Are you looking into disability forms in Canada? Being immobilized by a disability and rendered unable to work can be both socially and financially devastating, not to mention all the other cascading consequences that can arise when you’re physically or psychologically unfit to go to work.

For people with employer-supported disability insurance, or those seeking to go on government assistance for their disability, making a claim can hinge upon the cooperation of a doctor or a nurse practitioner willing to support their claim. 

Some people seeking benefits after becoming disabled, hit a snag when they go to their doctor seeking help, finding them unwilling to fill out the requisite forms to get their disability claim approved.

But is that even legal? Can a doctor in Canada refuse to fill out disability forms? And what recourse do people have if they find themselves unable to work while at the same time unable to find a doctor willing to support their claim for disability benefits? 

Whether making a claim for disability benefits with a government or private insurance company, having the support of doctors and other healthcare professionals is paramount for patients who can no longer go to work.

For example, the government of BC has a form online for physicians to fill out on behalf of patients seeking disability benefits. 

Attending Physician’s Initial Statement

The onus to complete disability forms falls mostly upon employees, including any charges or costs associated with the forms, and carries strict deadlines for completion before a claim is considered “abandoned.”

But doctors, according to the B.C. government, play a vital role in peoples’ claims for long-term disability and must fill out what’s known as an “Attending Physician’s Initial Statement.” 

The form requires doctors to fill out several pages detailing the patient’s situation and history, including the date when the symptoms or catalyzing event underlying the disability claim occurred.

It also requires them to disclose the dates and frequency of doctor visits for the condition for which they’re claiming a disability and asks whether it’s related to a patient’s job. 

Unable to work due to their medical condition

The form asks if the disability claimant has ever had a “similar condition” as well as the exact date when someone was rendered unable to work due to their medical condition. More detailed information is also required, including a doctor’s primary and, if applicable, secondary diagnosis of a patient’s disabling condition.

Doctors have to fill out a field for the condition’s “most disabling symptoms,” and attach copies of “objective signs” such as EKG reports, x-rays, or lab test results. Physicians are also asked about their expectations of how long the patient will recover and eventually return to work. 

Speak to a disability attorney

Physicians who fill out these forms also need to attach a whole host of other information, including medical tests, x-rays, and any specialist reports related to the diagnosis that underlie the claim for disability benefits.

The B.C. government’s physician’s statement also reminds doctors that patients seeking disability benefits are going through a “difficult time,” stating that doctors can “greatly assist” in the process of reviewing a disability claim by finishing the forms promptly and sending them in, while also formulating a rehabilitation plan to get the patient back to work as soon as they’re able. 

The doctor’s statement to support a disability claim also must include details of treatment and rehabilitation plans and a declaration that a patient follows any treatment plan recommended by their physician.

Disability forms in Canada

The doctor, when filling out the form, also must describe their patient’s “functional limitations,” rating them from mild to moderate to marked to the extreme. The list of functional limitations includes cognition, speaking, hearing, touch (sensation), psychological, driving, walking, standing, climbing, sitting, bending, and lifting, as well as details about a patient’s physical dexterity and vision.  

Though it may seem like standard practice for doctors to fill out disability paperwork for their patients, many people find that their doctors are reticent or unwilling to fill out the forms required to complete their disability claim for benefits.

This could be for any number of reasons. Filling out disability forms, especially for patients with complex conditions, could be quite time-consuming for an already overworked doctor. 

Disability insurance companies

They could have dozens of patients waiting in line for primary care, and the last thing they want to do is take up precious hours in their day filling out paperwork when people are in their medical office waiting room in need of care.

While it may be understandable and reasonable for a doctor to want to spend the bulk of their day caring for patients rather than doing paperwork, that’s cold comfort to anyone experiencing a debilitating condition preventing them from going to work and earning income. 

Other reasons for a physician’s refusal to sign off on disability forms could be more serious, such as the concern surrounding insurance fraud or potential dishonesty. 

In some places, fraud with insurance programs runs into the billions each year, with many of those perpetrating the frauds wearing white lab coats and stethoscopes around their necks. 

A doctor named Dr. George David and an accomplice were indicted for conspiracy to commit mail fraud tied to a scheme to defraud a Disability Insurance Program. The program gave recipients benefits to replace wages if they were deemed unable to work due to sickness, injuries, or if someone was pregnant.

