Table of Contents | Print Print This Page

Section D1 – Details about Your Claim

Note: Before you fill out this section, please read the online information available from the Ministry of Labour on employee and employer rights and responsibilities. Your Guide to the Employment Standards Act, 2000 may be of particular help, as each employment standard has a dedicated chapter along with examples.

For help estimating the amount you are claiming, please refer to the worksheets found in Appendix B in this Claim Guide.*

You can also call the Employment Standards Information Centre at 416-326-7160, or our toll-free line at 1-800-531-5551, from anywhere in Canada for more information on your employment standards rights. Service is available in multiple languages.

The officer will regard all calculations you include here as estimates only and as a guide to help the officer in investigating your claim. If you cannot estimate the amount you believe is owed to you, leave the space blank.

Put a check mark () in the box(es) that describe why you are filing this claim. Your claim may pertain to more than one standard.

Unpaid Wages:

  • Put a check mark () in this box if you are claiming that the employer owes you wages that you earned during your regular hours of work not including overtime or public holidays.
  • Give an estimated amount of wages owed in the space provided. See the Unpaid Wages Worksheet in Appendix B of this Claim Guide for help with calculations.

Overtime Pay:

  • Put a check mark () in this box if you are claiming the employer owes you wages that you earned working overtime.
  • Give an estimated amount of wages owed in the space provided. See the Overtime Pay Worksheet in Appendix B of this Claim Guide for help with calculations.

Vacation Pay / Vacation Time:

  • Put a check mark () in this box if you are claiming the employer owes you vacation pay or did not provide you with vacation time.
  • Give an estimate of the amount of vacation pay owed in the space provided. See the Vacation Pay worksheet in Appendix B of this Claim Guide for help with calculations.

Public Holidays / Public Holiday Pay:

  • Put a check mark () in this box if you are claiming the employer did not give you the time off for a public holiday that you were entitled to or if you are claiming the employer owes you public holiday pay and / or premium pay.
  • Give an estimate of the public holiday pay and/or premium pay owed in the space provided. See the Public Holiday Worksheet in Appendix B of this Claim Guide or the Public Holiday Pay Calculator for help with calculations.

Deductions from wages:

Only three types of deductions can be made from an employee’s wages: statutory deductions, deductions authorized by court order, and, subject to certain restrictions and conditions, deductions authorized by the employee in writing.

  • Put a check mark () in this box if you are claiming the employer took money from your pay that they were not supposed to.
  • Give an estimate of the deductions in the space provided. See the Unauthorized Deductions Worksheet in Appendix B of this Claim Guide for help with calculations.

Minimum Wage:

  • Put a check mark () in this box if you are claiming the employer paid you less than the required minimum wage
  • Give an estimate of the amount of wages owing in the space provided. See the Minimum Wage Worksheet in Appendix B of this Claim Guide for help with calculations.

Note: There are special minimum wage rates for liquor servers, students, hunting and fishing guides and homeworkers. See the Minimum Wage Worksheet for assistance with calculations.

Minimum Wage Rate Before June 1, 2014 June 1, 2014
General Minimum Wage $10.25 Per hour $11.00 Per hour
Student Minimum Wage $9.60 Per hour $10.30 Per hour
Liquor Servers Minimum Wage $8.90 Per hour $9.55 Per hour
Hunting and Fishing Guides Minimum Wage

$51.25
Rate for working less than five consecutive hours in a day

$102.50
Rate for working five or more hours in a day, whether or not the hours are consecutive.

$55.00
Rate for working less than five consecutive hours in a day;

$110.00
Rate for working five or more hours in a day, whether or not the hours are consecutive.
Homeworkers' Wage (110 per cent of the general minimum wage) $11.28 Per hour $12.10 Per hour

Termination Pay:

  • Put a check mark () in this box if you are claiming the employer did not provide you with the required written notice of termination or pay instead of notice.
  • Give an estimate of the amount of termination pay owing in the space provided. See the Termination Pay Worksheet in Appendix B of this Claim Guide or the Termination Tool for help with calculations.

Note: You will have an opportunity to tell us what happened in more detail in Section D2.

Severance Pay:

Generally, you are entitled to severance pay if the employer severs your employment and:

  1. You have been employed by the employer for five years or more, and
  2. The employer has an annual payroll in Ontario of at least $2.5 million or the employer severed the employment of 50 or more employees (including yours) in a six-month period because all or part of the employer’s business was permanently discontinued.
  • Put a check mark () in this box if you are claiming the employer owes you severance pay.
  • Give an estimate of the amount of severance pay owing in the space provided. See the Severance Pay Worksheet in Appendix B of this Claim Guide or the Severance Tool for help with calculations.

Note: You will have an opportunity to tell us what happened in more detail in Section D2.

Temporary Help Agency charged prohibited fees

  • Put a check mark () in this box if you are claiming a temporary help agency charged fees that it should not have charged.
  • Give an estimate of the prohibited fees charged in the space provided.

