RIDM is an independent disability management provider. We are not affiliated with, endorsed by, or acting on behalf of Costco Wholesale Canada Ltd. Costco is a trademark of its owner. This page is general information, not legal or medical advice.
Why there is no downloadable “Costco Functional Abilities Form”
If HR or your manager asked for a Functional Abilities Form (FAF) and you have been hunting for a Costco-branded PDF, you will not find one. Large employers use one of two things: the standard form published by their provincial workers’ compensation board, or an internal return-to-work form issued by HR or their disability carrier.
If it is internal, it comes to you directly from your warehouse HR representative, payroll clerk, or claims adjudicator, and it is not published publicly. Any site advertising a “fillable Costco FAF” is selling a generic template, not your employer’s document. Ask which version they need before your medical appointment. Arriving with the wrong form usually means paying a second completion fee.
What the form actually does
An FAF is a communication tool, not a diagnosis. It tells your employer what you can safely do, including standing tolerance, lifting limits, whether you can operate equipment, and whether you need modified hours, all without disclosing your medical condition. The WSIB describes it as giving worker and employer a common frame of reference for identifying suitable work.
That boundary matters. A properly scoped FAF should not contain your diagnosis, test results, or clinical notes. WSIB states that where an employer uses its own form, that form “should not request diagnostic or confidential information, and should be limited to functional information.” If a form you have been handed asks for a diagnosis, raise it with your union representative or HR before signing.
Who completes which section
Your treating health professional completes the functional sections. That can be a physician, physiotherapist, chiropractor, or other licensed provider actively treating you. You complete only the identifying information and consent. Your employer completes the job-demands portion where one exists, and cannot fill in your abilities for you. Either party can request the form, but it is meant for the point when you are able to do some kind of work, not while you still need time to heal.
Work-related versus personal illness, which changes everything
If your absence stems from a workplace injury, your provincial board is involved and the standard board form applies. If it is a personal illness or injury covered by short-term disability, no board is involved and the paperwork comes from your insurer or HR instead. Those two paths follow different rules, timelines, and privacy expectations, so see our page on the non-work-related Functional Abilities Form. Confirm which situation applies to you before chasing forms.
Where to get the right form, by province
Ontario uses the Functional abilities form for early and safe return to work (Form 2647A) with its completion guide for clinicians, and there is more detail on our WSIB FAF page. British Columbia uses WorkSafeBC’s Functional Abilities Assessment template for employers, which includes a cover letter to the health care provider. Alberta’s forms sit in WCB-Alberta’s employer forms and guides. Manitoba publishes separate physical and cognitive Functional Abilities Forms, covered on our WCB Manitoba page. Saskatchewan’s WCB explains what belongs on an employer medical restrictions form. Quebec operates differently, through CNESST’s temporary assignment process rather than a FAF. Our overview of provincial differences in functional abilities assessment compares all jurisdictions.
Who pays
On an accepted claim, the board generally covers the standard form. Where an employer uses a custom form, WSIB’s position is that the employer pays the health professional directly. You should not be absorbing that cost personally, so confirm with HR in advance who is being billed.
If the form shows restrictions
Restrictions do not automatically mean time off. Employers across Canada have a duty to accommodate to the point of undue hardship, as set out by the Ontario Human Rights Commission and the Canadian Human Rights Commission’s workplace accommodation guide. A well-completed FAF makes accommodation easier, because HR gets something concrete to match against job demands rather than a vague note saying “off work.” Our Return-to-Work Readiness Planner and Job Matching Tool can help you think through what modified duties might look like.
Note the difference between a form and an evaluation. The FAF is a one-page clinical opinion, while a Functional Abilities Evaluation is an objective standardized assessment of positional tolerances, strength, dexterity, and endurance conducted over one to three days. Where the concern is cognitive rather than physical, a Cognitive FAE assesses memory, attention, planning, and emotional regulation against the job’s cognitive demands. For background reading, see CCOHS on functional abilities evaluation.
For employers, insurers, and counsel
RIDM conducts independent FAEs and Cognitive FAEs across Canada, including mobile assessment units where no fixed site exists, backed by CARF International accreditation. Start with our FAE/IME referral tool or complex claim triage tool, or contact us at 1-866-490-8118.