Q: How do I initiate a WorkSafeBC claim for a patient with an injury or disease I think might be related to the workplace?
A: Your initial examination and treatment start injured workers on the path to recovery. As the patient’s physician, you are an important partner in that process. When your patient comes to you for initial treatment of a work-related injury or disease, fill out a Form 8. Please complete and submit the form as soon as possible after treating an injured worker for the first time; the sooner the claim is registered, the sooner your patient can receive applicable health care and wage loss benefits.
Physicians are reimbursed on a scale for Form 8/11 submission, which reflects the importance of your patient’s ability to access benefits in a timely way. Reimbursement is highest if the form is submitted on the first day the injured worker is seen, with decreases each day after that. Physicians will not be reimbursed if the form is received by WorkSafeBC 6 business days or more after the injured worker is seen.
Please ask your patient if they have reported their injury to WorkSafeBC. If they haven’t, remind them to call WorkSafeBC Teleclaim (604 231-8888 or 1 888 967-5377 toll-free).
Q: I am an emergency room physician. Should I submit a Form 8?
A: Yes. If you are seeing a patient with a workplace injury or you suspect a workplace injury or condition, please fill out and submit a Form 8.
See correction below: Q: How do I know if my patient’s claim has been accepted?
A: You can check an injured worker’s claim status by using the claim status tool at https://pvc.online.worksafebc.com or calling the WorkSafeBC Claims call centre at 604 231-8888 or 1 888 967-5377, Monday to Friday, 8 a.m. to 6 p.m.
Q: Can I speak to a medical advisor at WorkSafeBC about my patient’s WorkSafeBC claim via the RACE line?
A: Yes. You can reach a medical advisor via the RACE app or call 604 696-2131 or 1 877 696-2131 toll-free. Physicians are available Monday to Friday, 8 a.m. to 5 p.m. We will call you back within 2 hours.
If your call is about your patient’s claim, WorkSafeBC will be billed, so please use the unique physician fee code 19930; do not bill MSP.
Q: How do I bill the physician fee code 19930 for calls with WorkSafeBC?
A: The physician fee code 19930 is billable for telephone calls (including calls to the RACE line) to collaborate with other health care providers and WorkSafeBC case management team members involved in the care of injured workers.
This code is for consultation regarding a clinical issue for your patient with an active or pending WorkSafeBC claim; it is not for administrative billing.
The code applies to calls with a:
- WorkSafeBC medical advisor, board officer, or designate (e.g., case manager, return-to-work specialist).
- WorkSafeBC-sponsored treatment program physician or other program staff.
- Community physician involved in the care of an injured worker.
- Community allied health provider involved in the care of your patient (e.g., physiotherapist, occupational therapist, psychologist).
- Multidisciplinary team.
Q: Can I refer my patient with a workplace injury to the Visiting Specialist Clinic (VSC) at WorkSafeBC?
A: Community physicians cannot directly refer a patient to the VSC. If you would like your patient to be seen by a VSC specialist, please indicate this in the comments section on a Form 8/11 (or Form 8NP/11NP) and check the box to speak to a nurse or medical advisor so we become aware of your request and can follow up.
Patients with accepted WorkSafeBC claims can also be referred without authorization to specialists within the community for expedited consultations. The specialist seeing the injured worker for the injury accepted under the claim must use the fee code for expedited consultations.
Q: If my patient’s claim is denied, why do I not receive a copy of the rationale?
A: Under the Freedom of Information and Protection of Privacy Act, WorkSafeBC cannot share information about workers with others without prior written consent. However, your patient may share claim decision information with you.
—Olivia Sampson, MD, CCFP, MPH, RCPSC
Medical Services Manager, WorkSafeBC
—Celina Dunn, MD, CCFP, CIME
Medical Services Manager, WorkSafeBC
Correction: This article has been revised. Authors requested the highlighted changes to the following sentence postpublication:
Q: How do I know if my patient’s claim has been accepted?
A: You can check an injured worker’s claim status by using the claim status tool at https://pvc.online.worksafebc.com or calling the WorkSafeBC Claims call centre at 604 231-8888 or 1 888 967-5377, Monday to Friday, 8 a.m. to 6 p.m.).
This article is the opinion of WorkSafeBC and has not been peer reviewed by the BCMJ Editorial Board.
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