CA-20 - Attending Physician s Report 2025

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The document is an Attending Physician's Report (Form CA-20) required by the U.S. Department of Labor for the Office of Workers' Compensation Programs. It collects detailed information about a patient's work-related injury, including the nature of the injury, medical findings, diagnoses, and disability status. The form also outlines instructions for physicians on how to complete it accurately to support claims under the Federal Employees' Compensation Act (FECA). Additionally, it includes privacy statements and public burden information related to the collection of this data.

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Versions	Form popularity	Fillable & printable
2023	4.6 Satisfied (31 Votes)
2014	4.8 Satisfied (224 Votes)
1999	4.3 Satisfied (45 Votes)

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Who fills out CA 20 form?

Under the FECA, medical evidence must be submitted by a qualified physician. Nurse practitioners and physician assistants are not considered qualified physicians under the FECA unless the medical report is countersigned by a physician.

What is an attending physician report?

An attending physician statement (APS) is a report by a physician, hospital, or medical facility that has treated, or is currently treating, a person seeking insurance. In traditional underwriting, an APS is one of the most frequently ordered additional sources of medical background information.

Who might be asked to fill out a physicians statement?

In order to be effective, an Attending Physician Statement must be completed by a doctor who knows you in person your insurer or agency will reach out to get information from a physician who has either treated you in the past or is currently providing treatment.

How to obtain an attending physician statement?

When you file your claim for short-term disability or long-term disability benefits, the insurance carrier will likely send you an Attending Physician Statement (APS) form for your treating medical provider to complete. While an APS looks simple, how an APS is completed can make or break your case.

Who completes an attending physician statement?

This statement, filled out by your attending physician, provides the disability insurance company with vital data to assess the validity of your disability claim. The APS can influence the decision-making process significantly, making it crucial to ensure it is accurately and thoroughly completed.

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Who can fill out an attending physician statement?

It is important that the doctor treating your disabling condition is the one completing the APS. For example, if you suffer from Multiple Sclerosis, it is likely your neurologist would be the most appropriate doctor to complete the form.

CA-20 - Attending Physician s Report 2025

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