Practitioner’s Return-to-Work (PRTW) Report

Document type
Downloadable forms
Online submission forms
Customer type
Care providers

Document description
Once a return-to-work plan has been agreed upon, submit this report to the WCB with copies to the primary care provider, the employer and worker to confirm the hours of work and restrictions.

Fill Out Online

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application/pdf — 828.23 KB

Neck disability index (NDI)

Document type
Downloadable forms
Customer type
Care providers

Document description
Administer this Functional Outcome Measures self-report tests to WCB customers as soon as possible to measure self-rated disability due to neck pain.

Download

application/pdf — 315.71 KB

Lower extremity functional scale (LEFS)

Document type
Downloadable forms
Customer type
Care providers

Document description
Administer this Functional Outcome Measures self-report test to WCB customers as soon as possible if the worker is having any difficulty with activities because of a lower limb problem.

Download

application/pdf — 293.4 KB

International health care provider report (CR)

Document type
Downloadable forms
Customer type
Care providers

Document description
International health care providers can use this form to communicate with the WCB about their treatment of workers injured on the job in Saskatchewan.

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application/pdf — 270.34 KB

Functional examination record

Document type
Downloadable forms
Customer type
Care providers

Document description
Use this form to complete a functional examination of the injured worker.

Download

application/pdf — 783.8 KB

Client health questionnaire

Document type
Downloadable forms
Customer type
Care providers

Document description
Use this questionnaire for the assessment team to get a complete picture of an injured worker’s health.

Download

application/pdf — 973.02 KB

Psychological Injuries

Document type
Fact sheets
Customer type
Care providers
Workers
Employers

Document description
Find out what you need to know about work-related psychological injuries.

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application/pdf — 547.9 KB