Mental health or OT provider's request for authorization to provide primary-level treatment.
- Completed by
- Psychologist/mental health provider or occupational therapist
- Issued by
- WCB Saskatchewan
- Format
- Language
- English
WCB Saskatchewan PSYI: Psychology Initial Assessment
Psychologists treating a worker with a WCB Saskatchewan claim complete this nine-page initial assessment report. It covers any mental health assessment (MHA) and whether its findings were discussed, the claim background, prior treatment and medications, DSM-5 diagnoses, testing and a GAF score. It then records functioning at home and work, return-to-work planning with the employer and the recommended treatment.
Who completes it
The treating psychologist completes and signs the report with their degree and clinic number. When treatment takes place in a secondary or tertiary treatment centre, the treatment centre therapist also signs, and the report is integrated and sent from within the centre.
Submitting and payment
- How to submit it
- Submit it through WCB Saskatchewan's online form where offered, or complete the fillable PDF and send it to the WCB's Health Care Services with the claim number on each page.
- Who pays
- Fees follow WCB Saskatchewan's fee schedule for psychological health service providers.
Good to know
- The WCB recognizes three levels of diagnosis: reason for visit, working diagnosis and full assessment diagnosis; reason-for-visit diagnoses aren't accepted on this form.
- Label each DSM-5 diagnosis as working or full assessment; a full assessment diagnosis must come from an MHA or other approved assessment, and all diagnoses are subject to adjudication.
- After an MHA, updated testing needs prior approval from WCB Health Care Services, and symptom checklists must be reported as checklists with 'no validity scale results'.
- Describe psychological restrictions using the WCB List of Restrictions information sheet, without naming specific job positions or work locations, which are the employer's responsibility.
Get the official form
Download the current version from the source each time; forms change without notice.
Psychology - Initial Assessment (PSYI)
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.
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 the MHA section of the PSYI ask?
Whether a mental health assessment (MHA) has been completed. If so, its findings and recommendations should be discussed with the worker at the first session, and you record the outcome, whether you both agree, whether its return-to-work recommendations were discussed with the employer, and its DSM-5 diagnoses and GAF. Disagreement with the treatment plan is reported to WCB Health Care Services.
Which DSM edition does the PSYI use?
DSM-5 for all diagnostic information, except the global assessment of functioning (GAF), which comes from DSM-IV-TR. The GAF must be completed in every case with a number or range and a verbal description, noting whether it has changed and, if so, why.
Does the PSYI ask about return to work?
Yes. It asks whether the worker is at work on regular or accommodated duties, whether they are ready for full or accommodated work, and what psychological restrictions apply. The WCB expects the employer to be contacted about return to work, and the form asks whether a workplace visit for live exposure is needed and whether the worker and employer accept the plan.