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Attending Physician's Statement Send to: Group Long Term Disability Claims, P.O. Box 26025, Leigh Valley, PA 18002-6025 For Customer Service: (800) 538-4583 Fax: (610) 807-8221 Secure E-mail: www.GuardianAnytime.com,

How to fill out attending physician39s statement

How to fill out an attending physician's statement:

1. Begin by gathering all necessary information and forms. You will typically need the patient's personal details, medical history, and any specific questions or sections provided by the insurance company.
2. Ensure the attending physician's statement is properly titled and includes the patient's name, date of birth, and any identifying information requested.
3. Provide a concise summary of the patient's medical condition, including the diagnosis, current symptoms, and any relevant medical history. Be sure to include any objective findings or test results that support the diagnosis.
4. Fill out the treatment section of the statement, describing any current medications, therapies, or procedures the patient is undergoing. Include the frequency and duration of these treatments, as well as any potential side effects or complications.
5. If the patient is unable to work due to their medical condition, include a detailed explanation of their functional limitations. This may include physical restrictions, cognitive impairments, or emotional difficulties that impact their ability to perform job-related tasks.
6. Address any specific questions or concerns outlined in the attending physician's statement. This could include the patient's prognosis, expected duration of treatment, or recommendations for further care.
7. Review the completed statement for accuracy and make any necessary revisions or additions. Ensure that all sections are properly completed, signed, and dated.
8. Submit the attending physician's statement to the appropriate party, such as the patient's insurance company or employer, as instructed. Keep a copy for your records in case it is requested in the future.

Who needs an attending physician's statement?

1. Insurance companies often require attending physician's statements when evaluating a patient's eligibility for disability benefits or determining the extent of coverage for medical expenses. These statements provide an objective assessment of the patient's medical condition and the need for ongoing treatment or support.
2. Employers may request an attending physician's statement to verify an employee's need for medical leave or accommodations. This information helps the employer understand the limitations or restrictions placed on the employee due to their health condition.
3. Government agencies, such as social security offices or workers' compensation boards, may require attending physician's statements to assess an individual's eligibility for financial assistance or disability benefits.

In summary, filling out an attending physician's statement requires gathering relevant information, providing a concise summary of the patient's medical condition and treatment, addressing any specific questions or concerns, and reviewing the completed statement for accuracy. These statements are often necessary for insurance claims, employer accommodations, or government benefit applications.

For pdfFiller’s FAQs

What is attending physician's statement?

Attending physician's statement is a medical document completed by a patient's primary healthcare provider, detailing the patient's medical condition, treatment plan, and ability to work.

Who is required to file attending physician's statement?

The patient's primary healthcare provider or attending physician is required to file the attending physician's statement.

How to fill out attending physician's statement?

The attending physician must provide detailed information about the patient's medical condition, treatment plan, and ability to work on the attending physician's statement form provided by the requesting entity.

What is the purpose of attending physician's statement?

The purpose of attending physician's statement is to provide accurate and detailed information about the patient's medical condition for insurance claims, disability benefits, or legal purposes.

What information must be reported on attending physician's statement?

The attending physician's statement must include the patient's diagnosis, treatment plan, prognosis, current medications, functional limitations, and any restrictions on work activities.

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