Temporary Help Agency did not provide required information

Temporary Help Agency restricted the Client from hiring you or providing you with references

  • Put a check mark () in this box if you are claiming a temporary help agency stopped a client from hiring you, or that an agency prevented a client from providing you with a reference.

Note: You will have an opportunity to tell us what happened in more detail in Section D2.

Limits on Hours of Work / Eating Periods / Rest Periods (between shifts, daily, weekly or biweekly):

  • Put a check mark () in this box if you are claiming the employer did not follow the employment standards about limits on hours of work, rest periods, or eating periods.

Leaves of Absence (Pregnancy, Parental, Family Medical, Organ Donor, Personal Emergency, and Reservist):

  • Put a check mark () in this box if you are claiming the employer did not follow the employment standards on pregnancy leave, parental leave, family medical leave, organ donor leave, personal emergency leave, or reservist leave. Please tell us what happened in section 02.
  • Put a check mark () in the “Reprisal by the Employer” box if you are claiming the employer punished or threatened you because you planned to take or did take a leave of absence.
  • Put a check mark () in the “Reprisal by the Client of the Temporary Help Agency” box if you are claiming that a client of a temporary help agency punished or threatened you because you planned to take or did take a leave of absence.

Note: You will have an opportunity to tell us what happened in more detail in Section D2.

Reprisal by the Employer (which includes a Temporary Help Agency)

Employers cannot threaten or punish you because you ask the employer to follow the Employment Standards Act (ESA), file an employment standards claim, exercise or try to exercise your rights under the ESA or because your wages are subject to a garnishment order.

Put a check mark () in this box if you are claiming the employer threatened or punished you for any of the following reasons:

  • Asking the employer to comply with the ESA
  • Asking questions about your rights under the ESA
  • Filing a complaint under the ESA
  • Exercising or trying to exercise your rights under the ESA
  • Giving information to an employment standards officer
  • Taking, planning on taking, being eligible or becoming eligible to take a pregnancy, parental, family medical, organ donor, personal emergency, declared emergency, or reservist leave
  • There is a garnishment order against your employer (that is, a court has ordered your employer to pay someone else money that the employer owes to you in order to pay off a debt that you owe)
  • Participating in any proceedings under the ESA, or section 4 of the Retail Business Holidays Act (RBHA). The RBHA prohibits most retail stores from opening on certain holidays. Section 4 of the RBHA creates a process for the public to give their views to municipal councils on whether there should be an exemption to the closing requirement.

Note: As explained earlier in this package, an employee has up to two years to file a claim with the Ministry of Labour if an employee is claiming there has been a reprisal by the employer.

Reprisal by the Client of the Temporary Help Agency

Please only check this box if all of the following apply:

  • You are (or were) employed by a temporary help agency,
  • The temporary help agency assigned or attempted to assign you to perform work for a client , and
  • You are claiming a reprisal by the client.

Clients of a temporary help agency cannot intimidate you, refuse to have you perform work, terminate your assignment, or otherwise penalize or threaten to penalize you for any of the following reasons:

  • Asking a client or a temporary help agency to comply with the ESA
  • Asking questions about your rights under the ESA
  • Filing a complaint under the ESA
  • Exercising or trying to exercise your rights under the ESA
  • Giving information to an employment standards officer
  • Taking, planning on taking, being eligible or becoming eligible to take a pregnancy, parental, family medical, organ donor, personal emergency, declared emergency, or reservist leave
  • There is a garnishment order against your employer or the client (that is, a court has ordered your employer or the client to pay someone else money that the employer or client owes to you in order to pay off a debt that you owe), and
  • Taking part in any proceedings under the ESA, or section 4 of the Retail Business Holidays Act.

Note: As explained earlier in this Claim Guide, a temporary help agency employee has up to two years to file a claim with the Ministry of Labour if a temporary help agency employee is claiming there has been a reprisal by the client.

If you check this box, please ensure that you have completed Section C.

Other (specify):

The ESA provides rights to employees that are not covered by the list of employment standards above, including:

  • Rights of some employees in retail business establishments to refuse to work on Sundays or public holidays
  • Requirement for employers to post a poster about the ESA in the workplace
  • Prohibition against certain kinds of discrimination in benefit plans
  • Equal pay for equal work, and
  • Right to refuse to take or be asked to take a lie detector test

If you checked “Other,” briefly tell us the employment standard(s) not already identified that you are claiming. The Ministry of Labour cannot help you get your T4 slip or Record of Employment form.

The Ministry of Labour cannot help you with Employment Insurance or Income Tax issues.

Note: You will have an opportunity to tell us what happened in more detail in Section D2.

Previous | Next

This information is provided as a public service. Although we endeavour to ensure that the information is as current and accurate as possible, errors do occasionally occur. Therefore, we cannot guarantee the accuracy of the information. Readers should, where possible, verify the information before acting on it.

ISBN: 978-1-4606-4058-6 (PRINT)
ISBN: 978-1-4606-4059-3 (HTML)
ISBN: 978-1-4606-4060-9 (PDF)