What the CL489 is for
The family physician’s first report after a crash tells ICBC what the injuries are, how they affect daily life and what care the patient needs. ICBC uses it to support recovery goals such as return to activities and work planning, and to inform other benefits on the claim.
The CL489 is the Standard report, for a patient who can still fully complete their work, training or studies with no absence or reduction. If the patient is off work or on modified duties or hours, the form tells you to complete the CL489A Extended Medical Report instead. ICBC requires a report for each new claim.
Who completes it
The form says it’s to be completed by the primary care provider whenever possible. You complete every section. The patient has no part to fill in, but you need their ICBC claim number, from them or from ICBC, and their consent to share the report.
How to fill in the CL489
Invoice information, Patient information and Physician information
This block is what gets you paid. ICBC can’t process payment unless the report has the claim number, date of crash, payee name, payee address, patient name and date of report. Add your ICBC vendor number if you have one, and your own invoice or reference number for reconciliation. Dates use the dd/mmm/yyyy format. Say whether you’re the patient’s regular physician and whether an interpreter is needed.
Subjective, and Relevant pre-crash history
Subjective complaints are optional. Questions 1 to 3 are the pre-crash history: earlier symptoms or treatment in the injured areas, other conditions contributing to the current symptoms, and any investigations or specialist referrals for crash injuries. Describe how a pre-existing problem might affect recovery, since that’s what ICBC asks.
Vocational status and Avocational status
Questions 4 to 7 record employment and training status, any absence, and whether duties and hours are full or modified. On a CL489 these answers should show the patient still working, studying or training at full capacity. If they show absence or modified work, switch to the CL489A.
Questions 8 to 10 cover activities outside work, such as daily living, and whether the patient can do them as before the crash. If not, give the earliest date they could return.
Assessment
Enter the primary diagnosis, the most serious or significant injury, with nature of injury, body part, orientation and ICD-9 code from the drop-downs. Then list other diagnoses caused by or related to the crash. The form’s appendix lists the codes ICBC sees most, such as 847 for back sprain and 850 for concussion.
Medical restrictions, Barriers to recovery and Recommended Care Management Plan
Describe restrictions and limitations and whether they’re temporary or permanent. Name barriers to recovery, whether functional, physical, psychosocial, employer, medical or compliance. In the care plan, recommend treatments, investigations or referrals, say whether you expect a return to pre-crash function, and whether more therapy is likely.
Prognosis, Treatment notes and certification
Give the prognosis and expected recovery timeline. Under Treatment notes, say whether you’re following an established protocol, such as OPTIMa or ODG, and list any medication prescribed. Tick the certification, then tick either patient consent or an ICBC request under the Insurance (Vehicle) Act. The form has a Lock button that makes it read-only. Lock it only when you’re finished.
Common reasons it’s delayed or unpaid
- No ICBC claim number, or a missing payee name or address.
- A CL489 sent for a patient who’s off work or on modified duties.
- Both a CL489 and a CL489A sent for the same claim.
- Neither the consent box nor the ICBC request box ticked.
- A report sent more than 30 days after the assessment.
Submitting and who pays
Fax the report to ICBC at 1-877-686-4222 or mail it to ICBC, PO Box 2121, Stn Terminal, Vancouver, BC V6B 0L6. ICBC has built the family physician reports into several common EMRs, so check yours first. ICBC pays the report fee, currently $198 under code A94564, and the report serves as the invoice.
ICBC doesn’t prepay for reports, and doesn’t pay for missed or cancelled appointments or visits after a claim closes. Follow-up visits with no report are billed through MSP Teleplan with the usual visit codes.