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WorkSafeNB Mental Health Provider Report (MHPR)

Mental health providers treating a WorkSafeNB claimant use one Word template for initial, progress and discharge reports. It covers attendance and therapeutic approach, trauma-focused treatments used, symptoms, substance use, suicide risk, barriers to return to work, PHQ-9, GAD-7, PCL-5 and B-IPF scores against baseline, and the probability of returning to the pre-accident job or a new one.

Who completes it

The treating licensed psychologist (LPsych), licensed counselling therapist (LCT) or social worker (MSW) completes and signs the report with their WorkSafeNB provider number. The worker completes the separate Mental Health Questionnaire.

Submitting and payment

How to submit it
Submit through MyServices (preferred), fax or mail: the initial report within 5 business days of the first session, a progress report within 5 business days after each 8-week block, and the discharge report within 5 business days of the final appointment.
Who pays
WorkSafeNB pays the provider, who needs a WorkSafeNB provider number and can submit invoices and check their status through MyServices.

Good to know

  • Treatment runs in 8-week blocks of up to 8 sessions and should not go beyond 3 blocks (24 weeks) without WorkSafeNB's prior approval.
  • If sessions are less than weekly, or fewer than 6 in the past 8 weeks, explain why; the template notes trauma-focused therapy may be less effective when less frequent.
  • Record trauma-focused approaches used, such as Cognitive Processing Therapy, EMDR or Prolonged Exposure, or describe and justify any alternative approach.
  • Say whether clinical concerns would limit occupational therapist-guided modified duties and, if so, outline a therapeutic plan to address them.

Get the official form

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

Mental Health Provider Report

Rapport d'évolution en psychologie santé mentale

Official pageVersion française

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Frequently asked questions

When is the WorkSafeNB Mental Health Provider Report due?

Within 5 business days in each case: after the first session for the initial report, after each 8-week block of treatment for a progress report regardless of the number of sessions, and after the final discharge appointment for the discharge report. MyServices is the recommended way to submit.

How many sessions does WorkSafeNB approve for psychological treatment?

Treatment is provided in 8-week blocks of up to 8 sessions. The template says treatment should not continue beyond 3 blocks, or 24 weeks, without prior approval by WorkSafeNB, and each progress report records the block number and whether the worker completed it.

Who can complete the Mental Health Provider Report?

The template lists licensed psychologists (LPsych), licensed counselling therapists (LCT) and social workers (MSW). WorkSafeNB's psychological injuries page says New Brunswick psychologists, social workers and counselling therapists provide this treatment, and it offers MyServices for filing reports quickly.