Every other clinical form you fill in is one your profession designed. An attending physician statement (APS) is not. An insurer wrote the questions, set the format and owns the deadline, and your job is to answer it accurately out of a record written for an entirely different purpose.

Most physicians approach it the same way: disclose as little as possible, and reach for HIPAA's minimum necessary standard to justify it.

That rule does not apply here.

Here is a response template, a record preparation checklist, two worked examples, and what actually sets the scope of what you send.

Key Takeaway: An attending physician statement is a form an insurer sends to a treating physician, asking them to state a patient's diagnosis, treatment, objective findings, functional limitations and prognosis in support of a life, disability or long-term care claim. Two things surprise people. The scope of the disclosure is set by the patient's authorization, which must describe the information "in a specific and meaningful fashion" [1], rather than by the clinician's own judgment about necessity, because the Health Insurance Portability and Accountability Act (HIPAA) minimum necessary standard expressly does not apply to disclosures made pursuant to an authorization [2]. And there is a clock: for a disability claim governed by the Employee Retirement Income Security Act (ERISA), the plan must decide within 45 days, extendable twice by 30 days [3]. Sully.ai keeps the functional detail in the record that an APS later asks you to report.

What an Attending Physician Statement Is

The Only Form in This Series You Did Not Write

Here is the part no competing page states.

A SOAP note, a treatment plan, an admission note, a hospice certification narrative: every one of those is a document clinicians structure, for purposes clinicians understand, in a format the profession settled on.

An APS is somebody else's questionnaire.

Which produces a consequence worth sitting with. You cannot improve an APS at the moment you fill it in. By the time the form arrives, the quality of your answer has already been decided, months earlier, by whether your record holds numbers or adjectives.

If the insurer asks how far the patient can walk and your record says "ambulatory", there is no version of careful form-filling that recovers the answer. You will either write something vague or go back and measure.

Who Asks, and What They Are Deciding

Three requesters, deciding three different things.

Life insurers underwriting an application, deciding whether to offer cover and at what rating.

Disability insurers deciding whether a claimant meets the policy's definition of disability, which usually turns on function rather than diagnosis.

Long-term care insurers assessing benefit eligibility, which usually turns on activities of daily living (ADLs) or cognitive impairment.

None of this is new. The APS has been a standard step in insurance underwriting for decades and is written about as such in the medical literature [4]. What has changed is how little of the functional detail these forms ask for actually survives in a modern electronic record.

One honest note about who is reading this page. Search for "attending physician statement" and you will find results written for claimants, for insurers and for HR teams, because all of them look the term up. This page is written for the clinician who has one on their desk. If you are a claimant wondering why your claim is slow, the short answer is in the clock section below.

The Rule Most Physicians Get Backwards

Minimum Necessary Does Not Apply

Here is the instinct. An insurer asks for information about your patient, you feel protective, and you reach for the rule everyone remembers: disclose the minimum necessary.

That rule is real. 45 CFR 164.502(b)(1) requires a covered entity to "make reasonable efforts to limit protected health information to the minimum necessary to accomplish the intended purpose of the use, disclosure, or request" [2].

But the same section lists six situations where it does not apply, and the third one is this:

"Uses or disclosures made pursuant to an authorization under § 164.508." [2]

An APS disclosure made on a valid patient authorization sits squarely in that exception. Minimum necessary is not the governing test, and invoking it is not a defensible reason to answer a question narrowly.

This cuts both ways, which is why it is worth knowing rather than just being a technicality. You are not required to whittle the disclosure down. You are also not free to send whatever you like.

What Sets the Scope Instead

The authorization does.

A valid authorization must contain, at minimum: a description of the information to be used or disclosed "that identifies the information in a specific and meaningful fashion"; the name or other specific identification of the person authorized to make the disclosure; the name or specific identification of the person to whom it may be made; a description of each purpose; an expiration date or an expiration event; and the individual's signature and date [1].

