I declare my occupational accident myself

Fill in the declaration form

Print the declaration form (in Dutch /French) and fill it in thoroughly. This way, we will be able to handle your file more quickly.

If you have difficulties filling in the declaration form, your trade union or our social controllers in our Brussels office can help you. They are available on monday.

Add a medical certificate

Add a medical certificate established by the doctor who recorded your injuries after the accident. Preferably, ask your doctor to fill in the model medical certificate (only available in Dutch and French). A medical certificate is absolutely necessary to prove your injuries.

If possible, add other elements of proof to your declaration

Some examples of elements of proof:

•    the names of the direct witnesses. Those are the people who have seen the accident;
•    the names of the indirect witnesses. Those are the people who have not seen the accident, but who have seen you or talked with you just after.

Send the completed declaration form, medical certificate and any other potential element of proof to

your employer's insurance company

or

(if you do not know your employer's insurance company)

Agence fédérale des risques professionnels
Direction Contrôle
Avenue de l'Astronomie 1
1210 Bruxelles

Fedris will send you an acknowledgement of receipt within 7 days.