Sets out a worker's psychological/cognitive functional abilities and restrictions for return to work.
- Completed by
- Psychologist or other mental health provider
- Issued by
- Yukon Workers' Safety and Compensation Board
- Format
- Language
- English
Yukon WSCB Psychological Progress Report (F-0075)
Psychologists treating a Yukon worker's accepted psychological injury use this two-page report to update WSCB on treatment and to request more sessions. It records the treatment provided, up to three goals and progress toward them, current symptom severity and whether the worker is ready for pre-injury work. The last section doubles as WSCB's treatment authorization, returned approved, not approved or with a request to discuss.
Who completes it
The treating psychologist completes and signs the report. WSCB's claim owner completes the 'WSCB Psychological Treatment Authorization' box with a proposed treatment end date and their decision.
Submitting and payment
- How to submit it
- Fax or mail it to WSCB using the contact details on the form when you report progress, request an extension or conclude treatment, and share progress reports with the worker's family physician as policy 3.16 expects.
- Who pays
- WSCB pays for authorized psychological treatment on the terms and fees in the service agreement each provider must sign, and sessions beyond the initial approved set need its written approval.
Good to know
- If the worker is ready to return with limitations, attach a revised Psychological Functional Abilities Form (F-0071) where applicable.
- Requests for more treatment need a rationale, frequency, focus, plan and goals, expected results and an end date; WSCB may consult the worker's physician or its medical consultant.
- Where function has improved and the extension has a defined end date within one month of the request, policy 3.16 says no physician referral is needed.
- Common limitations named on the form include limited tolerance for deadlines, time pressure and high productivity expectations, and for tasks with frequent customer contact.
Get the official form
Download the current version from the source each time; forms change without notice.
Psychological 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.
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
How do I request more psychology sessions from Yukon WSCB?
Use the treatment extension section on page 2: give the rationale, frequency, focus of treatment, treatment plan and goals, expected results and end date. Policy 3.16 requires a written request with rationale for treatment beyond the initial set of approved sessions, and WSCB may consult the worker's physician, a specialist or its medical consultant.
When does WSCB end psychological treatment?
The conclusion section mirrors policy 3.16: no objective evidence of improvement in function, treatment no longer related to the compensable injury, no reasonable expectation of further improvement while treatment no longer helps keep or return the worker to work, or treatment unlikely to bring further gains in function or to be needed for maintenance.
How is symptom severity rated on F-0075?
Tick one of five levels: no significant symptoms, minimal symptoms, some mild symptoms but generally functioning well, moderate symptoms or moderate impairment in function, or serious symptoms or serious impairment in functioning. Page 2 then asks whether the worker is ready for pre-injury work from a psychological perspective, with or without limitations.