The physician's report Retraite Québec's medical team uses to decide whether a person applying for the QPP disability pension, or being medically reassessed, meets the disability requirements of the Act respecting the Québec Pension Plan. The applicant fills sections 1 and 2 and gives you the form with its notice page. You document history, examination, investigations, diagnosis, treatment and work capacity, then send it with supporting reports.
A physician completes sections 3 to 12 and signs the declaration; Retraite Québec requires a general practitioner or specialist, though an optometrist may sign in cases of legal blindness. The applicant first completes section 1 (new application or medical reassessment) and section 2 (identity) and writes their social insurance number at the top of each page.
Completed by the applicant before the form reaches you: whether this is a new application for a disability pension or a medical reassessment, then name, date of birth, health insurance number, address and telephone, with the social insurance number at the top of each page. The applicant also gives you page 1, which carries the notice to the physician, the billing rules and the legal definition of disability you are reporting against.
State how long the person has been your patient, list relevant medical history, and describe the current physical or mental disorders that prevent work: symptoms, onset, course and treatment to date, with all pertinent dates. Retraite Québec's guide asks for a complete history, including how and when the condition began, and notes that the patient's or family's statements must be reported but cannot on their own support a diagnosis. Use section 10 if you need more space.
Enter the examination date, height, weight and blood pressure, then describe the clinical signs of the main health problems under eleven headings, from general appearance (posture, gait) through the heart (with functional class), spine and extremities, nervous system and mental health. The guide puts signs ahead of symptoms: deficits must be ones you observed, consistent from one exam and examiner to the next, and for mental disorders it wants your mental status findings, not only the patient's complaints.
List the investigations done and their results, and enclose the reports, such as X-rays, pathology, exercise stress tests or respiratory function tests. The guide says test results should corroborate the clinical signs you report, not the reverse, and that even a malignant neoplasm must be confirmed by histopathology reports and a detailed clinical examination describing how the disease affects the patient's activities.
Point Retraite Québec to other medical documents it could consult: files at the CNESST, the SAAQ or an insurance company (name it), hospital stays with approximate dates, and other institutions such as a rehabilitation centre, physiotherapy clinic or CLSC. Where they exist, attach hospitalization summaries, specialist consultation reports and reports sent to an insurer or to agencies such as the CNESST, SAAQ or MTESS; they support your report but do not replace it.
The diagnosis must be certain or at least very probable and rest on adequate investigation; the guide refers to ICD-10 criteria for physical conditions and DSM-5 for mental disorders. Base the prognosis on irreversible findings or on repeated failure of treatment given according to accepted practice; a patient is not expected to undergo experimental or high-risk treatment. When several conditions combine, describe the resulting limitations rather than listing diagnoses.
Say whether the person takes medication, with dosage and frequency, whether they are receiving or have received other treatments, and whether further consultations, investigations or treatments are planned. Retraite Québec lists the history of treatments received or planned and the response to treatment among the required contents of the report, and its guide notes that work capacity can only be assessed fairly after adequate investigation and treatment.
Complete this even if the patient is retired. Say whether the person is fit to drive, whether you advised stopping or reducing work (why and for how long), whether they can return to their usual work or end a reduction in hours, whether, from a strictly medical standpoint, they can do other work, and since when their condition has prevented working. These answers feed the two tests: any full-time work, or usual work from age 60.
Section 10 holds anything that did not fit elsewhere; on extra sheets, write the applicant's social insurance number. In section 11, indicate any medical information that cannot be shared with your patient without risk of serious harm, and when it could be. The guide also asks the report to flag any inconsistency between the functional incapacity claimed and the deficits you observed.
Give your name, licence number, address, telephone and fax, and tick general practitioner or specialist (with the specialty). You declare that the information is true and complete and that the patient's condition is as you observed it at the clinical examination, then sign and date. The form lists a line, for physicians only, to reach a Retraite Québec physician with questions.
Download the current version from the source each time; forms change without notice.
Medical Report - Québec Pension Plan
Rapport médical – Régime de rentes du Québec
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Sources for this guide
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A general practitioner or specialist physician. Retraite Québec makes one exception: in cases of legal blindness, an optometrist may sign. Reports from a psychologist, physiotherapist, occupational therapist, speech-language pathologist, social worker or other professional should be attached when relevant, but they do not replace the physician's report.
The clinical examination and complementary tests are billed to the RAMQ as insured services. Any fee for writing the report is the patient's. When Retraite Québec requests a medical report for a reassessment, it reimburses the patient on presentation of the original medical invoice, and it pays for any expert assessment it orders, including the patient's transportation costs.
Yes. Retraite Québec publishes it in French (B-076) and English (B-076A), both dated December 2024, as fillable PDFs that accept an electronic signature. Its detailed guide for physicians, Guide des médecins: L'invalidité dans le Régime de rentes du Québec, is published in French only.
Retraite Québec has to ask for more information whenever the medical evidence is judged unsatisfactory, and its guide says any delay in answering slows the patient's file considerably. Its physicians review each file individually; the assessment is not automated. With the person's authorization, it may also request progress notes, hospital or CLSC records, absence or pharmacy records, or a functional capacity evaluation.