{ "version": 1, "name": "ot", "label": "Occupational therapy document forms", "description": "ICBC and WorkSafeBC occupational-therapy supplier forms (PDF and Word) prepared for filling. Each form ships with its untouched supplier document.", "forms": { "ot-01-cl489l-occupational-therapy-initial-report-pdf": { "guidance": { "purpose": "The occupational therapist's first report to ICBC after the initial assessment: diagnosis, current status, limitations, function, treatment goals and the requested program.", "audience": "Completed and signed by the treating OT; read by the ICBC recovery specialist who approves treatment.", "tips": [ "Dates print as dd/Mmm/yyyy; still submit them as yyyy-MM-dd.", "The header carries claim number, dates of accident and report, payee and practitioner details — take these from the referral and the practice profile, never from memory.", "Yes/No questions gate the box beneath them: answer the gate, then the detail box, and leave both blank when the topic did not come up.", "Symptom, limitation and functional-ability checklists are independent checkboxes; tick every one that applies, not just the first.", "The Work and study status and Critical job demands tables are repeating rows — build each row from its `table` object, not from labels.", "Narrative boxes are read by an ICBC recovery specialist: state findings and their functional effect, in the third person, without speculation about causation.", "Up to four dates of assessment are separate questions — one per visit, in order.", "Question 3 medication source is two checkboxes (prescription bottle review, client report), not either/or.", "Treatment goals and action steps is a table: goal, action step and timeframe per row.", "The Expenses table and the services request (hours, rehabilitation assistant visits) are what ICBC authorises — fill them from the plan, not from the narrative." ] } }, "ot-02-cl489m-occupational-therapy-progress-report-pdf": { "guidance": { "purpose": "Progress update to ICBC partway through an approved OT program: what changed since the previous report and what is still requested.", "audience": "Treating OT; ICBC recovery specialist.", "tips": [ "Dates print as dd/Mmm/yyyy; still submit them as yyyy-MM-dd.", "The header carries claim number, dates of accident and report, payee and practitioner details — take these from the referral and the practice profile, never from memory.", "Yes/No questions gate the box beneath them: answer the gate, then the detail box, and leave both blank when the topic did not come up.", "Symptom, limitation and functional-ability checklists are independent checkboxes; tick every one that applies, not just the first.", "The Work and study status and Critical job demands tables are repeating rows — build each row from its `table` object, not from labels.", "Narrative boxes are read by an ICBC recovery specialist: state findings and their functional effect, in the third person, without speculation about causation.", "Date of previous assessment and number of treatment sessions to date anchor the report — take them from the record, not the transcript.", "Pre-accident and current function are paired boxes; describe both so the change is visible.", "'If no, provide additional information' boxes follow goal-met questions; fill them only when the answer was No." ] } }, "ot-03-cl489n-occupational-therapy-discharge-report-pdf": { "guidance": { "purpose": "Closing report to ICBC at the end of OT involvement: outcomes against goals, remaining limitations and any recommendations.", "audience": "Treating OT; ICBC recovery specialist.", "tips": [ "Dates print as dd/Mmm/yyyy; still submit them as yyyy-MM-dd.", "The header carries claim number, dates of accident and report, payee and practitioner details — take these from the referral and the practice profile, never from memory.", "Yes/No questions gate the box beneath them: answer the gate, then the detail box, and leave both blank when the topic did not come up.", "Symptom, limitation and functional-ability checklists are independent checkboxes; tick every one that applies, not just the first.", "The Work and study status and Critical job demands tables are repeating rows — build each row from its `table` object, not from labels.", "Narrative boxes are read by an ICBC recovery specialist: state findings and their functional effect, in the third person, without speculation about causation.", "Number of OT visits and RA/KIN visits are totals for the whole program.", "Summary/Analysis is the box ICBC reads first: outcome, residual limitation, and whether further services are recommended." ] } }, "ot-04-cl751b-occupational-therapy-treatment-plan-pdf": { "guidance": { "purpose": "A one-page request to ICBC for additional OT treatment hours beyond the initial allocation.", "audience": "Treating OT; ICBC recovery specialist.", "tips": [ "Hours completed, additional hours requested and approved