Disability Form Help

OSS is ready to fill out its part on the forms

You will be able to use the provider’s recovery directions so you can then organize what you need to do to receive special accommodations, or disability benefits, for the short term.

Provider Authorization is needed; it is required.  For you to apply for disability benefits (e.g., income support, job protection, school excusal, handicap placard, etc.), your provider must authorize that you need to limit or restrict one or more activity.

Before you learn more about how OSS can help with different benefit filings, please understand that your provider will consider the following factors:  your age,  your profession (your job duties), the type of injury you have had, and the prescribed treatment.  Some of our patients chose to use their vacation days instead of applying for disability benefits because the recovery period for certain procedures is short.

Handicap Placard with DMV. This is common form to request if your ability to walk has been affected.  You can request DMV placard form completion after your office visit (when you check out). It will take the OSS team approximately 20 minutes to complete.  Our office has the DMV form. 

Work – Income or Job Protection.  If your provider approves the disability request, your provider will give you a note that you can use to submit to your employer or your insurance company. This note can often get the disability benefit(s) process started.  Your provider will also submit a note into your medical record so the OSS team knows your doctor has approved the accommodation.

EDD (State of California)


  1. REQUIRED.  You must get approval from the doctor for disability income support.  Again, the best time to get this authorization (approval) is at your appointment with the provider.      
  2. Pay the OSS processing fee for EDD and take photo of receipt OSS gives you.      

    Best to do this when you check out from your OSS appointment.      
  3. At home, go to to register and fill out your section.  If you have any difficulty, please call the telephone number listed on the EDD website.      
  4. Fill out this OSS form: Disability Income / Work Support: OSS Disability Intake Form.      
  5. Email the following to the OSS Disability Coordinator:

You’ll then wait 10 business days for OSS to do its part (to fill out it’s form).      

FMLA / Private Insurance


  1. REQUIRED.  You must get approval from the doctor for disability income / job protection support.  Again, the best time to get this authorization (approval) is at your appointment with the provider.       
  2. At home, fill out your section on the FMLA or Private Insurance form(s).  To get these forms, please talk to your employer.  You must complete your section in its entirety. Please, do not have the forms faxed to OSS since you must complete your section first.       
  3. Fill out the OSS Form:  Disability Income / Work Support: OSS Disability Intake Form.      
  4. Bring the following to OSS at your next appointment; best to give at appointment check out. 

You’ll then wait 10 business days for OSS to do its part (to fill out it’s form).

Need to Contact the OSS Disability Coordinator?


  1. If applying for EDD and you have paid the OSS processing fee for EDD, email the required information to the coordinator.
  2. Want status from OSS on submitted disability form?  Please wait 10 business days before you email the coordinator.  We appreciate your patience.

Emails for Our Team
Dr. Stephan Yacoubian – Missy
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