Approved out-of-province providers send Form B to WCB Nova Scotia after first assessing a worker with a physical or psychological injury. The one-page May 2014 report covers the diagnosis by body part, the Orebro score, expected return-to-work dates and duties, a job match summary and a collaborative treatment plan with goals, methods and time frames. Progress is then reported on Form C.
The treating health care provider, such as a physiotherapist or chiropractor, completes the whole form, including practitioner and clinic details. Copies go to the worker's physician and WCB.
Download the current version from the source each time; forms change without notice.
Form B: Initial Assessment (For out of province providers)
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.
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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Providers located outside Nova Scotia who are approved to deliver services on WCB musculoskeletal and psychological injury claims. WCB tells them to keep using the existing process: find the form, complete, print and sign it, put the worker's claim number on every page and fax it. Providers in the Work-Connected Recovery network report through Lifemark instead.
Form B asks for the worker's Orebro score along with significant subjective and objective findings, and prints the bands used to read it: 0 to 98 low, 98 to 148 medium and 148 or more high. Form C, the progress report, later asks for the current score and the previous one if applicable.
Whether the worker is at pre-injury work, transitional duties or not working, the expected start dates for transitional or pre-injury work and the duties involved, and whether a case conference is required. The job match summary rates pre-injury requirements, present capability and transitional duties from sedentary to very heavy.