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ontario regulation 124/16

made under the

Workplace Safety and Insurance Act, 1997

Made: February 25, 2016
Approved: May 4, 2016
Filed: May 6, 2016
Published on e-Laws: May 6, 2016
Printed in The Ontario Gazette: May 21, 2016

Amending O. Reg. 456/97


1. Clause 1 (a) of Ontario Regulation 456/97 is revoked and the following substituted:

(a) the form that is prescribed is the form titled “Functional Abilities Form for Planning Early and Safe Return to Work” that is dated July, 2006, and that is available on the Internet on the website of the Workplace Safety and Insurance Board; and

2. The Regulation  is amended by adding the following French version:

formule de renseignements sur l’habileté fonctionnelle

1. Pour l’application du paragraphe 37 (3) de la Loi :

a) la formule prescrite est le formulaire intitulé «Détermination des capacités fonctionnelles pour la planification d’un retour au travail rapide et sécuritaire», daté de juillet 2006, qui est disponible sur Internet sur le site Web de la Commission de la sécurité professionnelle et de l’assurance contre les accidents du travail;

b) les renseignements que doit donner le professionnel de la santé sont les renseignements nécessaires pour remplir le formulaire mentionné à l’alinéa a).



3. This Regulation comes into force on the day it is filed.

Made by:

Workplace Safety and Insurance Board:

Diane Weber

Corporate Secretary, WSIB

Elisabeth Witmer

Chair, WSIB

Date made: February 25, 2016