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BC PPMB Application (HR2892): Health Assessment

BC's Ministry of Social Development and Poverty Reduction uses HR2892 to decide whether an income assistance client qualifies as a Person with Persistent Multiple Barriers to Employment. A health professional documents the health conditions, their expected duration and the resulting restrictions in Section 1, and the applicant lists non-medical barriers in Section 2. Incomplete answers can mean the applicant is not adjudicated for the right client category.

Who completes it

Section 1, Part C (Health Assessment) is completed by a medical practitioner, nurse practitioner, registered nurse or registered psychiatric nurse, chiropractor, occupational or physical therapist, registered social worker, psychologist, school psychologist or registered clinical counsellor. The applicant signs the Part B release and completes Section 2, the barriers to employment and declaration.

Submitting and payment

How to submit it
Return the completed form and supporting documents to the applicant to submit, or send it on their behalf to the ministry's Health Assistance office by fax or mail. The ministry also publishes an electronic version of HR2892 on its website.
Who pays
A fee is paid only when Section 1 is fully completed: physicians bill MSP under Fee Item 96503, and other health professionals invoice the ministry with the invoice printed in the form.

Good to know

  • Question 2 asks whether the condition is expected to continue 2 years or more and, if it is episodic, how often episodes occurred in the past year and are likely to recur.
  • Enclose documents that confirm the existence and severity of the restrictions, such as laboratory or diagnostic reports or psychological reports, as the form's Enclosures question asks.
  • The report is shared with the applicant, with the Employment and Assistance Appeal Tribunal if an appeal is started, and may be reviewed by a ministry medical consultant.
  • If the applicant cannot attend in person to sign Section 1, the health professional attaches addendum HR4018, Certification of Authorization to Collect Information. Keep a copy of Section 1 until paid.

Get the official form

Download the current version from the source each time; forms change without notice.

Persons with Persistent Multiple Barriers Application

Official pagePDF

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Frequently asked questions

Who can complete the PPMB health assessment?

HR2892 lists ten professions: medical practitioners, nurse practitioners, registered nurses or registered psychiatric nurses, chiropractors, occupational therapists, physical therapists, registered social workers, psychologists, school psychologists and registered clinical counsellors. In the certification, the professional names their regulatory body and registration number and says whether they are self-employed, work for a health authority or another employer.

Does the applicant need to be on income assistance before applying for PPMB?

The form's instructions say the applicant should already be receiving income assistance. If not, they should contact the ministry and complete an eligibility intake appointment, which checks residency, citizenship, identification, income and assets, before the PPMB application is completed.

What does Section 2 of the PPMB application cover?

Section 2 is the applicant's own part. They tick non-medical barriers that seriously impede work, such as homelessness in the past 12 months, domestic violence in the past 6 months, a criminal record, less than Grade 12 education or recent refugee status, then sign a declaration that the information is true.