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WorkSafeBC Form 83D516: Massage Therapy Extension

Registered massage therapists use this two-page form to ask WorkSafeBC to approve massage therapy beyond 8 weeks (more than 60 days) from the date of injury. Approval is required before providing those services, so the request sets out treatment to date, whether the worker has improved, factors delaying recovery, findings, the rationale and a proposed treatment plan.

Who completes it

The registered massage therapist completes every field, as the form requires, including whether this is the first extension request and whether there is a physician's referral.

Submitting and payment

How to submit it
Submit it through Teleplan or My Provider Services by the end of week 6 of treatment, then wait for WorkSafeBC's approval before continuing treatment.
Who pays
Treatment beyond 8 weeks needs WorkSafeBC approval before it is provided, and the request carries the clinic's WorkSafeBC payee number.

Good to know

  • If this is not the first request, give the date of the last approved extension along with the number of requests made.
  • Subjective findings should cover mechanism of injury, chief complaint, history, pain scale, aggravators, alleviators and functional limitations in activities of daily living.
  • The proposed plan lists treatment types such as manual technique or remedial exercise, the number and frequency of treatments, and start and end dates.
  • The form asks whether the worker is expected to return to work after the additional treatment, or is already at work.

Get the official form

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

Extension of Massage Therapy Treatment Request (Form 83D516)

Official page

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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 do I need WorkSafeBC approval for more massage therapy?

For treatment beyond 8 weeks (more than 60 days) from the date of injury. Submit form 83D516 by the end of week 6 of treatment and wait for approval before continuing. Within the first 8 weeks, the initial assessment and up to 6 treatments need no pre-approval.

What does WorkSafeBC look for in a massage therapy extension request?

The form asks whether the worker's condition has improved, what is delaying recovery, significant subjective and objective findings, and why an extension is needed, plus anything on expected benefit and return to work. All fields must be completed, and the current version is revision R23/03.