Surgeons and other specialists send this one-page request to WorkSafeBC to have proposed surgery authorized on a worker's claim before it is performed. It records the date of the latest consultation, the diagnosis, the surgery proposed, the planned date and facility, and the requesting physician's details, with the consult report attached; the claim owner completes the authorization section.
The requesting specialist completes the request and attaches the consult report; the authorization box at the bottom is completed by the WorkSafeBC claim owner.
Download the current version from the source each time; forms change without notice.
Authorization Request for Surgery (Form 83D6)
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For surgery on a WorkSafeBC claim, the specialist requests authorization on form 83D6 before performing it, attaching the consult report, and the claim owner completes the authorization section. Authorization does not waive the contract terms that apply to expedited surgery under the Doctors of BC and WorkSafeBC Physician Services contract.
The consult report. The request must include the specialist's name, the date, the worker's name and claim number, details of the proposed surgery and the consult report, which is faxed with the Physician Consult Report Fax Cover Sheet (83D556). The form also asks for your payee number and contact details.