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1. Click ‘Get Form’ to open the Physician’s Report on Disability in the editor.
2. Begin with Section 1 by entering the member's information, including their name, Social Security Number or CalPERS ID, position title, and birth date. Ensure accuracy as this information is crucial for processing.
3. In Section 2, provide a detailed history of the patient's illness or injury. Include dates of visits and examinations, and specify whether the origin of the injury was work-related or not.
4. Move to Section 3 to document examination findings. Fill in chief complaints, subjective symptoms, height, weight, blood pressure, and diagnosis. Attach additional sheets if necessary for comprehensive details.
5. In Section 4, review any diagnostic tests performed and include findings. Clearly label any attachments with the member’s Social Security number for easy reference.
6. Complete Section 5 by confirming incapacity details and ensuring all required documents are included before mailing directly to CalPERS as instructed in Section 6.

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