Periodic physician update on an ongoing HBT long-term disability claim (LTD maintenance).
- Completed by
- Attending physician
- Issued by
- Healthcare Benefit Trust (claims adjudicated by Canada Life)
- Format
- Language
- English
HBT LTD Attending Physician's Statement (BC)
BC health care, community social services and public sector employees covered by Healthcare Benefit Trust plans claim long-term disability with this statement. The Trust is a not-for-profit employee life and health trust, and its claims-paying agent, Canada Life, assesses the claim. HBT's note to doctors says the claim can only be assessed once all the medical information has been received.
Who completes it
The claimant signs the authorization releasing information to Canada Life and the Trustees. The attending physician completes the nine numbered sections, from primary diagnosis to additional information, and strikes out areas that do not apply.
Submitting and payment
- How to submit it
- At the physician's discretion, give the form to the patient, mail it to Canada Life, or email it to the appropriate Canada Life Disability Management Services office in Calgary, Langley or Vancouver.
- Who pays
- The claimant's authorization states that the claimant is responsible for any charges for completing the form.
Good to know
- Attach copies of all clinical notes, consultation reports, test results and functional testing supporting the condition from the date it became disabling to the present.
- Section 5 rates 16 functions, including judgement, concentration, driving, sitting, lifting with a maximum weight, dexterity and vision, from none to severe.
- Section 6 asks whether clinical findings are proportional to the complaints and, if not, whether a psychiatric assessment or treatment would be useful.
- Canada Life offers rehabilitation services at no charge where medically appropriate, and the form asks whether your patient would benefit from them.
Get the official form
Download the current version from the source each time; forms change without notice.
Attending Physician's Statement
Fill it with Vero
If your copy of the form is a fillable PDF, upload it 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.
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.
Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.
Frequently asked questions
Which plans use the HBT Attending Physician's Statement?
HBT lists the same statement for its Healthcare Provincial Union, CSSEA Provincial Union, Non-Union (Healthcare and CSSEA), Public Sector and Non-Provincial Union plans. The form header names policies for HBT, the Joint Community, Joint Facilities and Joint Health Science Benefits Trusts, and CSSEA.
Can my patient get a copy of the completed statement?
Yes. The form states that copies of it and other medical reports will be released to the patient when the patient requests them in writing. The back page can be used to expand on any heading or add information relevant to the claim.
What does HBT ask doctors to send with the statement?
HBT's information sheet for doctors asks you to complete the statement as soon as possible and attach all relevant test results, x-ray reports and specialists' reports that support the diagnosis. Without complete medical information, Canada Life cannot assess the claim.