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WSIB IDT Program of Care Initial Assessment (10708A)

Contracted interdisciplinary teams complete this seven-page report at the start of the WSIB interdisciplinary team program of care, an eight-week community program for people with complex musculoskeletal injuries. It documents the injury history, physical findings, standardized outcome measures, diagnosis and prognosis, recovery barriers, treatment goals and abilities for return-to-work planning. The WSIB must approve the person's participation before the program is delivered.

Who completes it

The contracted team, at minimum a physiotherapist or chiropractor plus an occupational therapist, completes the whole report; the team lead regulated health professional and another team member sign Section G, and the team lead signs Section I.

Submitting and payment

How to submit it
Once the WSIB has approved the person's participation, submit the form and supporting documents through WSIB online services at wsib.ca/submit.
Who pays
Payment follows the contract each provider holds with the WSIB after its open procurement process, and the WSIB's list of practitioner fee schedules has no separate schedule for this program.

Good to know

  • Complete at least one functional outcome measure for the injured area, such as NDI, ODI, QuickDASH, LEFS or WHODAS, and repeat the same measure throughout treatment.
  • Where clinically indicated, add GAD-7, PHQ-9 or the Pain Self-Efficacy Questionnaire; the form prints the scoring bands for each measure.
  • Section E lists recovery barriers to tick, such as fear-avoidance, believing hurt equals harm, low mood, medium to heavy job duties, shift work or difficulty moving from modified duties.
  • In the abilities and restrictions section, note potential medication side effects without naming the medications, as the form instructs.

Get the official form

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Interdisciplinary team program of care: Initial assessment report

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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

Who can deliver the WSIB interdisciplinary team program of care?

Only contracted providers that met the WSIB's requirements through an open procurement process. The team must include, at minimum, a physiotherapist or chiropractor and an occupational therapist, and providers are listed in the WSIB's interdisciplinary team program of care directory. The injured person needs WSIB approval to participate.

What happens after the IDT initial assessment?

The program runs eight weeks in two four-week blocks. At the end of block one the team files the mid-point report (10710A), and at completion or discharge the care and outcomes summary (10712A). A supplementary report (10714A) applies only if the WSIB approves additional treatment.

Is Form 10708A available in French?

Yes. The form notes that it is available in French as Programme de soins assuré par une équipe interdisciplinaire : Rapport d'évaluation initiale, 10708B (11/23). When the WSIB approves work hardening, that service has its own initial assessment report, 10709A.