Insurance form
Attending Physician Statement (APS)
An attending physician statement is the insurer's request for the treating clinician's facts: diagnoses, dates, treatment, and current function. Life, disability, and critical-illness carriers each print their own APS. There is no single Canadian APS. Complete the PDF the patient or the carrier sent.
What an APS is asking
The carrier is reconstructing a medical timeline to decide underwriting or a claim. They want onset, first visit for this problem, investigations, specialists, current status, and whether you are still the most responsible clinician. They are not asking you to approve the policy.
Use the carrier's form. A clinic summary letter that ignores their boxes will be followed by the same form again. If a question is outside your knowledge, write that. Guessing a date of first symptoms from a problem list you inherited is how statements get challenged later.
Authorization first
Do not send an APS without a signed authorization that covers this carrier and this purpose. Keep the authorization with the copy in the chart. Fees are billed to the patient or the carrier per your clinic policy, not per this page.
Who completes it
The attending physician or nurse practitioner who has the longitudinal file. A specialist APS should come from that specialist for their disease. Do not complete a cardiology APS from a family chart because the cardiologist is slow — say you are not the attending for that condition.
How to complete the statement
- How long you have known the patient and date of last visit.
- Diagnoses relevant to this claim, with onset as supported by the chart — not as hoped by the broker.
- First consultation for this problem, and who else is treating it.
- Objective findings and investigations, with dates.
- Treatment, response, adherence, and complications.
- Current function if the form asks (work, ADLs). Leave work capacity blank if you have not assessed it.
- Prognosis only as far as you can defend. 'Permanent' on a six-week file is a gift to a later dispute.
- Any material inconsistency between the patient's application and your chart, stated as fact.
Worked example (fictional)
Family medicine APS — breast cancer, life insurance claim
Fictional 51-year-old. Do not copy into a real APS.
Attending FP since 2018. Last visit 12 Aug 2026. Condition: invasive ductal carcinoma left breast, diagnosed 4 Mar 2026 (core biopsy). First presentation to this office 18 Feb 2026 for a lump noticed 2 weeks prior. No prior breast complaints in this chart. Treatment: lumpectomy 28 Mar 2026, sentinel node negative, currently adjuvant radiation (oncology: Dr. K. Singh). Medications: letrozole started July 2026. Function: working reduced hours (office, 4 h/day) as of last visit. Fatigue, no restaging disease. Prognosis: defer to oncology for disease-specific prognosis. From a primary-care standpoint, expected to complete radiation this fall; I am not certifying life expectancy. I have not completed a separate LTD form. Authorization on file for this carrier only.
Why carriers send a second APS
- Blank dates, or dates that contradict the application.
- Copy-paste of the whole EMR with no answers in the boxes.
- Certifying a specialty opinion you do not hold.
- Missing authorization.
- Illegible handwriting on a form that will be scanned twice.
Draft the APS from the chart and visit
In Scribeberry, open Forms, search for attending physician statement, or upload the carrier's current PDF. Generate from the encounter and your notes, then edit every field before you sign. Scribeberry does not pre-map this form. You still review and sign.
Frequently asked questions
Is an APS the same as an LTD medical form?
Sometimes the carrier uses one PDF for both. Often the LTD form is longer and focused on work capacity. Complete the document you were sent. Do not assume one signature covers the other product.
Who pays for an APS?
Usually the patient or the carrier, per the form and your clinic policy. It is not an insured provincial visit unless a schedule says so.
What if I disagree with the patient's application?
Write your chart. You are not obliged to reconcile their answers. Material differences should be visible.
Does Scribeberry send the APS to the insurer?
No. Scribeberry helps you complete the PDF. You or the patient return it to the carrier. Keep a copy in the chart.
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