Once a psychiatric short-term disability claim is open, Sun Life uses GSTDFM-5145 to get periodic updates from the treating provider. The three-page questionnaire asks for mental status exam results from the last visit, progress with treatment, current DSM diagnosis, symptoms preventing the claimant's job duties, impairment level, medication changes, psychotherapy status and the target part-time and full-time return dates.
The treating behavioral health provider completes the whole questionnaire and signs with name and specialty. Section 1 identifies the claimant, employer and group policy number.
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Short Term Disability Provider Update Questionnaire
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Section 4 asks whether the provider and claimant have discussed return to work, whether it is one of the treatment goals and why not if it is not, what specific actions the provider is taking to support it, and the target return date for part-time and full-time work.
The provider rates the claimant's current degree of impairment as none, slight, moderate, marked or severe. That rating sits beside the description of specific symptoms that keep the claimant from performing the material and substantial duties of their occupation, with examples where possible.