hours remaining are three separate numbers; do not derive one from the others.", "Practitioner / Therapist Type has a single option, Occupational Therapy.", "Contact preference is a two-state choice; send the option text from the schema.", "Anticipated end date is the date the requested block would finish." ] } }, "ot-06-cl392-health-provider-invoice-pdf": { "guidance": { "purpose": "ICBC's standard invoice for health-provider time and expenses on a claim.", "audience": "Prepared by the practice; paid by ICBC against the claim number.", "tips": [ "Time charges and Expenses and disbursements are repeating tables: one service date, description, hours or sessions, rate and GST per row, built from the `table` object.", "Rates and amounts are numbers; the invoice total is recomputed from the rows.", "Vendor and payee details come from the practice profile; the claim number and date of MVA from the referral." ] } }, "ot-83d201-job-site-visit-report-mar-2026-word": { "guidance": { "purpose": "Report of a job-site visit: the worker's job demands measured on site, findings, and recommendations to support return to work.", "audience": "OT or kinesiologist who made the visit; WorkSafeBC case manager and the employer's RTW contact.", "tips": [ "Dates are yyyy-mm-dd in the document itself; submit yyyy-MM-dd.", "Header fields (claim number, worker name, date of injury, area and nature of injury accepted on claim) come from the WorkSafeBC referral — copy them exactly.", "Either/or answers are separate checkboxes with nothing stopping both: tick exactly one.", "Distinguish compensable from non-compensable findings wherever the label asks for it; WorkSafeBC officers read for that split.", "Recommendations for equipment or additional sessions must have been discussed with the WorkSafeBC officer before the report is submitted — record the date and officer's name where the form asks.", "Session counts are numbers; leave them blank rather than guessing when the transcript does not state them.", "Strength, Physical and Cognitive demands are tables with frequency, distance or duration columns per demand — fill the row for each demand observed.", "Provider travel time and distance are numbers used for billing; take them from the visit record.", "List every participant with their role; the report is often shared with the employer." ] } }, "ot-83d202-graded-return-to-work-plan-mar-2026-word": { "guidance": { "purpose": "A week-by-week graduated return-to-work schedule agreed with the worker and employer.", "audience": "Written by the OT; signed off by WorkSafeBC and shared with the employer.", "tips": [ "Dates are yyyy-mm-dd in the document itself; submit yyyy-MM-dd.", "Header fields (claim number, worker name, date of injury, area and nature of injury accepted on claim) come from the WorkSafeBC referral — copy them exactly.", "Either/or answers are separate checkboxes with nothing stopping both: tick exactly one.", "Distinguish compensable from non-compensable findings wherever the label asks for it; WorkSafeBC officers read for that split.", "Recommendations for equipment or additional sessions must have been discussed with the WorkSafeBC officer before the report is submitted — record the date and officer's name where the form asks.", "Session counts are numbers; leave them blank rather than guessing when the transcript does not state them.", "Each week is its own table: week commencing, hours per day (Monday to Sunday), tasks to perform, tasks not to perform, comments.", "Hours are numbers per day, not totals; leave days off blank.", "Revision number increments on every reissued plan." ] } }, "ot-83d357-time-sensitive-dms-preauthorization-editable-word": { "guidance": { "purpose": "Word version of the fast-track WorkSafeBC pre-authorisation for durable medical equipment or services.", "audience": "Requested by the OT or supplier; approved by the WorkSafeBC officer.", "tips": [ "Line items are repeating table rows: answer one row at a time using the `table` object (table name, row, column), never the `· item N` suffix alone.", "Prices are numbers; `$1,250.50` is accepted. Totals, GST and PST are recomputed from the rows unless recalculation is turned off.", "Delivery dates and item descriptions belong on the same row as their price.", "Leave a row entirely blank rather than half-filling it.", "Each equipment or service item is a row: description with item or part number, quantity and price.", "Comments should state why the request is time-sensitive." ] } }, "ot-83d357-time-sensitive-dms-preauthorization-pdf": { "guidance": { "purpose": "Fast-track WorkSafeBC pre-authorisation for durable medical equipment or services the worker needs urgently.", "audience": "Requested by the OT or supplier; approved by the WorkSafeBC officer.", "tips": [ "Line items are repeating table rows: answer one row at a time using the `table` object (table name, row, column), never the `· item N` suffix