Disability forms to print out 2026

1. Click ‘Get Form’ to open the Physician’s Report on Disability in the editor.
2. Begin with Section 1 by clearly describing the nature and severity of the impairment. Ensure you include any relevant medical reports as attachments.
3. In Section 2, provide a comprehensive history of the patient’s illness or injury. Fill in all member information accurately, including name, Social Security number, and occupational title.
4. Proceed to Section 3 where you will document examination findings. Include chief complaints, subjective symptoms, height, weight, and blood pressure.
5. In Section 4, detail any diagnostic tests performed along with their findings. If necessary, attach additional sheets labeled with the member's Social Security number.
6. Section 5 requires you to assess the member's incapacity based on job duties. Answer all questions thoroughly to avoid delays in processing.
7. Finally, ensure that all sections are completed before mailing the report directly to CalPERS as instructed in Section 6.

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