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WSIB MSK Care and Outcomes Summary (10637A)

The WSIB requires this five-page report when a person completes the musculoskeletal program of care or is discharged, including early discharge during or after block one. It records whether the person completed the program or self-discharged, sessions in block two, response to treatment, findings, outcome measures and final abilities and restrictions. It is also where you recommend a supplementary block of treatment.

Who completes it

The registered regulated health professional delivering the program, such as a physiotherapist or chiropractor, completes and signs the whole report.

Submitting and payment

How to submit it
Submit it online at wsib.ca/submit within two business days of the last block two treatment, or at discharge, and bill it electronically through TELUS Health.
Who pays
Bill the report under MPOCCOS; the WSIB withholds block two payment (MPOCSB2 or MPOCMB2) until it receives this report and its billing.

Good to know

  • If the person is discharged during or after block one, this summary replaces the mid-point report.
  • To recommend a supplementary block, tick yes and contact a WSIB clinical expert, giving the treatment frequency, duration and recovery and return-to-work goals.
  • Repeat the same functional outcome measure used at the initial assessment, such as NDI, ODI, QuickDASH, LEFS or WHODAS, and interpret the results in the comments.
  • Summarize changes in functional abilities since the mid-point report, and record whether you discussed returning to work with the injured person.

Get the official form

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

Musculoskeletal (MSK) program of care: Care and outcomes summary

Sommaire des soins et des résultats dans le cadre du Programme de soins musculo-squelettiques

Official pagePDFVersion française

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 WSIB MSK care and outcomes summary due?

When the person completes the MSK program of care or whenever they are discharged. The fee schedule asks you to complete it at the end of block two or at discharge and submit it online within two business days of the last block two treatment. Block two payment is withheld until it arrives.

How do I request a supplementary MSK treatment block?

On the care and outcomes summary, answer yes to recommending a supplementary block and contact a WSIB clinical expert, then give the treatment frequency, duration and recovery and return-to-work goals. A supplementary block is available to people approved for additional community treatment and needs at least three visits for the full fee.

Is Form 10637A available in French?

Yes. The French version is the Sommaire des soins et des résultats dans le cadre du Programme de soins musculo-squelettiques (10637B), and the English form notes that it is available in French. Either version is submitted online through wsib.ca/submit.