What the C1446 is for
WCB-Alberta may fund medical cannabis for a compensable condition only for designated conditions: chronic neuropathic pain, spasticity from a central nervous system or spinal cord injury, chemotherapy-related nausea, vomiting and loss of appetite, and opioid harm reduction. Outside palliative care, the worker must first have exhausted conventional treatment, including a three-month trial of a pharmaceutical cannabinoid such as nabilone. The C1446 is the ongoing report that shows whether the trial is working. It doesn’t replace the medical document the Cannabis Regulations require.
Who completes it
The physician who authorizes the cannabis and manages the related condition completes and signs it after each reassessment. WCB’s guide requires an in-person assessment before cannabis starts. The worker doesn’t complete any part, though their own pain rating goes on the form.
How to fill in the report
Worker details and diagnosis
Enter the WCB claim number, the worker’s name and date of birth, your name, phone, WCB billing number and contract ID, and the date of examination. Name the diagnosis you are prescribing for, in the terms of the designated conditions.
Current complaints, findings and medications
List current complaints and objective findings separately. Give all current medications and doses, including new prescriptions. Opioids and benzodiazepines are precautions in WCB’s guide, and for opioid harm reduction WCB needs the current opioid dose.
Cannabis use
Record daily use in grams, THC potency and the route. Smoking isn’t an accepted route. Stay within 3 grams a day and 9% THC unless the worker is in palliative care, and explain any change in dose or potency.
Function and pain
Score the worker’s function at this visit and the worker’s estimate of average pain in the past week, both on the 0 to 10 scales printed on the form. Say whether each has improved since cannabis started. If not, choose whether the regimen will be adjusted, discontinued or something else, explain why you would continue, and give your plan. Compare against baseline measures such as the Brief Pain Inventory, which the guide recommends.
Work capability
Describe the effect on safety-sensitive tasks such as driving or operating machinery. Say whether the worker can do their date-of-accident job, modified or alternate work, any restrictions, expected return to pre-accident level, whether permanent impairment is anticipated, and the work capability level. Request WCB resources such as a case manager contact, a work assessment centre referral, an independent medical examination or a call with a WCB physician if needed.
Common reasons funding stops
- No report within three months of the last approval.
- Function and pain scores that show less than 30% improvement with no plan to change.
- A dose above 3 grams a day or THC above 9% outside palliative care.
- A smoked route of administration.
- No assessment of safety-sensitive work.
Submitting and who pays
Fax the report to WCB-Alberta at the number on the form, (780) 427-5863 or 1-800-661-1993. The form identifies you by your WCB billing number and contract ID, and WCB-Alberta’s physician billing guide covers how claim services are paid. The form notes that anyone with a direct interest in the claim may examine it.