General Industry

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Complete the general industry questionnaire – determining worker/independent status if:

  • you believe you may be an independent operator
  • you’re the hiring company or their respective representatives
  • you're not employing full or part-time help and
  • you've been asked to show proof of WSIB coverage by the company or companies with which you currently have a contract, or
  • you're a company engaging contractors and need a worker/independent operator status determination, or
  • you'd like to establish an account for optional insurance

The individual and the company may submit separate questionnaires if:

  • they disagree with the answers to some or all of the questions
  • the individual wants to submit the financial information required to support the answer in the part 3 to us in confidence.

We’ll review your response and notify both the individuals and company of our decision in writing.

Key terms

Workers are entitled to benefits provided by the Workplace Safety and Insurance Act and their employers must pay premiums to the WSIB.

Independent operators can choose to apply for coverage as workers under the Workplace Safety and Insurance Act. If they want insurance, they must pay their own premiums.

Company is the principal or the business that hires the individual.

Principal is a person or business awarding or letting a contract to a contractor or a sub-contractor.

Name of company Phone number

Part 1

What type of legal entity does the worker/independent operator operate?
Is there a written contract stating the terms of the work relationship?

One file only.

10 MB limit

Allowed types: pdf, doc, docx, jpg, png.

Do you have a previous or current WSIB account number?

Part 2

Training and supervision

Does an employee of the company train and/or supervise you?
Do you have to attend meetings and follow specific instructions that indicate the company wants the services performed in a particular way?

Hours of work

Does the company set the hours and days of work?
Do you decide your vacation time?

Order of work

Do you perform services in the order or sequence set by the company?
Do you report to the company’s office at specified times, follow up on leads and perform tasks at set times?
Is your work coordinated with the work of others employed by the company?

Payment

Does the company pay you in regular amounts at stated intervals?
Does the company decide the amount and payment method?
Do you receive payment for overtime and statutory holidays?
Do you receive a T4 income tax slip from the company?
Does the company pay you according to a standard pay or rate scale?

Licenses

Does the company hold the licenses (if required) to do the work?

Serving the public

Does the worker/independent operator make their services available on behalf of or as a representative of the company?
Do you invoice customers on the company’s behalf?
Do you file HST returns?
Do you invoice the company for materials used to complete the work?
Do you wear a uniform that has the company’s name, colours or logo on it?
Is the worker/independent operator registered as a business with the Ministry of Public and Business Service Delivery?

Collective agreement

Do the terms of a collective or union agreement govern the relationship between the worker/independent operator and the company?

Part 3

Beside each of the assets listed, please state the approximate value of each item or its cost in dollars per month.
Does the worker/independent operator own 80 per cent or more of the equipment (i.e., business vehicle, tools, computer, etc.) necessary to do the work?
Does the worker/independent operator pay for these expenses?

Part 4

Hiring, supervising and paying assistants

Does the worker/independent operator hire, supervise and pay workers at the company’s direction (i.e., act as a supervisor or representative of the company)?
Can the company hire, discipline or fire these support staff?
Do you pay the support staff directly?

Doing the work on company premises

Does the company own or control the site where the work is performed?

Oral and written reports

Does the worker/independent operator have to submit regular oral or written reports to the company?

Right to terminate

Can the worker/independent operator end their relationship with the company at any time?
If additional work has to be done to correct or improve a job, does the worker/independent operator have to accept these costs or any other losses due to poor workmanship?

Working for more than one firm at a time

Is the worker/independent operator engaged in work for more than one company at the same time?
Does the worker/independent operator contract with the company prohibit the worker/independent operator from working with others?

Declaration

To the best of my knowledge, information and belief, the information provided is true.

I/we understand the WSIB reserves the right to audit and verify these responses. If these responses don’t truly represent the nature of the working relationship, the WSIB may reverse the determination of status retroactively to the date that the working relationship began.

By submitting this form, the individual acknowledges that if they experience a work-related injury or illness, they won’t be eligible for any WSIB benefits unless they request optional insurance coverage and the WSIB approves it.

Personal information on this form is collected under the authority of the Workplace Safety and Insurance Act and may be used to register/determine your status for coverage and to administer to enforce the act.

Principal validation

A principal is a person or business awarding or letting a contract to a contractor or a sub-contractor. We’ll send a copy of this completed questionnaire to the principals you provide. They’ll have two business days to validate this form. If we don’t receive a response within two business days, we’ll adjudicate the questionnaire with a decision.

Please email us at employeraccounts@wsib.on.ca or send us a message through our online services if you have any questions.