alone.", "Prices are numbers; `$1,250.50` is accepted. Totals, GST and PST are recomputed from the rows unless recalculation is turned off.", "Delivery dates and item descriptions belong on the same row as their price.", "Leave a row entirely blank rather than half-filling it.", "Each equipment or service item is a row: description with item or part number, quantity and price.", "Comments should state why the request is time-sensitive." ] } }, "ot-83d486-ot-discharge-report-jun-2024-word": { "guidance": { "purpose": "Final OT report to WorkSafeBC at discharge: services delivered, functional status, return-to-work outcome and any ongoing needs.", "audience": "Treating OT; WorkSafeBC officer and the claim owner.", "tips": [ "Dates are yyyy-mm-dd in the document itself; submit yyyy-MM-dd.", "Header fields (claim number, worker name, date of injury, area and nature of injury accepted on claim) come from the WorkSafeBC referral — copy them exactly.", "Either/or answers are separate checkboxes with nothing stopping both: tick exactly one.", "Distinguish compensable from non-compensable findings wherever the label asks for it; WorkSafeBC officers read for that split.", "Recommendations for equipment or additional sessions must have been discussed with the WorkSafeBC officer before the report is submitted — record the date and officer's name where the form asks.", "Session counts are numbers; leave them blank rather than guessing when the transcript does not state them.", "Completed services is a table of session counts by service type.", "The RTW section must be completed whenever the referral included RTW, even if no attempt was made — say so in the 'Other' box.", "If equipment rental continues past discharge, give the reason and the follow-up plan where the note asks." ] } }, "ot-83d487-ot-progress-report-jun-2024-word": { "guidance": { "purpose": "Interim OT report to WorkSafeBC requesting the next block of sessions: progress against goals, plan and dates.", "audience": "Treating OT; WorkSafeBC officer.", "tips": [ "Dates are yyyy-mm-dd in the document itself; submit yyyy-MM-dd.", "Header fields (claim number, worker name, date of injury, area and nature of injury accepted on claim) come from the WorkSafeBC referral — copy them exactly.", "Either/or answers are separate checkboxes with nothing stopping both: tick exactly one.", "Distinguish compensable from non-compensable findings wherever the label asks for it; WorkSafeBC officers read for that split.", "Recommendations for equipment or additional sessions must have been discussed with the WorkSafeBC officer before the report is submitted — record the date and officer's name where the form asks.", "Session counts are numbers; leave them blank rather than guessing when the transcript does not state them.", "Sessions requested are per service type; total sessions approved is what the officer already authorised.", "Short-term and long-term goals are separate boxes; the long-term box is only for goals that differ.", "Record the date of communication with the WorkSafeBC officer and their name; without it the plan cannot be approved." ] } }, "ot-83d488-ot-initial-assessment-jun-2024-word": { "guidance": { "purpose": "The OT's initial assessment report to WorkSafeBC: subjective and objective findings, function, home and work factors, and the proposed treatment block.", "audience": "Treating OT; WorkSafeBC officer.", "tips": [ "Dates are yyyy-mm-dd in the document itself; submit yyyy-MM-dd.", "Header fields (claim number, worker name, date of injury, area and nature of injury accepted on claim) come from the WorkSafeBC referral — copy them exactly.", "Either/or answers are separate checkboxes with nothing stopping both: tick exactly one.", "Distinguish compensable from non-compensable findings wherever the label asks for it; WorkSafeBC officers read for that split.", "Recommendations for equipment or additional sessions must have been discussed with the WorkSafeBC officer before the report is submitted — record the date and officer's name where the form asks.", "Session counts are numbers; leave them blank rather than guessing when the transcript does not state them.", "Home environment, existing equipment and recommended equipment are three separate boxes; recommendations must already have been discussed with the officer.", "The employer contact date is anticipated, not past.", "Analysis should separate recovery factors from return-to-work factors." ] } }, "ot-83d542-ergonomic-assessment-may-2023-word": { "guidance": { "purpose": "Ergonomic assessment of a workstation or task, with equipment and layout recommendations.", "audience": "OT or ergonomist; WorkSafeBC officer and the employer.", "tips": [ "Dates are yyyy-mm-dd in the document itself; submit yyyy-MM-dd.", "Header fields (claim number, worker name, date of injury, area and nature of injury accepted on claim) come from the WorkSafeBC referral — copy