Posted on Tuesday, March 15th, 2022 at 9:49 pm
It should be simple to file for your long term disability insurance benefits. You fill out your claim form and send it in. Unfortunately, it doesn’t end there. You will need to send in supporting documents from your employer, your doctor, medical records, and documents from anyone else who treated you.
Attending Physician Statement
The person who actually does your therapy, treatments, or other types of care for your injury or illness is the one who should fill out the bulk of this document. Insurance companies like to see it appear over the signature of the physician who runs the practice or oversees the therapists. If there is such a person, you should try to make the insurers happy.
The attending physician statement, or APS, is a questionnaire that the doctor uses to certify how your illness or injury makes you unable to work. This standardized form contains basic questions and checkboxes requesting details such as:
- Your diagnosis and symptoms
- The doctor’s history of treating you for this condition (start and end dates)
- Treatment plan and possible course of the treatment
- Prescribed medications and therapies
- Whether you are disabled from performing your work duties
- The date you became so disabled
- The date you are expected to be able to return to work
- Any restrictions on your return to work
You may have multiple doctors treating you, and multiple doctors could fill out an APS. The one most closely involved with your treatment should be the one to fill out the form. For instance, say that you have relapsing MS and you have been working until now. Then you are in a car accident that aggravates your MS. The ER doctor will treat you for the car accident, but your neurologist who has been treating your MS should be the one to determine whether you need disability benefits and should fill out the APS form. Contact us today, if you have more questions.
What Needs to Be on the APS?
The APS is the form that supports your contention that you cannot work, so it must be filled out completely. It must accurately and consistently show how your symptoms prevent you from working.
The insurance company will ask the doctor for follow-up APS reports during the course of your treatments, and each report needs to mirror the original report. The insurance adjuster will be looking for any discrepancy, and errors will be grounds for the rejection or cancellation of your claim. Even a mistake, such as writing “right leg” when they meant “right arm,” is a red flag to the insurers. They do not consider that doctors are busy people who sometimes make mistakes.
If you do not feel the APS adequately describes your condition because of the space provided, your doctor is allowed to provide a supplemental statement if they will do so. This can be a narrative statement explaining one or more answers fully or clarifying how your condition prevents you from performing your job duties. This statement can be attached to the APS.
You should always make an appointment to see your doctor when taking in an APS to be filled out. Never just drop off the form at the front desk and assume it will be filled out. Doctor’s offices are busy places filled with paperwork, and it could be a long time before your APS is seen again. Scheduling a visit lets you go over the form with your doctor. Make sure you ask any questions you might have- and if you’d like some help in this process, contact us for a free initial consultation our results speak for themselves.
How We Can Help
Doctors get busy, and you are busy too, trying to recover from your injury or illness or learning to live with it. You don’t have the time you need to call doctors and therapists and ask questions about the APS or insurance forms. You may not be sure what you should be asking them, and both of you could have questions that you need to have answered.
At Capitan Law, our long term disability applications lawyers know that insurance companies like to keep things as confusing as possible so that doctors and patients alike won’t have all the answers. We are here to help you find them and get your disability claim filed as easily as possible.
Our legal team will call the doctors’ offices and get your reports and records from their staff. We can help the doctors with the APS, both initial and follow-up so that the insurance companies have no reason to question their statements. When you have questions, we will be there for you, too. Contact us today at (267) 419-7888, or online for help getting your paperwork together and your claim application filed.