Illinois Report Of Physician and Other Evaluators

State:
Illinois
Control #:
IL-NSKU-3537
Format:
PDF
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Description

Report Of Physician and Other Evaluators

The Illinois Report Of Physician and Other Evaluators is a document created by the Illinois Department of Human Services to provide information regarding the physical and mental status of a person. The report is used to assist in determining the person's eligibility for disability benefits from the state. The report is completed by a qualified physician or other evaluator and includes information about the person's medical history, physical and mental condition, and any prescribed treatments. There are two types of Illinois Report Of Physician and Other Evaluators: the Basic Form and the Supplemental Form. The Basic Form includes information about the person's medical history, physical condition, and any prescribed treatments. The Supplemental Form includes additional information about the person's mental condition and any psychological treatments. Both forms must be completed in order for the person to qualify for disability benefits.

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Illinois Report Of Physician and Other Evaluators