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WCB Nova Scotia Psychology Assessment Form: Report

Psychologists use this report to give WCB Nova Scotia their initial assessment of a worker with a psychological injury. It covers the worker's account of the injury, current symptoms with standardized inventories such as the BAI or PCL-5, the DSM diagnosis, pre-existing conditions, behavioural observations and daily function, then a treatment plan, any risk of harm, and the worker's work abilities and readiness.

Who completes it

The assessing psychologist completes sections D to F and signs, adding their printed name and clinic name. WCB lists the form for approved providers outside Nova Scotia.

Submitting and payment

How to submit it
Fax it to WCB within 14 calendar days of completing the assessment, as printed on the invoice version of the form, with the claim number on every page.
Who pays
WCB also posts an invoice-plus-report version whose first page, with worker, psychologist and payee details and the amount invoiced, means no other invoice submission is necessary.

Good to know

  • If treatment is recommended, a Progress Form is required at the end of every fourth session or fourth week, whichever comes first.
  • Readiness to work is rated 1 to 10 from a mental health perspective, not physical, for workers off work; workers at work get a 1 to 10 stay-at-work likelihood rating.
  • The occupational section lists tasks the worker can and cannot do in their current job, employment status at assessment, and barriers such as harassment or lack of accommodation.
  • Care for psychological injuries in Nova Scotia is now delivered through the Work-Connected Recovery network, whose providers report and invoice through Lifemark rather than WCB.

Get the official form

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

Psychology Assessment Form: REPORT

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 is the WCB Nova Scotia psychology assessment report due?

Within 14 calendar days of completing the assessment, according to the invoice version of the form. After that, if treatment continues, a Psychology Progress Form is required at the end of every fourth session or fourth week, whichever comes first.

Which standardized measures does the WCB psychology assessment ask for?

The current symptoms section asks for a brief summary of standardized inventories used, giving the BAI and PCL-5 as examples, followed by the DSM diagnosis and the approximate onset of symptoms. You also note pre-existing psychological conditions or contributing factors, behavioural observations and impairments in social, family and other day-to-day function.

Do I need a separate invoice for the psychology assessment?

Not if you use the invoice-plus-report version. Its first page captures the worker's details, the psychologist and facility, the assessment report date, the amount invoiced and the payee, and states that no other invoice submission is necessary. WCB posts both that version and a report-only version.