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Attending Physicians Statement (APS) 2026

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The document is a Supplementary Attending Physician’s Statement (APS) for Long Term Disability claims under Manulife Group Policy. It includes sections for patient information, declarations, and authorizations by the claimant, as well as detailed instructions for physicians to provide medical information regarding the patient's diagnosis, treatment, and functional impairments. The form aims to assess the patient's eligibility for long-term disability benefits.

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Click ‘Get Form’ to open the Attending Physicians Statement (APS) in our editor.
Begin with Part I, where the patient/claimant must fill in their personal information including Service Number, name, address, and contact details.
In the Declaration and Authorization section, ensure the patient signs and dates the form to confirm the accuracy of their information.
Proceed to Part II for the attending physician's input. Fill in all required fields regarding diagnosis, current impairments, and treatment details.
Provide objective findings and any relevant medical evidence that supports the patient's health status. This may include test results or consultation notes.
Complete sections on prognosis and competency, ensuring all questions are answered thoroughly for clarity.
Finally, have the attending physician sign and date at the end of Part II to validate the information provided.

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2015	4.9 Satisfied (56 Votes)

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Who fills out attending physician statement?

Have the appropriate doctor complete the APS. You may have multiple doctors treating you for different medical issues, not all relating to your disability. It is important that the doctor treating your disabling condition is the one completing the APS.

Who completes an attending physicians 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.

What would an attending physicians statement be appropriate for?

Attending Physicians Statement in Health Insurance Its primary purpose is to assist in the underwriting process, which involves evaluating the risk of insuring an applicant. Among the options provided, the most appropriate response is: At the request of the insurer to assist in the underwriting decision.

Who fills out APS?

It is written by your doctor, and the information contained in the APS varies and depends on what your insurer is looking for.

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.

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What is the purpose of an attending physician statement?

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.