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BC Form HR3069: Medical Report for Employability

B.C.'s Ministry of Social Development and Poverty Reduction uses this one-page report to learn whether an income assistance client's medical condition affects their ability to seek, accept or continue employment. A physician describes the condition, its severity, expected duration and restrictions. The ministry uses it to set the client's category, such as Expected to Work (Medical Condition), and any temporary exemption from employment obligations.

Who completes it

A physician registered with the College of Physicians and Surgeons of BC, either a GP or a specialist, completes the medical assessment (conditions, severity, onset, prognosis, episodic pattern, restrictions) and the certification. The client signs Part B authorizing release of the information, with a witness.

Submitting and payment

How to submit it
The ministry issues the form to the client and the completed report goes back to the ministry, which may also weigh other evidence such as earlier documentation or contact with the practitioner.
Who pays
The physician may bill the fee for completing the form through MSP under fee item 96504.

Good to know

  • Expected duration is chosen from ranges (1 to 3, 3 to 6, 6 to 9, 9 to 12, 12 to 18 or 18 to 24 months), with comments if longer than 2 years.
  • Incomplete answers mean the recipient is not adjudicated for the appropriate client category, so every question on the report must be completed.
  • The report is confidential but is shared with the applicant and, if an appeal starts, with the Employment and Assistance Appeal Tribunal.
  • Medical condition exemptions are reviewed at intervals of no more than two years, and part-time work for this purpose means at least 10 hours a week.

Get the official form

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

Medical Report – Employability

Official pagePDF

Fill it with Vero

If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

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How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms change without notice, so download the current version from the official page before you fill it in.

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Frequently asked questions

What does the HR3069 restrictions section ask for?

The physician describes the nature of any restrictions specific to the diagnosed conditions, such as restricted motion in the arms or legs, attaching extra pages if needed. The ministry uses this to judge whether the condition obstructs or prevents participation in employment, including part-time work.

Who can sign the BC Medical Report for employability?

A physician registered with the College of Physicians and Surgeons of British Columbia and licensed to practise clinical medicine in B.C., as a general practitioner or specialist. The physician states how long they have treated the patient and, if 6 months or less, whether previous records were reviewed.