F-0043Doctor's first report
Physician's first report: subjective/objective findings, diagnosis, treatment plan and follow-up.
- Completed by
- Physician
- Issued by
- Yukon Workers' Safety and Compensation Board
- Format
- Fillable PDF
- Language
- English
Yukon WSCB Doctor's Progress Report (F-0042)
Yukon physicians use this one-page report to update the Workers' Safety and Compensation Board on a worker's recovery after the Doctor's First Report (F-0043). It asks whether the diagnosis has changed, then records subjective complaints, objective findings including diagnostic results, and the treatment plan and medication. It also lets you ask WSCB to arrange a specialist referral or an assessment by its medical consultant.
Who completes it
The attending physician completes the whole form, giving their name, address and telephone number or a health care provider's stamp. The worker completes no part of it but receives a copy of any Functional Abilities form you attach.
Submitting and payment
- How to submit it
- Fax or mail it to the WSCB in Whitehorse using the contact details printed on the form, as often as you consider appropriate or as the board requires.
- Who pays
- WSCB pays health care providers on terms and fees it sets, including a set amount for information provided under the Act and for functional abilities information given on its own form.
Good to know
- Attach a Functional Abilities form (F-0044) only if the worker's abilities have changed significantly since the last report, and give the worker a copy.
- Dates are written day first (dd/mm/yy), and the 'Claim # or Body Part' field takes the injured body part when no claim number exists yet.
- Reports you send become the property of the board, and payment to a provider does not by itself mean the worker's claim has been accepted.
- Health care providers need a WSCB service agreement, applied for through the online Yukon Health Care Provider Application (F-0198).
Get the official form
Download the current version from the source each time; forms change without notice.
Doctor's progress report
Fill it with Vero
If your copy of the form is a fillable PDF, upload it 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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Frequently asked questions
How often must a Yukon doctor send a progress report?
Section 113 of the Workers' Safety and Compensation Act requires progress reports as the health care provider considers appropriate, or as the board requires from time to time. The form sets no fixed interval but records the date of the follow-up visit. The Doctor's First Report (F-0043) is due within two days of first attending the worker.
Can I ask WSCB to arrange a specialist referral on F-0042?
Yes. The Investigation section asks whether you are referring the worker to a specialist, the type of specialist, and whether WSCB should arrange the referral. You can also ask WSCB to refer the worker to its medical consultant for assessment, and say whether you would like WSCB to contact you about the worker.
When should I attach a Functional Abilities form to the progress report?
When the worker's abilities have changed significantly. The form asks you to attach a Functional Abilities form (F-0044) in that case and give the worker a copy. WSCB pays for functional abilities information provided on its own form and uses it, with the worker and employer, to develop the return-to-work plan.