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WCB NS Opioid (Pain Medication) Special Authorization

Prescribers use this two-page form to ask WCB Nova Scotia to cover an opioid beyond the automatic coverage period, outside the worker's assigned formulary, or above the quantity limit. It covers the requested product and duration, treatment goals, the rationale beyond pain control, medications and non-drug therapies tried, and the worker's function and pain response, adverse effects and psychosocial factors. An opioid treatment agreement and substance abuse assessment are required.

Who completes it

The prescriber completes both pages and signs with their licence number, adding the date of the next follow-up visit. For a first start of opioids, skip the response-to-opioids section on page one.

Submitting and payment

How to submit it
Fax or mail it to Medavie Blue Cross; for continued coverage, WCB's opioid guide asks you to submit two weeks before the coverage term date.
Who pays
Physicians bill fee code WCB24 through MSI for the completed form, separately from the office visit, and other prescribers invoice WCB directly.

Good to know

  • Most injuries get automatic coverage for many short-acting opioids for 12 weeks from the date of injury, cancer claims for 24 weeks; the clock starts at injury, not the first visit.
  • A completed Substance Abuse Assessment Form must be on file at Medavie Blue Cross before the first opioid request is processed; later requests need only this form.
  • An opioid treatment agreement must be completed and acknowledged on the form; WCB advises completing one before prescribing opioids, even within the automatic coverage period.
  • The form notes that for a sprain or strain, opioid use beyond the acute phase is rarely indicated, and amounts over 200 morphine equivalents a day always need special authorization.

Get the official form

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

Pain Medication (OPIOID) Special Authorization Request Form

Official pagePDF

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.

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Frequently asked questions

When does WCB Nova Scotia require opioid special authorization?

For continued coverage past the automatic period (12 weeks from the date of injury for most injuries, 24 weeks for cancer), for an opioid not in the worker's formulary, for products that always need it such as fentanyl patches or methadone, and for doses over the 200 morphine-equivalent daily limit. Psychological and some other claim types have no opioid formulary at all.

What must accompany a first opioid special authorization request?

A WCB Substance Abuse Assessment Form, which must be on file at Medavie Blue Cross before the opioid request is processed, and an opioid treatment agreement with your patient, acknowledged on the form. WCB posts sample treatment agreement and informed consent documents. Later requests need only the opioid form, plus any updated substance abuse risk information.

Which fee code applies to the WCB opioid special authorization form?

Fee code WCB24, printed at the bottom of the form and billed through MSI with WCB responsibility. WCB's billing information says these fees cover form completion and submission only, so the office visit is billed separately with its own fee code. Dentists, nurse practitioners and pharmacists invoice WCB directly.