PEERS of Missouri Attending Physician Statement

Missouri school employees in PEERS, the Public Education Employee Retirement System for non-certificated staff, need statements from their treating physicians to apply for disability retirement. Each statement covers the diagnosis, work restrictions and whether the member is permanently incapacitated for any occupation, and the physician sends it straight to PEERS with supporting medical records.

Who completes it

Each of the member's treating physicians completes the whole statement and signs it. The member completes the PEERS Disability Retirement Application Packet and the Authorization for Release of Medical Records.

Submitting and payment

How to submit it
The physician sends the completed statement directly to PEERS along with supporting medical records, rather than returning it to the member.

Good to know

  • The statement asks whether the member is permanently incapacitated for any occupation, a broader test than inability to do the school job alone.
  • PEERS and PSRS are administered together, and PSRS members use the separate PSRS Attending Physician Statement, so check which system the patient belongs to.
  • Missouri state employees in MOSERS do not use this form; their long-term disability coverage is insured through The Standard, which handles physician statements for each claim.
  • The fillable form is posted on the PEERS forms page with the disability retirement application packet and the medical records authorization.

Get the official form

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

PEERS Attending Physician Statement

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 sends the PEERS Attending Physician Statement to PEERS?

The physician does. Each treating physician completes the statement and sends it directly to PEERS with the member's supporting medical records. The member's own forms, including the disability retirement application and the records authorization, go in separately as part of the application packet.

Is the PEERS form the same as the PSRS Attending Physician Statement?

They are separate forms for the two systems that PSRS/PEERS administers together. PEERS covers the Public Education Employee Retirement System for non-certificated staff, and PSRS covers the Public School Retirement System. Use the form that matches the member's system.