Get the free Attending Physician's Statement - laborcommission utah

This form is to be completed by the attending physician of an injured employee and sent to the Labor Commission to assess the employee's condition regarding their ability to return to work.

How to fill out attending physicians statement

How to fill out Attending Physician's Statement

1. Obtain the Attending Physician's Statement form from your insurance provider or medical institution.
2. Fill in your personal information at the top of the form, including your full name, date of birth, and policy number.
3. Provide details of the medical condition being treated, including diagnosis and treatment dates.
4. Have the attending physician fill out their information, including name, contact details, and medical license number.
5. Ensure the physician provides detailed information on the condition, treatments, medications, and any functional limitations.
6. Review the form for completeness and accuracy before submission.
7. Submit the completed form to your insurance provider as per their guidelines.

Who needs Attending Physician's Statement?

1. Individuals filing for short-term or long-term disability benefits.
2. Patients applying for life insurance claims.
3. Individuals seeking medical leave from work.
4. Patients requiring assistance with health-related claims.

People Also Ask about

What is included in an attending physician statement?

An attending physician statement is a form your physician must fill out. It comes in the form of a questionnaire. It will ask questions about your conditions and symptoms and how they impact your ability to work. You may come across other names for this form, such as a “functional report.”

What is the difference between an attending doctor and a regular doctor?

Attendings are fully licensed doctors responsible for overseeing the care team, while residents are physicians in training working under their supervision. Residents play a crucial role in day-to-day patient care, acting as the first point of contact and communicating patient concerns to attending physicians promptly.

Is attending the highest level of doctor?

While residents undergo specialized training under the guidance of attending physicians, attending physicians hold the highest positions, overseeing patient care and providing mentorship. These differences include autonomy, patient care responsibilities, educational roles, salary prospects, and work settings.

What is attending physician in English?

A medical doctor who is responsible for the overall care of a patient in a hospital or clinic setting.

Who is considered the attending physician?

In a medical facility, the the attending physician is the physician who has the major responsibility for a patient's care. Attending physicians have completed their training and often play an active role in the education of medical students.

Who completes an attending physician's statement?

Have the appropriate doctor complete the APS. You may have multiple doctors treating you for different medical issues, not all relating to your disability. It is important that the doctor treating your disabling condition is the one completing the APS.

What is the difference between a treating physician and an attending physician?

Your treating doctor, also known as your attending physician, is the person who's primarily responsible for treating your injuries. You need a doctor that does more than treat your injuries—you need someone who will help you with your workers' compensation case.

What is an example of an attending physician?

Attending physicians may also still be in training, such as a fellow in a subspecialty. For example, a cardiology fellow may function as an internal medicine attending, as they have already finished residency in internal medicine. The term is used more commonly in teaching hospitals.

For pdfFiller’s FAQs

What is Attending Physician's Statement?

An Attending Physician's Statement (APS) is a medical document completed by a physician that provides details about a patient's medical condition, diagnosis, treatment, and prognosis, typically required for insurance claims or underwriting processes.

Who is required to file Attending Physician's Statement?

Typically, the attending physician treating the patient is required to file the APS, especially when requested by an insurance company or during a claims process involving the patient's health.

How to fill out Attending Physician's Statement?

To fill out an APS, the physician must accurately complete sections detailing the patient's medical history, current condition, treatments provided, and any relevant diagnostic test results, ensuring all information is clear and comprehensive.

What is the purpose of Attending Physician's Statement?

The purpose of the Attending Physician's Statement is to provide necessary medical information to insurers or other entities to support claims, facilitate coverage decisions, assess treatment needs, or evaluate a patient's eligibility for benefits.

What information must be reported on Attending Physician's Statement?

The APS must report information such as the patient's personal details, medical history, diagnosis, treatments received, response to treatments, and any limitations or impairments resulting from the condition.