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Law Educator, Esq.
Law Educator, Esq., Lawyer
Category: Family Law
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Experience:  Experienced attorney: Family law, Estate Law, SS Law etc.
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Who completes attending physician form if multiple doctors?

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This question is for a lawyer familiar with disability insurance law: Do disability companies want attending physician's statements from all physician's involved, or just one physician? In a hospital, I think only one physician is really the "attending physician," although the attending physician might consult with specialists. I do not know though if a disability company would expect an orthopedist to be the attending physician even if he was not involved in treating the problem initially. I have a private, individual regular occupation policy with a residual disability clause. My PCP, an internist, has been following me for months, for a combination of problems, one of which included my shoulder. She is the only doctor whom would know the history of all the various medical problems and she also was the first informed. She completed disability forms. However, the original period of disability began a long time ago prior to my having any problem with my shoulder. The shoulder problem was expected to resolve, but as it has taken a while I was referred to an orthopedist. The orthopedist will not know the history of how this overlapped with another problem, but he is very willing to complete forms as well, even though the PCP did provide an attending physician's statement. The policy covers overlapping and concurrent disabilities. The orthopedist referred me to PT which will start next week. The main question: Since my PCP, an internist, completed the attending physician's statement for a shoulder injury, is it necessary for the orthopedist to complete an attending physician's statement? I am wondering if disability company woul require it to be an orthopedist, but he did not treat me for many months when I had the problem. Are there potential pitfalls if both complete a statement, or if the orthopedist does not? I will be signing a release so that the disability company can get all medical records from all people involved in treating me. The disability company told me once they receive all information they will determine if this is a separate claim or if the previous claim should be reopened.

Submitted: 2 years ago.
Category: Family Law
Expert:  Law Educator, Esq. replied 2 years ago.
Thank you for your question. I look forward to working with you to provide you the information you are seeking.

When a person has multiple disabilities causing their need for the insurance payments, for each disability the doctor with the specialty in that disability is the preferred party to fill out and submit the insurance reports. Specialty treating physicians carry more weight with the insurer than a doctor who does not specialize in the disability the patient has.

If you have a shoulder issue that the orthopedist is treating, then the orthopedist should be filing forms regarding only the shoulder matter, even if your internist is writing reports including your shoulder injury, because the specialist has more experience.

This is important when the insurance company is denying a claim, but if the insurance company is not denying the claim, the one treating physician's report about everything is fine.

However, if your shoulder injury is going to keep you out or restrict you beyond your surgical problem, THEN you need to switch over to the specialist to submit a report to justify the new injury as the specialist in that type of injury.

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Law Educator, Esq., Lawyer
Category: Family Law
Satisfied Customers: 104028
Experience: Experienced attorney: Family law, Estate Law, SS Law etc.
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