Insurance companies offering policies for Long Term Disability benefits commonly require the completion of forms such as an Attending Physician’s Statement by your primary disabling physician. As part of the contractual relationship entered into by you and the insurance company, they are entitled to this input by the medical professionals establishing your medical disability. Without it, they are unable to ensure they are paying benefits to those claimants that are indeed disabled.
What if my doctor does not complete forms like an Attending Physician Statement for my Long Term Disability claim?
In short, if your disabling physician informs you they will not complete any forms needed to prove your claim, you may need to seek treatment elsewhere. Most usually, if you are seeking disability benefits for a condition that is diagnosed and being treated by a specialist, the insurance company will usually like for that particular physician to be the one to complete the APS on your behalf, rather than, say, your primary care physician. There are some exceptions to this, but it is a good idea to consider seeking out alternate specialists who will be more cooperative with your claim.
In our office, we state with much regularity, that the condition should drive the treatment, not the disability claim. But this particular issue where particular treatment can kill your claim.
What information is the insurance company seeking through the use of an Attending Physician Statement?
An attending physician’s statement can bridge the gap between the medical condition and the disability. This is a question of functionality. It is difficult to establish a medical disability with medical records alone. With limited interaction during an office visit, it can be difficult for your treating physician to want to attest to your day-to-day functionality in a vocational setting.
Our firm frequently engages a vocational expert to analyze both medical records and input from treating physicians to arrive at a functionality level that would most accurately reflect a client’s ability to work. This report does the best job at analyzing a claimant’s overall functionality.
An attending physician’s statement issued (written) by an insurance company can be quite slanted against the finding that there is significant functional loss. We provide our own forms, which are similar in nature, but flesh out the limitations and restrictions necessitated by the amalgamation of conditions causing the disability in our clients much more clearly than an APS is able to do.
If you are finding that your physician is reticent to complete the APS form that the insurance company has sent to you during the application phase or as part of an update packet while receiving benefits, please contact our office. We navigate these issues with our clients daily and would be happy to help you submit the medical evidence that best advocates for your right to Long Term Disability benefits.
