Do You Have A Case?

When filing for long-term disability insurance, it is common for your insurance company to request a statement from your doctor, known as an Attending Physician Statement (APS). It is very likely that your insurance company will request an APS during your application for benefits. Generally, the outcome of your claim can be heavily influenced by your doctor’s answers to the APS. While it isn’t the most important factor in your application, it can make a big difference. Below, we will discuss the importance of the APS, and how to make sure they help your claim.

What is an Attending Physician Statement (APS)?

An Attending Physician Statement is a questionnaire that your disability insurance company provides for your doctor to fill out. Generally, this questionnaire is to allow your doctor to provide support for or against your disability. Overall, it can certify your inability to continue working because of your condition. While each insurance company has its own questionnaire, and they may change to better fit the condition in question, they often ask similar questions. Common aspects of the APS include:

  • The doctor’s history of treatment with you
  • Your symptoms and diagnosis
  • Your treatment plan
  • Any prescribed medications you take
  • Whether your condition disables you
  • The date you became “disabled”
  • Potential recovery timetables
  • Potential work limitations
  • and more.

The APS can be crucial to securing your long-term disability insurance claim. The insurance company will often dismiss cases if it is not sufficient enough, even if you provide a lot of other strong evidence.

When Will my Insurance Company Ask for an Attending Physician Statement?

There is no set time for your insurance company. However, they may ask for it at any stage in your application process. Generally, the APS is an important factor in determining whether or not you qualify for benefits.

It is not uncommon for the insurance company to periodically check up on your situation after you have been approved. In some cases, an insurance company can ask for another APS after you begin receiving benefits. It can be used to check if you are keeping up with your care and treatment. Otherwise, they can use an unsupportive APS as a reason to terminate your benefits. The frequency of these additional statements can vary case by case. Policies for different conditions may also differ.

Is my Doctor’s APS Supportive Enough for My Case?

Doctor filling out an attending physician statement in an office with a patient

After your doctor fills out the APS, you should review it with your disability attorney before submitting it. The insurance company can use almost any mistake on that form to deny your claim. As such, it is important to review it carefully, and ensure that you and your disability attorney are comfortable with it before submitting it. There are also a few different things to consider when handling the APS.

Choosing the Right Doctor to Complete the APS

Generally, you want to choose a doctor that is very familiar with your condition. It may be helpful to have a specialist be the one to provide the APS. For example, if you are suffering from CRPS, you may want your neurologist to fill it out. If you are disabled because of your asthma, your pulmonologist is likely the right doctor for your application. Your specialist would likely have the most understanding of your condition.

Ask Multiple Doctors to Fill out the APS

Your condition can often be complex, so having multiple doctors fill out the APS can be helpful. One doctor alone may not be able to cover all of your symptoms and issues. This can also be helpful in determining which doctors will provide a more supportive APS. Just provide your doctors with a blank copy of the form to fill out. Your disability attorney can help you choose which one(s) are supportive enough to submit. The more supportive APS documents you have can provide the insurance company with a better understanding of your condition and disability. Even a form from your primary care physician can help build your case.

Reviewing your Doctor’s Attending Physician Statement

It is important for you and your disability attorney to review any Attending Physician Statement you receive before submitting it. There are a few potential issues to be aware of. Firstly, all questions must be answered. Otherwise, your claim could be invalidated. Next, check any dates provided within the document. If your doctor’s answers do not match up with important dates in your claim, it can be dismissed. Dates such as your day of injury, treatment dates, disability start date, etc. should all match with your application. Inconsistencies can raise red flags for the insurance company. Doctors are often busy and can make mistakes. If needed, ask your doctor to fill the document out again with the right information.

Additional Statements

The APS questionnaire may not provide enough context for your condition. As such, a doctor may also provide additional statements to go along with their APS. These supplemental statements can help your doctor elaborate in ways that the initial questionnaire didn’t cover.

Your APS and Objective Medical Evidence

In addition to your APS documents, you will need some objective medical evidence to back up your disability claim. This can come in the form of diagnostic test results, Functional Capacity Evaluations, Neuropsychological tests, and more. However, it is important that your doctor’s Attending Physician Statements provide support and evidence that is backed up by these tests. Your doctor should be aware that you have this objective medical evidence. Additionally, that evidence should be used to support how they answer the questions for the APS. For more multi-faceted conditions, such as those that require multiple specialists, they may not be aware of all of your supporting medical evidence. Providing this evidence for your specialists can be vital in building strong supporting documentation.

Can my Disability Attorney Help Me with my Attending Physician Statement?

If you are looking to file a long-term disability claim for your debilitating condition, you should seek out an experienced disability attorney. At D’Agostino & Associates, we help people living with disabling conditions file long-term disability claims. We help you through the process step by step to help you build a strong case. Our law team is here for you.

Reviewing APS documents can be a stressful process. You may not know what insurance company might flag as an issue within the questionnaire. By working with your disability attorney, you lower the risk of being denied because of issues within the APS.

At D’Agostino & Associates, our team of lawyers can help you sort through all the details, understand what you are entitled to, and fight to get what you deserve. D’Agostino & Associates P.C. has offices in New York and New Jersey. Contact us, or call us at 1-888-245-2924 to schedule a free consultation with our attorneys.