them exactly.", "Either/or answers are separate checkboxes with nothing stopping both: tick exactly one.", "Distinguish compensable from non-compensable findings wherever the label asks for it; WorkSafeBC officers read for that split.", "Recommendations for equipment or additional sessions must have been discussed with the WorkSafeBC officer before the report is submitted — record the date and officer's name where the form asks.", "Session counts are numbers; leave them blank rather than guessing when the transcript does not state them.", "Assessment location is a set of checkboxes (jobsite, training facility, worker's home, other): tick one.", "Pictures go in an appendix; the workstation description box should still stand on its own.", "Travel time and distance are billing numbers from the visit record." ] } }, "ot-83d608-dme-and-services-quote-nov-2025-pdf": { "guidance": { "purpose": "A supplier or OT quote to WorkSafeBC for durable medical equipment, rentals, repairs and delivery.", "audience": "Prepared by the supplier or OT; approved by the WorkSafeBC officer.", "tips": [ "Line items are repeating table rows: answer one row at a time using the `table` object (table name, row, column), never the `· item N` suffix alone.", "Prices are numbers; `$1,250.50` is accepted. Totals, GST and PST are recomputed from the rows unless recalculation is turned off.", "Delivery dates and item descriptions belong on the same row as their price.", "Leave a row entirely blank rather than half-filling it.", "Quote type is a two-state choice, Initial or Revised.", "Purchase, Rental, Repair and modification, and Delivery and labour are four separate tables; the same column labels repeat in each.", "Discount, GST and PST are percentages per row." ] } }, "ot-83d608-dme-and-services-quote-nov-2025-word": { "guidance": { "purpose": "Word version of the WorkSafeBC quote for durable medical equipment, rentals, repairs and delivery.", "audience": "Prepared by the supplier or OT; approved by the WorkSafeBC officer.", "tips": [ "Line items are repeating table rows: answer one row at a time using the `table` object (table name, row, column), never the `· item N` suffix alone.", "Prices are numbers; `$1,250.50` is accepted. Totals, GST and PST are recomputed from the rows unless recalculation is turned off.", "Delivery dates and item descriptions belong on the same row as their price.", "Leave a row entirely blank rather than half-filling it.", "Initial and Revised are two independent checkboxes; tick one.", "Purchases, Rentals, Repairs and modifications, and Delivery and labour are four separate tables with the same column labels." ] } }, "ot-83m10-vehicle-modification-assessment-word": { "guidance": { "purpose": "Assessment of a worker's driving needs and the vehicle modifications or adapted equipment required.", "audience": "OT with driver-rehabilitation expertise; WorkSafeBC officer.", "tips": [ "Dates are yyyy-mm-dd in the document itself; submit yyyy-MM-dd.", "Header fields (claim number, worker name, date of injury, area and nature of injury accepted on claim) come from the WorkSafeBC referral — copy them exactly.", "Either/or answers are separate checkboxes with nothing stopping both: tick exactly one.", "Distinguish compensable from non-compensable findings wherever the label asks for it; WorkSafeBC officers read for that split.", "Recommendations for equipment or additional sessions must have been discussed with the WorkSafeBC officer before the report is submitted — record the date and officer's name where the form asks.", "Session counts are numbers; leave them blank rather than guessing when the transcript does not state them.", "Diagnosis boxes (paraplegia level, quadriplegia level, amputee, brain injury, other) describe the accepted condition; leave the ones that do not apply blank.", "Owned, adapted and proposed vehicle details are separate groups; do not mix years or makes between them.", "Control and equipment types are free text next to a checkbox; tick the box and name the type.", "Reduced-effort steering and braking are percentages." ] } }, "ot-legacy-83d35-supplier-vendor-quote-pdf": { "guidance": { "purpose": "Legacy WorkSafeBC supplier quote form for equipment and services.", "audience": "Prepared by the supplier; approved by the WorkSafeBC officer.", "tips": [ "Line items are repeating table rows: answer one row at a time using the `table` object (table name, row, column), never the `· item N` suffix alone.", "Prices are numbers; `$1,250.50` is accepted. Totals, GST and PST are recomputed from the rows unless recalculation is turned off.", "Delivery dates and item descriptions belong on the same row as their price.", "Leave a row entirely blank rather than half-filling it.", "Quote items span two pages as two tables; continue onto page 2 only when page 1 is full.", "Client date of birth uses the document's own date format; still submit yyyy-MM-dd." ] } } } }