The first of those is your boundary. The authorization has to describe the information specifically, and that description is the permission you are operating under.

So the practical rule is simple, and it is not the one most people apply:

Read the authorization's description. Answer within it. Do not volunteer beyond it.

Not because minimum necessary requires restraint, but because the authorization is the permission, and its description is where the permission ends.

If There Is No Valid Authorization

Then this route is not available, and the analysis is different.

The six core elements above are requirements rather than good practice, and an authorization missing one is not valid. The release of information article covers the full element list and the defects that void a signed form.

Worth knowing alongside it: the patient has a right of access to their own protected health information [5], so a claimant who wants to see what was sent about them generally can ask.

A boundary on this whole section. What follows from these rules in any specific disclosure is a judgment for you and, where it matters, your counsel or privacy officer. This page states what the regulations say. It does not advise on your case.

The Clock You Are Part Of

Forty-Five Days, Then Thirty, Then Thirty

There is no federal rule setting a deadline for the physician to return an APS. There is a hard one on the plan, and the two are connected.

For a disability claim governed by ERISA, the plan administrator must notify the claimant of an adverse benefit determination "within a reasonable period of time, but not later than 45 days after receipt of the claim by the plan" [3].

That may be extended by up to 30 days, provided the administrator determines the extension is necessary due to matters beyond the plan's control and notifies the claimant before the initial 45-day period expires. If a decision still cannot be rendered, it may be extended for up to a further 30 days on the same conditions [3].

A scope note.29 CFR 2560.503-1 governs employee benefit plans covered by ERISA. An individual policy bought outside an employer plan follows state insurance law instead, and the timetable will differ.

Why an Unreturned Form Shows Up in the Extension Notice

Here is the part that makes the clock personal rather than administrative.

Where an extension is necessary because the claimant has not submitted the information needed to decide the claim, the regulation requires that "the notice of extension shall specifically describe the required information", and the claimant must be afforded at least 45 days from receipt of that notice to provide it [3].

Read that again from the patient's side. The notice names the missing thing. Frequently, the missing thing is your form.

A claimant waiting on a disability decision is usually not being paid. That is the whole context in which an APS sits in a pile, and it is a reasonable argument for handling these faster than they typically get handled.

The Attending Physician Statement Templates

Two blocks, and neither is a form to send. The insurer supplies the form. What follows is a structure for composing the answers before you transcribe them, and a checklist for the record that makes the answers possible.

The Response Template

APS RESPONSE WORKING DOCUMENT

• Patient, date request received: (and the date you are completing it)

• Requesting insurer, claim or policy number: (as stated on the request)

• Authorization on file: (date signed, expiration date or event, and whether it is still in force)

• Scope as described in the authorization: (quote the description; this is your boundary)

• Diagnoses: (each with date of onset and the diagnostic code, and how it was established)

• Treatment history: (interventions with dates, including what was tried and stopped)

• Current medications: (with doses, and any that affect function or cognition)

• Objective findings: (each with a date and a value; imaging, laboratory, examination measurements)

• Functional limitations: (in measurable terms, matching the categories the form asks about; the same discipline that makes a nursing note usable later)

• Prognosis: (your clinical prediction, and the basis for it)

• Expected duration and review point: (how long, and when you would reassess)

• Restrictions and their basis: (what the patient should not do, and why)

• Capacity for their own occupation: (your assessment and the reasoning behind it)

• Date, signature and credentials: (the clinician attesting)

The functional limitations line is the one that decides whether the form comes back. Everything above it is usually already in the chart. That line often is not.

The Record Preparation Checklist

This is the one that actually matters, and it runs long before any form arrives.

