COVID-19 Update

WSCC’s Yellowknife and Inuvik offices are now open to the public. Our Iqaluit office is currently closed to the public and our employees are working from home. Our services are still available online or on the phone. Visit our COVID-19 page for important service updates, and the COVID-19 Resource page for essential tools for your workplace.

Claims Forms for Health Care Providers

Claims Forms for Health Care Providers

Communication between health care providers, WSCC, employers, and workers is critical to ensure quick and efficient processing of claims, and a successful return to work outcome.

The following medical report forms are available for health care providers to communicate medical information to the WSCC:


First Medical Report
Dental Report and Estimate
Electronic Fund Transfer
Functional Abilities – Behavioural, Cognitive and Emotional
Hand Arm Vibration (HAV) Syndrome Assessment Form
Hand Injury Report
Massage Therapy Treatment
Medical Invoice
Medical Progress Report
Medical Report Eye Injuries
Physiotherapy Request for Extension
Physiotherapy/Occupational Therapy Functional Abilities Report – Form C
Physiotherapy/Occupational Therapy Initial Assessment – Form A
Physiotherapy/Occupational Therapy Progress Report – Form B
Physiotherapy/Occupational Therapy – Discharge Report
Psychiatric/Psychological Initial Report
Psychologist Progress Report