What to do if your doctor won’t fill out a disability Medical Report?

To be eligible under the state program, patients seeking benefits needed forms from a doctor to support their claim. David’s accomplice Linda Nguyen, the government claimed, had been on its radar for nearly 20 years and would allegedly charge people who weren’t actually disabled fees for assisting them with their fraudulent claims.

The doctor, in turn, would provide the fake disability certification forms to the non-disabled patients who then filed for benefits under the state program. 

But Nguyen and David’s case pales in comparison to the case of a psychiatrist years earlier. The case of Dr. Fernando Mendez-Villamil was particularly egregious. The doctor’s activities back in 2009 had raised the ire of a lawmaker, who raised the alarm about how this one man was responsible for writing nearly 100,000 prescriptions for patients.

Though he was eventually prohibited from insurance policies, the doctor reportedly continued to make thousands of fraudulent claims by using an “elaborate network” involving kickbacks bribery and payoffs enabling hundreds if not thousands of fake Social Security disability claims.

Mendez-Villamil was apparently able to keep his scheme going for years, ducking multiple agencies who could never prove wrongdoing on his part, that is until a veteran investigator doggedly pursued him before putting him away. 

Disability forms in Canada

The investigator found the psychiatrist was seeing up to five dozen patients a day, billing the system nearly a million dollars a year, even though he was the only doctor on staff at his practice.

Investigators found the psychiatrist’s patients were not only being prescribed all manner of drugs billed to the government but also receiving disability benefits under the federal Social Security program. Two of the “disabled” patients, they found, were working as dancers at a strip club. 

Eventually, with the help of a confidential informant and the Federal Bureau of Investigation, the psychiatrist was confronted with a mountain of evidence against him and his scheme that lasted more than a dozen years.

Mendez-Villamil ended up pleading guilty to healthcare-related fraud, was ordered to pay back more than $50 million and was sentenced to more than a dozen years in prison. 

Such egregious abuses of the disability benefits system may be costly and somewhat rare. Still, they have the potential effect of casting a pall of suspicion over anyone who tries to access benefits legitimately.

Patients with real disabilities may come up against doctors who are reluctant to sign off on disability forms for fear of being accused of health care fraud. In those cases, a patient’s only other option may be to seek out a new doctor with a second opinion on their condition.

Get another medical opinion

Failing that, people who feel they’re disabled and unable to work may find themselves with no other choice than to find a disability lawyer or disability law firm to take on their case.

A disability lawyer can likely help gather medical evidence and obtain a second medical opinion to support your claim for either long-term or short-term disability benefits or represent you in case of a dispute over your disability insurance claim. 

There are dozens of conditions that may entitle someone to disability benefits, whether they’re work-related injuries mental illnesses or physical impairments due to car accidents or other personal injuries. Those conditions can include: 

• Chronic back pain (sciatica, spinal cord injuries, etc.)
• Depression, bipolar, anxiety or other mood-related disorders
• Brain injuries
• Carpal tunnel syndrome
• Chronic fatigue
• Crohn’s disease or other gastrointestinal conditions (irritable bowel syndrome, etc.)
• Fibromyalgia
• Heart conditions 
• Migraines
• Joint conditions and muscle-related pain
• Chronic conditions including lupus or Lyme disease
• Multiple sclerosis or amyotrophic lateral sclerosis (also known as Lou Gehrig’s disease)
• Arthritis
• Sleep disorders (sleep apnea, chronic insomnia, etc.)
• Cataracts and other vision-based impairments

Fill out disability forms in Canada

Your doctor or nurse practitioner assigned to assist you with your health-related problems may refuse to fill out the needed paperwork to get your disability insurance claim rolling, and they may have many reasons for doing so. In those cases, some patients may find themselves feeling unsupported by the medical establishment when seeking disability benefits. 

Federal laws in Canada exist to ensure that disabled workers are treated fairly and equitably by both governments and employers. But when it’s a doctor who refuses to fill out the needed paperwork to support a claim for disability, many people may not know what to do next.

If you find yourself without the proper doctor support for your disability claim, and a second medical opinion isn’t easy to come by, consulting with a disability lawyer is likely your next best option.  

We hope you found this guide on disability forms in Canada helpful.