RECORD READINESS FOR AN APS

• Are functional statements measured? (distances in feet or meters, durations in minutes, weights in pounds or kilograms; not "limited" or "reduced")

• Is function recorded at every visit? (rather than only at diagnosis, so a trajectory exists, the way hospice documentation has to show one)

• Is there a dated baseline? (a point that later measurements can be compared against)

• Do objective findings carry values and dates? (a result without a date cannot support a claim about timing)

• Is prognosis written down anywhere? (or does it exist only in your head, where an APS cannot reach it)

• Are restrictions recorded with their reasons? (a restriction without a rationale reads as preference)

Every item on that list is free to do at the visit and expensive to reconstruct afterwards.

Where Sully.ai Fits in Insurer Documentation

The useful thing to say here is narrower than usual, because the honest answer is that the work determining an APS answer happened long before the APS existed.

An insurer asks how far your patient can walk. You answer from the record. If every visit note for the past year says "ambulatory with a cane", there is no answer in there, and no amount of tooling at the moment of the request creates one.

Sully.ai's AI scribe, used across primary care and specialty practices, captures what you describe during the visit, so distances, assist levels and durations land in the note rather than being flattened into adjectives at the end of a clinic. That is upstream of the form, and it is the only place a documentation tool genuinely helps with this.

Two boundaries, and the first is a refusal rather than a limitation.

Nothing should draft an APS answer for a physician to sign. The statement is your own attestation about your own patient, and an insurer is making a financial decision about somebody's income in reliance on it. A drafted answer that a clinician approves is not the same document, and it should not be produced.

Prognosis is a clinical prediction and stays with you.It is the field insurers weigh most heavily, it cannot be derived from the record alone, and it requires knowing the patient.

Sully operates across 5,000+ providers, has delivered 50M+ hours of work, and prices each role 80 to 90 percent below the human equivalent [6].

Two Worked Examples

A Disability Claim for a Patient With Rheumatoid Arthritis

The form asks four functional questions. Here are the answers written from a record that holds numbers.

Walking: Can walk approximately 300 feet on level ground before stopping because of foot and knee pain. Recorded 14 August, unchanged 2 September. At diagnosis in March 2025 she walked 1 mile without stopping.

Lifting: Can lift and carry up to 5 pounds with both hands. Cannot grip a standard kettle handle with the right hand. Grip strength 11 kg right, 14 kg left, measured 2 September.

Sitting and standing: Can sit 30 minutes before needing to change position. Can stand 10 minutes. Both recorded at the 2 September visit.

Hand function: Cannot fasten buttons or manipulate a keyboard for more than 10 minutes. Swan neck deformity at the right index and middle fingers, documented on examination 14 August with photographs in the record.

Objective findings supporting these limitations: Rheumatoid factor positive and anti-CCP positive, 4 March 2025. Radiographs of both hands 11 June 2026 showing periarticular erosions at the second and third metacarpophalangeal joints bilaterally. DAS28 of 5.4 on 2 September, indicating high disease activity despite methotrexate and adalimumab.

Prognosis: Disease activity remains high on combination therapy after 14 months. A third biologic is planned, and the realistic expectation is partial improvement in inflammation without recovery of the established erosive joint damage. I would not expect her hand function to return to a level permitting sustained keyboard work.

Now the same four questions answered from a record that holds adjectives:

Patient has significant functional limitations due to rheumatoid arthritis. Ambulation is limited. Grip strength is reduced. Prognosis is guarded.

Every word of that is true and none of it decides anything. An insurer reading the second version has no basis to grant the claim and no basis to deny it, which in practice means a request for more information and another 30 days.

A Long-Term Care Claim Turning on Activities of Daily Living

Long-term care policies usually pay when the insured needs substantial assistance with a set number of ADLs. So the form asks about them individually, and the useful answer is an assist level rather than an impression.

Bathing: Requires hands-on assistance to enter and exit the shower and to wash his lower legs and feet. Can wash his upper body seated. Assessed 8 September.

Dressing: Requires hands-on assistance for socks, shoes and lower body garments. Manages upper body clothing with set-up only.

