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For disability benefits. 1. Complete this form: a. As soon as the member has stopped working and is expected to remain disabled for thirty (30) days or more. b. Whether the disabling condition is work-related or not. 2. "Last date the member actually worked" refers to the last day the member was physically present at his or her job. This does not include sick or vacation time. 3. "Last date the member was or will be paid" refers to the last day for which the member will receive wages (or compens.

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