Es are covered under your claim, please contact your WorkSafeBC representative. Approved expenses will be paid at the applicable WorkSafeBC rate; refer to page 2 of this form for further details. If you have receipts for prescription medications, please submit a Worker Prescription Claim (Form 3). Submit copies of receipts for all expenses. Keep your original receipts as they may be required for audit purposes. Write your name and claim number on each copy submitted. Please com.
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How to fill out the Canada WorkSafeBC 3A online
Completing the Canada WorkSafeBC 3A form online can help you efficiently request reimbursement for approved medical supplies and services. This guide will walk you through each section of the form, ensuring you provide all necessary information for a smooth submission.
Follow the steps to successfully complete the form.
- Click ‘Get Form’ button to obtain the form and open it in the online editor.
- Begin filling out your personal information. Provide your last name, first name, and Personal Health Number (BC Services Card/CareCard). These fields are crucial for identifying your claim.
- Enter your WorkSafeBC claim number and your mailing address for payment, including the city, postal or ZIP code, and country if applicable. Make sure to complete the questions regarding any address changes within the past six months.
- Provide a daytime phone number where you can be reached, and enter the dates of service or purchase, along with the date of the injury.
- For each expense, specify the fee code, type of expense or supply, quantity or units of service, and the unit price. Include applicable taxes (PST and GST) if they were paid.
- List the name of the provider or supplier for the services or supplies you are claiming expenses for.
- Sum the total amount paid for each expense and enter it in the designated field. Ensure this total aligns with the invoices you are submitting.
- At the end of the form, certify that the information provided is true, correct, and complete to the best of your knowledge. Sign and date the form to confirm your submission.
- After completing all fields, remember to include copies of receipts for the expenses claimed, keeping the originals for your records. You can then save changes, download, print, or share the completed form as needed.
Start your process to complete the Canada WorkSafeBC 3A form online today!
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