Ontario Claim Form 3 (OCF-3)
Disability Certificate

Effective June 1, 2016.

If your insurance company asks you to complete this form, fill out Parts 1 through to 3 and give the form to your health practitioner (chiropractor, dentist, nurse practitioner, occupational therapist, optometrist, physician, physiotherapist, psychologist, speech language pathologist).

After your health practitioner has explained your accident-related injury to you, then sign Part 4.

Your health practitioner will complete the rest of the form, based on his or her most recent
assessment of you, and return it to the insurance company.

Remember, only an authorized health practitioner can complete this form.

Your health practitioner’s opinion will be relied upon by people who review the certificate to make important decisions, concerning your entitlement to accident benefits. Accordingly, it is necessary to be accurate and complete.

Please print clearly and provide all information requested. This form may not be materially altered.

Concerning confidentiality, please note that the collection, use and disclosure of this information is subject to all applicable privacy legislation.

If you want to learn more about the companion accident benefits claim, and kickstarting the accident benefits application process, then please click the “link” to read my blog entitled “How to Get Your Accident Benefits Application Started”.


Get Your Free, No Obligations Consultation!

Time limitations can effect your right to make a claim.

Act now and book a free consultation meeting with us to learn what accident benefits
you’re entitled to! Become informed now, so you can make an informed decision!


Phone Number: 289-430-0728 or Toll Free Number: 877-409-4528

Get your free ebook on what do immediately when you get into a accident

Get Your Free Ebook!