WORK BC

Application for Compensation and
Report of Injury or Occupational Disease

If you have any questions, please call our Contact Centre at 604.231.8888 or toll-free at 1.888.967.5377.

Worker first name:

MARK HOLAND

Worker last name:

PHN:
9128-549-738

SIN:
730-742-368

Claim number:
42647461

Earnings information - BRITISH COLUMBIA RAPID TRANSIT COMPANY LTD.

Base salary?

$47.34 hourly

Is your employer continuing to pay you your full salary?
Yes

No

Vacation pay? Percentage: Paid vacation pay while on Paid on every paycheque?
WorkSafeBC compensation?

Yes 0.00% No No

Shift differential? Value: Same for all shifts worked?

No No

Regular overtime? Explanation:

No

Room and board? Value: Continuing to receive room Value of continued room and
and board? board:

No No

Tips and gratuities? Average amount:

No

Other earnings? Explanation:

Return to work - BRITISH COLUMBIA RAPID TRANSIT COMPANY LTD.

Returned to work?
Yes

Date returned
January 27, 2026

Changes to duties or hours?

Yes (Full hours, Modified or
alternate duties)

Anticipated return to normal work
Unsure

Further details provided by worker

The worker RTW for full hours and duties Jan 27th, they were able to continue with their training class until Jan
29th, when they had to leave after only 5 hours worked. Worker remains off work at this time.

6T

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