Is It Unusual for a Disability Insurance Company to Request an Attending Physician Statement (APS) Once a Year?

Disability insurance companies require disability claimants to prove that they are disabled. All disability companies require claimants to have their treating physician(s) to complete an Attending Physician Statement Form (APS). Some disability companies require the APS to complete monthly while others require the form every two, three, six, or twelve months. The frequency requirement varies based upon the medical condition and the carrier handling the claim.

We recently received a question on the blog, dealing with this issue:

I am now being paid under any occ. The disability insurance company seems to only be requesting that an APS be filled out once a year by my main doctor. No requests are being made for recent medical records. Both of my treating doctors have told me no requests have been made. Is this customary? I suppose this might also depend on the particular insurer as they all have slightly different claim handling procedures. Thanks for your website. I read it daily.

John

John,

You do not need to be concerned that the carrier is only asking for an APS once a year. Most disability companies will request your medical records every few months even if they don’t ask for an APS. We request records for our clients at least 3 times a year to make sure everything supports the claim. We also limit the scope of the medical authorisations from disability companies so that we know when the disability company is requesting records. With some disabling conditions, the disability companies will only check medical records once a year. It is also possible that your claim may be on auto pay and the disability company forgot about you. This happens rarely. You need to make sure you continue your medical treatment regularly.

Leave a comment or ask us a question

There are 4 comments

  • Jason, the carrier can request any information it deems necessary to properly investigate your claim. Typically, they will require that the attending physician(s) complete paperwork providing information beyond what is in the medical records. I suggest you contact our office and speak with one of the attorneys to address the specific questions you have regarding your situation.

    Jay SymondsJan 25, 2020  #4

  • I have the same question and have been on a LT disability policy that is for a CPA. You stated they can ask for a physician progress report but what if my doctor wishes not to fill it out, my benefits will stop? I continue to go to treatment and send in my paperwork. I put the information of my doctor, appointments etc. Also, my policy says nothing about termination of benefits due to not filing this form. It’s a 2001 policy until age 65. I just wanted to see my options. Thank you.

    JasonJan 25, 2020  #3

  • Dee Dee, unfortunately, yes. Disability benefits are determined on a month by month basis, which means they can require updated information each month to certify disability. Typically, the frequency of requests will reduce to every other month, or at the very least only require an update from your doctor every three months. If you would like to discuss your claim in detail please feel free to contact our office.

    Stephen JessupMay 29, 2019  #2

  • I am a Long Term Disability claimant with Lincoln Financial Group, I signed a medical release form however they are making monthly claims to include all medical records; physicians and psychiatric statement from my providers on a monthly basis. Is this legal? Can they badger both my providers and myself?

    Dee DeeMay 29, 2019  #1

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