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WCB Alberta C988: Prosthetic Physician Assessment

WCB-Alberta uses this two-page physician assessment when a worker may be fitted with a microprocessor or myoelectric prosthetic device. The physician confirms whether three criteria are met, covering medical stability, weight stability over the past 12 months and tolerance of the current prosthesis, then states whether they support providing the device and recommends how to meet any unmet criteria.

Who completes it

The worker's physician completes and signs the assessment, recording the part and side of body, the type of device and comments on each criterion.

Submitting and payment

How to submit it
Fax or mail the completed Word form to WCB-Alberta using the details printed on it, with the worker's WCB claim number.
Who pays
The assessment is billed to WCB-Alberta under service code RF06, which is printed on the form.

Good to know

  • Criterion 1 asks you to confirm the worker is medically stable and will not need any revision surgeries.
  • Criterion 2 asks for the worker's current weight and whether it has been relatively stable over the past 12 months.
  • Criterion 3 asks whether the worker is in a permanent socket and can wear the current prosthesis at least 5 hours a day, 7 days a week.
  • The prosthetist's side uses separate forms, including the prosthetist request (C987) and the prosthetist assessment for a microprocessor knee or myoelectric device (C989).

Get the official form

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

Prosthetic and orthotic services physician assessment - C988

Official page

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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 WCB Alberta check before funding a myoelectric or microprocessor device?

A physician assessment on form C988 confirming three criteria: medical stability with no revision surgeries expected, a relatively stable weight over the past 12 months, and a permanent socket worn at least 5 hours a day, 7 days a week. The physician then states whether they support providing the device at this time.

Is WCB Alberta form C988 a fillable PDF?

No. WCB-Alberta posts C988 as a Word document under prosthetic and orthotic providers on its forms and guides page. The current version is revised August 2020, runs two pages, and includes space for recommendations on how the worker could meet any criterion that is not yet met.