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PA-1000 PS: Physician's Statement of Total Disability

Pennsylvania's Property Tax/Rent Rebate program accepts this physician's statement from disabled claimants who are not covered under the federal Social Security or Railroad Retirement Acts, or who cannot otherwise prove permanent and total disability. The physician applies the same standards those federal programs use. The claimant files it with the PA-1000 claim on paper or through the myPATH online application.

Who completes it

The claimant enters their name as shown on the PA-1000 and their Social Security number. The physician signs the certification, briefly describes why the claimant is permanently and totally disabled, and prints identification details including the National Provider Identifier.

Submitting and payment

How to submit it
Return the signed statement to the claimant, who includes it with the paper PA-1000 claim or the myPATH online application.
Who pays
PA-1000 PS lists no fee or billing code for the physician's statement.

Good to know

  • If the claimant applied for Social Security disability and SSA did not rule in their favor, the claimant is not eligible for the rebate, so this statement cannot substitute.
  • By signing, the physician agrees to provide medical reports or records showing diagnosis and prognosis, including signs, symptoms and laboratory findings, if the Department of Revenue asks.
  • The form is reissued for each tax year (the 2025 version is PA-1000 PS 04-25), and the information on it is confidential and used only to decide rebate eligibility.
  • The Department of Revenue extended the deadline for Property Tax/Rent Rebate claims to December 31, 2026.

Get the official form

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

Physician's Statement of Permanent and Total Disability

Official pagePDF

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 and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

Who needs a PA-1000 PS?

Disabled Property Tax/Rent Rebate claimants who are not covered under the federal Social Security Act or Railroad Retirement Act, or who cannot submit other proof of permanent and total disability. Claimants with SSA or RRB disability proof submit that instead. A claimant whose Social Security disability application was denied is not eligible.

What standard does the physician use on PA-1000 PS?

The physician determines permanent and total disability using the same standards the federal Social Security Act or Railroad Retirement Act use. The certification states that the claimant is the physician's patient and meets those standards, and the physician briefly describes the reasons for the disability.

Can PA-1000 PS be filed with a myPATH application?

Yes. The claimant can apply online through myPATH or on the paper PA-1000, and the physician's statement accompanies the claim either way. Use the version for the claim's tax year, because the department reissues the form annually.