Ldss 486t 2026

1. Click ‘Get Form’ to open the ldss 486t in the editor.
2. Begin with Section I – Identification. Fill in the agency’s name and address, patient’s name, case number, and patient’s address. Ensure all details are accurate for proper identification.
3. Next, provide the patient's social security number, sex, and date of birth. This information is crucial for processing the disability application.
4. Move to Section II – Medical Report. Here, physicians should complete the required fields regarding the patient's current condition. Include diagnosis, height, weight, and date of last exam.
5. Indicate exertional functions by checking what the individual is capable of doing regarding lifting, carrying, standing, walking, sitting, and pushing. Be as specific as possible.
6. For non-exertional functions, check any limitations that exist in sensory, postural, environmental, manipulative, and mental areas. This helps provide a comprehensive view of the patient's capabilities.
7. Finally, ensure that the physician signs and prints their name along with their specialty and office contact information before submitting the form back to the agency.

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