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Co-operators Initial Disability Medical Statement

Co-operators Life lists the industry Initial Disability Insurance Medical Statement among the attending physician statements for its group disability claims, printed under its own code GL2338 (09/25). Its last page adds the Disability Claims Department's mail, fax and email contacts. A Co-operators Disability Case Manager uses it, with the job description and employee and employer information, to decide whether the employee is totally disabled.

Who completes it

The patient completes Section 1 (patient information, medications and consent). The attending physician or other medical provider completes Section 2, the Medical Statement, and signs with their specialty and licence or registration number.

Submitting and payment

How to submit it
Return it to Co-operators' Disability Claims Department by mail, fax or email; when the employee files online through Benefits Now, they can request the statement electronically and the physician submits it online.
Who pays
As printed at the top of the first page, the patient is responsible for any fees related to completing the statement.

Good to know

  • Co-operators has separate attending physician statements for mental health conditions (GL2554 series) and asks that the form be chosen by primary diagnosis.
  • Co-operators' employer guide asks for disability claims four to six weeks before the end of the elimination period.
  • Most Co-operators policies define total disability by the duties of the employee's own occupation, which is why the employer supplies a job description.
  • The employee files the Disability Benefits plan member form, and the employer files the short- or long-term disability plan sponsor statement.

Get the official form

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

Initial Disability Insurance Medical Statement

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

Can the Co-operators medical statement be completed online?

Yes, when the claim is filed online. According to Co-operators' employer guide, an employee submitting a disability claim online can ask for the attending physician statement electronically, and the physician then completes and submits it online. Otherwise, return the paper version by mail, fax or email.

Will Co-operators tell the employer the diagnosis?

No. Co-operators' employer guide says it will not give the employer any personal information about the claim, including the reason for the absence. It can confirm whether a claim was approved or declined, payment dates, requests for more information and estimated return-to-work dates.