As long as you have already completed the Application for Disability, no additional claim form is needed. After you have been on short term disability for four months and it is anticipated that you may be eligible for long term disability coverage, any additional paperwork needed will be requested directly to your home address.

Additional documentation typically required includes:

You must complete all requested documentation to receive Basic Long Term Disability Plan benefits.

The Claims Administrator has full discretion and authority to control and manage the operation of this plan, including determining eligibility to receive benefits under the Plan.

There are special rules, procedures and deadlines that apply to appeals of benefit determinations and denied claims, and you have special legal rights under ERISA. Please refer to the Administrative Information section for a description of the appeal process.