Paperwork for nurse practitioners and physician assistants

A note before you read

I am a physician, so I would keep this page to what the forms and the rules themselves say, and I name the source for each example. The short version is that it depends on the form, and sometimes on the state, so the first thing I would read on any form is its signature section and its instructions.

FMLA forms (WH-380-E and WH-380-F)

The FMLA regulations name nurse practitioners and physician assistants as health care providers, as long as you are authorized to practice under state law and are working within your scope of practice as state law defines it. The Department of Labor’s WH-380-E and WH-380-F have one signature line, for the health care provider, and no line for a co-signature. Being allowed to sign does not settle whether the condition meets the FMLA’s test, and the employer decides whether the leave is protected. Quite often the form is an insurer’s own version instead, such as MetLife’s or The Standard’s, and in my experience it is the same questions in a different order.

The rule: 29 C.F.R. § 825.125(b)(2). FMLA paperwork for doctors covers the form itself.

Disability claim statements

Insurers call their form an Attending Physician Statement, but the name does not decide who may sign it. Unum’s short-term disability statement, for example, says it is to be completed by the physician or treating provider. State disability forms can be narrower. New York’s DB-450, the health care provider’s statement for state disability benefits, asks the signer to certify that they are a physician, chiropractor, dentist, podiatrist, psychologist or nurse-midwife, and does not list nurse practitioners or physician assistants. New York’s PFL-4 for paid family leave does list both. So I would read the signature section of each one before starting. The Attending Physician Statement guide walks through what the carriers ask.

Workers’ compensation reports

Workers’ compensation forms vary the most, because each state and the federal program set their own rules, so here are a few examples, each from the form’s own instructions. The federal CA-20 says nurse practitioners and physician assistants are not considered qualified physicians under the federal workers’ compensation law unless a physician co-signs the report, and it prints a second line for that signature. I would check that the edition you have still says this. Ohio’s MEDCO-14 says physician assistants and nurse practitioners may complete it, but may certify temporary disability only for the first six weeks after the injury. The form says any later period of temporary disability needs the treating physician’s co-signature.

Texas’s DWC073 can be completed by a physician assistant or advanced practice registered nurse under a delegating doctor, whose name goes in its own box. Washington’s Activity Prescription Form has signature boxes for a doctor, an advanced registered nurse practitioner (ARNP) or a certified physician assistant (PA-C), but names doctors and department-approved chiropractors as the providers qualified to rate permanent impairment.

So when a workers’ compensation form arrives, I would check whether it accepts your signature alone, for this kind of report and for this stage of the claim. The CA-17 and CA-20 and Ohio MEDCO-14 walkthroughs go box by box.

Disabled parking placards

Every state and D.C. decides who may certify its placard application, and some limit what each kind of clinician may certify. New York’s MV-664.1 names physician assistants and nurse practitioners alongside physicians. California’s REG 195 lets a physician assistant, nurse practitioner or certified nurse-midwife certify every condition on its list except the vision one. Missouri’s Form 1776 names an advanced practice registered nurse and a physician assistant among its signers. Other states name fewer, so I would read the signature section and the instructions. If your profession is not there, I would check the state’s own instructions before sending the patient to a clinician who is named. Disabled parking placard applications compares the states.

Jury duty excuses

Some courts publish their own medical excuse sheet, and those can name the signer. Arizona’s medical excuse form says Arizona law requires a statement from a physician, physician assistant or registered nurse practitioner licensed by Arizona. Connecticut’s form says a permanent medical disqualification has to be completed by a physician, a physician assistant or an advanced practice registered nurse. So if the court sent its own sheet, I would check that your profession is on it before you sign.

Where PatientPapers fits

I built PatientPapers to make this paperwork easier to complete. PatientPapers walks you through the forms you are asked to complete, such as FMLA forms, insurers’ disability statements, workers’ compensation forms, parking placard certifications and letters on your letterhead, so you can fill them out more quickly and more confidently. You set up your information once on each computer you use. Then you answer one question at a time, and nothing goes on the form until you confirm it. Before you sign, it flags some problems, such as family history on an FMLA form. On a parking form, it also checks your credential and will not let you sign where that state’s form rules your profession out. Then you review the completed form, and if everything looks correct, you sign it and you’re done.

Your patients’ information is encrypted on your own device with a passcode only you know, and none of it is sent to us or anyone else. Because we never receive it, there is no business associate agreement to sign with us. We cannot reset your passcode, so setup asks you to save a recovery code, and if you forget the passcode that code lets you set a new one. HIPAA still applies to how your office handles that computer, any copies you export, and the forms you print and sign. If you want to see whether it helps with your own paperwork, try the free trial, and I think you will find it saves you time and makes the forms more intuitive to complete.

Questions the office asks

Can a nurse practitioner or physician assistant fill out FMLA paperwork?

Yes. The FMLA regulations name nurse practitioners and physician assistants as health care providers when they are authorized to practice under state law and working within their scope of practice. The rule is 29 C.F.R. § 825.125(b)(2).

Can a nurse practitioner sign a disabled parking placard application?

In many states, but not all. New York’s MV-664.1 and Missouri’s Form 1776 name them, and California’s REG 195 does for every condition except vision. Read the signature section of your state’s form and its instructions.

Does a physician have to co-sign workers’ compensation forms?

On some. The federal CA-20 asks for a physician’s co-signature on a report from a nurse practitioner or physician assistant, and Ohio’s MEDCO-14 asks for one on temporary disability past the first six weeks. Other states’ forms differ, so check the form’s own instructions.

Can my nurse or medical assistant fill in the form for me?

Yes. A provider can add staff such as a nurse or medical assistant, at no extra charge, and each one gets their own passcode. They can fill in the whole form and mark it ready for you, but only the certifying provider can sign it, so I would read what they entered before signing. Everything stays on one computer, so a simple setup is one laptop or tablet kept just for forms that staff and clinicians share. How staff help with forms is the practice’s to arrange and supervise.