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SISIP 6E: LTD Attending Physician's Statement

Canadian Armed Forces members claiming SISIP long-term disability on release complete the 20-page Long Term Disability Claim Form, SISIP Financial 6E, under Manulife group policy 901102. Its last five pages are the Attending Physician's Statement, which gives Manulife objective information on functional abilities so it can compare the impairment with the requirements of various occupations.

Who completes it

The member completes Part A, an authorization releasing information to Manulife, SISIP FS and the Group Master Policyowner, and takes it to the treating physician. The treating physician completes Part B.

Submitting and payment

How to submit it
The physician sends the completed statement and supporting records directly to Manulife, Attention SISIP Services, in the pre-paid envelope provided or by mail.
Who pays
The form states that the patient or claimant is responsible for any fee for completing this and any future Attending Physician's Statement.

Good to know

  • The completed claim must be received within 120 days of the member's date of release from the Canadian Armed Forces.
  • Part B asks you not to use subjective descriptions such as pain in the diagnosis, and to list objective clinical findings and investigation results with dates.
  • Physical function is classed from 1 (heavy occupational activities) to 5 (not capable of any gainful employment); psychiatric function from 1 to 4.
  • Manulife asks for test results, clinical notes from the first visit for the present condition, and specialist reports, and uses the statement to schedule future medical updates.

Get the official form

Download the current version from the source each time; forms change without notice.

Long Term Disability Attending Physician's Statement (APS)

Official pagePDF

Fill it with Vero

Upload the fillable PDF once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

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How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms change without notice, so download the current version from the official page before you fill it in.

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Frequently asked questions

Where does the physician send the SISIP Attending Physician's Statement?

Directly to Manulife, Attention SISIP Services, in the pre-paid envelope provided or by mail. The member's package checklist also refers to submitting the APS portion to the Medical Officer, and members can ask their DND Case Manager's office for pre-paid envelopes.

What does section 7 of the SISIP APS ask?

Whether the patient is medically fit to take part in a vocational rehabilitation program or return to work, whether they have expressed a desire to return, what is needed for a return to their own or another occupation, and their specific restrictions and limitations.