Get Metlife Attending Physician Statement

Filling out the Metlife Attending Physician Statement online is a crucial step in assisting with a disability determination. This guide provides clear, step-by-step instructions to help you complete the form accurately and efficiently.

Follow the steps to successfully complete the form.

1. Press the ‘Get Form’ button to access the Metlife Attending Physician Statement and open it in your preferred document editor.
2. Begin by filling in the Claim Number and your personal details, including your Social Security Number, name, occupation, employer, and group report number. Ensure all mandatory fields are completed.
3. Authorize the release of information by signing where indicated, including your date of birth and the date you are completing the form.
4. The attending physician will need to complete their section. They should provide a detailed history, symptom evaluation, and indicate if the condition is related to work, along with treatment dates.
5. Fill out the diagnosis and treatment sections. Include the primary and secondary ICD-9 diagnosis codes, subjective symptoms, and objective findings, and attach any relevant documentation.
6. Have the physician assess the patient's psychological functioning and physical capabilities. They should check the applicable boxes and provide additional remarks as needed.
7. Complete the prognosis section, specifying if the physician advises a return to work and any applicable restrictions.
8. Once all sections have been filled out accurately, the physician should sign and date the statement, providing their contact details and fax number.
9. Retain a copy of the completed form for records. Fax the claim form to expedite the process, ensuring to keep the original safe.

Complete your documents online today to ensure a smooth submission process.