Transferring: Requires one-person hands-on assistance from bed to chair. Uses a transfer belt. Cannot rise from a standard chair without assistance. Was transferring with supervision only in February 2026.

Toileting: Requires hands-on assistance with clothing management and perineal hygiene. Continent of bladder and bowel.

Eating: Independent with set-up. No assistance required.

Cognitive status: Recorded as a full mental status exam would put it. Oriented to person and place, not consistently to time. Requires prompting for medication and cannot manage his own finances. Montreal Cognitive Assessment 19 out of 30 on 8 September, down from 24 out of 30 in November 2025.

Note what makes that answerable: each ADL has an assist level, several carry a comparison to an earlier date, and the cognitive claim has a scored instrument behind it. None of that is available unless somebody recorded it at the visits.

What Gets an APS Returned

Adjectives where the form asks for measurements. "Limited ambulation" is not an answer to "how far can the patient walk". Give the distance.

A prognosis left blank or filled with one word. "Guarded" is the most common answer and carries almost no information. State what you expect to happen and why.

Answers beyond the authorization's described scope. The authorization has to describe the information specifically [1]. Going past that description is not protected by the fact that minimum necessary does not apply.

A delay long enough to appear in an extension notice. Where the extension is because required information is missing, the notice has to specifically describe it [3]. Your form gets named.

FAQ

What is an attending physician statement?

A form an insurer sends to a treating physician requesting a patient's diagnosis, treatment history, objective findings, functional limitations and prognosis, in support of a life, disability or long-term care claim. The physician answers it from the medical record and signs it as their own statement.

Who fills out an attending physician statement?

The treating clinician, or someone in the practice with access to the record and the standing to attest to it. It is signed rather than simply produced, because it is an attestation about the patient rather than a records release.

Does HIPAA minimum necessary apply to an attending physician statement?

Not where the disclosure is made pursuant to a valid authorization. 45 CFR 164.502(b)(2) lists six situations where the minimum necessary standard does not apply, and disclosures made pursuant to an authorization under 164.508 are one of them [2]. The authorization's own description of the information sets the scope instead [1].

How long does a physician have to return an attending physician statement?

No federal rule sets a deadline for the physician. One applies to the plan. For an ERISA-governed disability claim the decision is due within 45 days of receipt, extendable by 30 days and then a further 30 on stated conditions [3]. A pending APS is frequently what triggers those extensions.

Can an AI scribe help with an attending physician statement?

Not by writing it, and it should not. The statement is the physician's own attestation and an insurer relies on it. What helps is upstream: Sully.ai captures distances, assist levels and durations at the visit, so the record can answer the questions the form will eventually ask.

Sources

[1] U.S. Government Publishing Office — 45 CFR 164.508, Uses and disclosures for which an authorization is required. https://www.govinfo.gov/content/pkg/CFR-2023-title45-vol2/xml/CFR-2023-title45-vol2-sec164-508.xml

[2] U.S. Government Publishing Office — 45 CFR 164.502, Uses and disclosures of protected health information: general rules. https://www.govinfo.gov/content/pkg/CFR-2023-title45-vol2/xml/CFR-2023-title45-vol2-sec164-502.xml

[3] U.S. Government Publishing Office — 29 CFR 2560.503-1, Claims procedure. https://www.govinfo.gov/content/pkg/CFR-2023-title29-vol9/xml/CFR-2023-title29-vol9-sec2560-503-1.xml

[4] British Columbia Medical Journal— The attending physician's statement, an important step in many insurance applications. https://bcmj.org/news/attending-physician-s-statement-important-step-many-insurance-applications

[5] U.S. Government Publishing Office — 45 CFR 164.524, Access of individuals to protected health information. https://www.govinfo.gov/content/pkg/CFR-2023-title45-vol2/xml/CFR-2023-title45-vol2-sec164-524.xml

[6] Sully.ai — AI Medical Scribe. https://www.sully.ai/medical-scribe