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Many orthopaedic conditions, injuries, and treatments temporarily interfere with one’s physical capabilities and their ability to work at full duty. You may have short term or long term disability insurance through your employer, union, or on your own to replace income lost while off work. Worker’s Compensation insurance may cover lost income in addition to covering your care for qualifying injuries that occur at work.

Worker’s Compensation and short and long term disability claims typically require various forms to be completed. Greater Pittsburgh Orthopaedic Associates has policies and procedures in place regarding completion of Workers' Compensation, short and long term disability, and Family Medical Leave Act (FMLA) forms.

Options:

  1. GPOA Physical Capabilities Form
    • No charge
    • Accepted by most employers and many disability insurers
    • Fastest turnaround time, usually same day
  2. Your employer’s or disability insurer’s simple form
    • $15 charge EACH AND EVERY TIME the form must be filled out
    • 7-10 business day turnaround time
  3. Your employer’s or disability insurer’s physical capabilities form
    • $75 charge EACH AND EVERY TIME the form must be filled out
    • 7-10 business day turnaround time
  4. Family Medical Leave Act (FMLA)
    • Check with your employer, this may be required IN ADDITION to any other forms
    • $15 charge EACH AND EVERY TIME the form must be filled out
    • 10-14 business day turnaround time
  5. Social Security Disability (SSI)
    • No charge for completion
    • 7-10 business day turnaround time
  6. Medical Assistance application form
    • No charge for completion
    • 7-10 business day turnaround time

There is a fee for each form requested, and payment is due at the time of request. There is no fee for the GPOA Physical Capabilities form, which many companies and insurance companies will accept instead of their own form. You will be notified when the form is completed and available to be picked up. You will not be notified if you request that it be faxed to another party.

Disability insurers and the Social Security often require copies of your medical records for which there is an additional charge depending on the number of pages to be copied.