician fee schedule lists it in the physician reports table and describes it as a form the WSIB sends when a person reports a work-related skin condition, to be completed and returned to the WSIB. Bill the WSIB directly; accounts received more than six months after the service may be reduced.

Do I need my patient's consent to send Form 8D2 to the WSIB?

The WSIB's reporting requirements page cites section 37(1) of the Workplace Safety and Insurance Act, which requires health care practitioners to share the information the WSIB needs, and section 43(1)(h) of the Personal Health Information Protection Act, which allows a health information custodian to disclose health information to the WSIB without consent.