The Attending Physician Statement MetLife form supports disability insurance claims by providing direct medical assessments from the treating physician. The form has two main parts: a patient section and a physician section.
The patient section requires your name, occupation, Social Security number, and a signed authorization allowing your doctor to release medical information to MetLife. Complete this part before presenting the form to your physician.
The physician section covers clinical details including your primary and secondary ICD diagnosis codes, current treatment plan, subjective symptoms, and objective findings. The physician evaluates your physical capabilities (lifting, carrying, climbing, and sitting tolerance) and psychological function. This assessment helps MetLife determine your work capacity and evaluate your claim.
The form includes a fraud warning that applies under both federal and state-specific laws. Submitting false or misleading information has serious legal consequences for all parties.
For related forms you may need during the claims process, see the long-term disability form or the Aetna attending physician statement for employer-sponsored plans.
| Question | Answer |
|---|---|
| Form Name | Attending Physician Statement Metlife Form |
| Form Length | 4 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 1 min |
| Other names | metlife attending physician statement form, 5320 statement, metlife 5320, metlife physician statement |