ICBC CL489B: FP Reassessment Medical Report

When a crash-injured patient is not recovering as expected and needs an updated care plan or a changed diagnosis, the family physician reports back to ICBC on this form. It can be sent proactively or at ICBC's request, but it is not required at regular intervals or with every follow-up visit. It updates work and daily-activity status, diagnosis, restrictions, barriers, care plan and prognosis, and serves as the invoice.

Who completes it

The family physician, ideally the patient's primary care provider, completes the whole report, including the certification and the consent or ICBC-request statement. The patient's role is consent to release it, unless ICBC has requested the report formally.

How to fill it in

Invoice information

As with the first report, this block makes the reassessment its own invoice: claim number, date of crash, date of the FP report, ICBC vendor number, invoice or reference number, and payee name and address. ICBC will not pay if the claim number, accident date, payee name and address, patient name or report date are missing.

Patient information, Physician information and Subjective (optional)

Enter the patient's first and last name, date of birth, Personal Health Number and whether an interpreter is required. In the physician block, give your name and MSP/practitioner number and state whether you are the patient's regular physician. The key subjective complaints box is optional on the reassessment as well.

Vocational status (questions 1 to 6)

Question 1 records current absence from work, training, school or homemaking because of the crash, and questions 2 and 3 whether duties and hours are full or modified for a patient who is still active. If the patient is not working, studying, training or caregiving, question 4 asks why. Questions 5 and 6 ask whether you support continued restrictions on regular duties or hours and the earliest date the patient could return to pre-crash vocational activities.

Avocational status (questions 7 and 8)

Question 7 asks whether the patient has returned to a pre-crash level of activity outside work; choose N/A if avocational activities were never affected. If not, comment and give the earliest return date. Question 8 records regular or modified duties and hours for activities the patient continues, with reasoning and recommendations if modified.

Assessment: Diagnosis

First answer whether the diagnosis of the crash injuries has changed since the last report; if not, the form tells you to skip to the next section. If it has, list the primary diagnosis (most serious or significant injury) and all other crash-related diagnoses, each with nature of injury, body part, orientation, ICD-9 code and comments.

Key Objective Findings (optional), Medical restrictions and/or limitations (questions 9 and 10), Barriers to recovery

Physical exam findings and key objective complaints remain optional. Question 9 asks you to describe current medical restrictions or limitations, and question 10 whether they are temporary or permanent, with details. Then list barriers to recovery, whether functional, physical, psychosocial, employer, medical or compliance related.

Recommended Care Management Plan (questions 11 and 12)

Set out the updated management recommendations, including the treatments, medical investigations or referrals now appropriate for the crash injuries. Question 12 asks whether the patient will likely need therapy beyond this plan and, if so, what. ICBC's physician resources note that you can also suggest a Comprehensive Medical Assessment on a medical report.

Prognosis and recovery timelines (questions 13 and 14)

Give the current prognosis and the anticipated recovery timeline in light of the updated care plan. ICBC's family physician quick guide explains that it uses these reports to support recovery goals such as return to daily activities and work planning, and to inform other benefit entitlements.

Additional comments and certification

Add anything ICBC should know that does not fit elsewhere. Tick the box certifying that the information is true and correct to the best of your knowledge, then select one statement: either the patient consented to sharing all information about the crash injury with ICBC, or the report responds to an ICBC request under section 28 or 28.1 of the Insurance (Vehicle) Act.

Common mistakes

Sending reassessment reports at routine intervals or with every follow-up visit; ICBC says they are not required that way.
Relisting an unchanged diagnosis. The form asks whether the diagnosis changed since the last report and says to skip the section if it has not.
Missing the claim number, accident date, payee name and address, patient name or report date; ICBC cannot pay a report without them.
Releasing the report without consent or an ICBC request letter (CL491), or leaving the consent and request statements unticked.

Submitting and payment

How to submit it: Send it by fax or mail, from an EMR with ICBC's integrated template, or through ICBC's online submission tool for physicians. ICBC asks for reports within 30 days of the assessment date.
Who pays: ICBC pays the physician under fee code A94566 with the report as the invoice, and routine follow-up visits without a report are billed to MSP through Teleplan.

Good to know

ICBC does not expect this report at regular intervals or with every follow-up visit; it is for recovery that is off track, when the care plan or diagnosis needs updating.
If the diagnosis has not changed since the last report, answer No to the diagnosis question and skip to the next section, as the form instructs.
For a patient you expect to improve further who is not progressing as planned, you can suggest an ICBC-funded Comprehensive Medical Assessment on a medical report or by phone.
Talking with ICBC or other treating providers about the care plan is a separate physician conference fee (A94569), billed per 15 minutes up to 45 minutes per claim per day.

Get the official form

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

Family Physician (FP) Reassessment Medical Report

Official page PDF

Fill it with Vero

Upload the fillable PDF 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.

Sources for this guide

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Frequently asked questions

When should a family physician complete ICBC's CL489B?

When a patient injured in a crash is not recovering as expected and an updated care plan or a change in diagnosis is needed. You can send it on your own initiative or when ICBC asks for it. ICBC states the reassessment report is not required at regular intervals or with every follow-up visit.

Does ICBC pay for a CL489B at every follow-up?

No. ICBC pays fee code A94566 when a reassessment is warranted or requested, not for routine follow-ups. Visits without a medical report are billed to MSP through Teleplan using standard MSP visit codes. ICBC also does not prepay reports or pay for visits after a claim has closed.

Can I ask ICBC for a Comprehensive Medical Assessment?

Yes. ICBC funds Comprehensive Medical Assessments for crash injuries you expect to improve further that are not progressing as planned. Suggest one to the patient or their ICBC recovery specialist on a medical report or by phone consultation. If ICBC agrees, the recovery specialist refers the patient to an assessment provider, who schedules the assessment directly.

How does CL489B differ from the first report?

It is shorter and focused on change. It asks about current absence from work, training, school or homemaking, reasons the patient is not working, continued restrictions and the earliest return date, then whether the diagnosis changed since the last report. Pre-crash history, employment type and the medication question from the first reports are not repeated.