What Is An Attending Physician Statement?

When an injury or illness makes it impossible to work, employer-provided long-term disability insurance compensates you for lost wages. However, before approving your claim, the insurance company will want thorough documentation proving you have a qualifying condition. An Attending Physician Statement (APS) is an important part of this documentation. 

Our seasoned and skilled Illinois long-term disability lawyers at Bartolic Law explain more about this form and the types of information it should contain. 

Information Included In An Attending Physician Statement

According to the Centers for Disease Control and Prevention (CDC), as many as one out of every four adults eventually suffers some type of physical, mental, or cognitive condition that prevents them from working for a year or longer. Long-term disability benefits available through your employer provide a safety net, compensating you for up to two-thirds of your lost wages. 

To be eligible, you must prove that you have a qualifying condition that prevents you from working. An attending physician statement, sometimes referred to as a functional report, plays an important role in making this determination. It is filled out by medical providers and submitted to insurers when filing your long-term disability claim. 

Attending physician statements are typically in the form of a questionnaire and provide pertinent information used in reviewing your eligibility for benefits. This includes: 

• A firm diagnosis of your condition
• A list of all your symptoms
• Results of medical testing and treatments you have undergone
• Current treatment, including physical therapy and any prescribed medications
• Information regarding how your condition prevents you from working or engaging in your usual activities
• Your prognosis for recovery and when you might be able to return to work

Problems With Attending Physician Statements That Could Impact Your Rights To Benefits

In reviewing long-term disability claims, the National Institutes of Health (NIH) advises that insurers typically look at two specific areas in determining whether you are eligible for benefits. These are how your condition impacts activities of daily living (ADL) and residual functional capacity (RFC), which describes what you are able to do and any current limitations. 

An attending physical statement plays an important role in assessing both of these areas. They are required both prior to having your claim approved and throughout the time you are receiving benefits. Problems that can arise with these statements include: 

• Failure on the part of your doctor to complete the form;
• Not providing it in a timely manner to insurers;
• Not providing a firm diagnosis or any details describing your condition;
• Disputing whether your condition impacts you on the job or whether it qualifies as a long-term disability.  

Contact Our Illinois Long-Term Disability Lawyers

Problems with attending physical statements can result in a denial of your long-term disability benefits. At Bartolic Law, we can help ensure these forms are completed properly, provide the required information, and are submitted to insurers in a timely manner. Call or contact our office online and request a consultation with our Illinois long-term disability lawyers.