You're saying a psychiatrist in the U.S. would put their license to practice at stake and write fake disability notes? This would also continuous documentation as long-term disability would be through the company's provider, who don't operate in an easy peasy 1 letter and you're good system, they require a ton of paperwork up front and continuous supporting paperwork for a valid medical claim that can be supported by patient evidence. They even have their own doctors on staff verifying these claims. Those insurance companies are itching to find a reason to stop covering someone / deny long-term payments.