Get Aetna Notice Of Disability Form - Nrlc

Filling out the Aetna Notice of Disability Form - NRLC is an important step for individuals seeking disability benefits. This guide provides a step-by-step approach to help users complete the form accurately and efficiently online.

Follow the steps to complete the Aetna Notice Of Disability Form - NRLC online.

1. Press the ‘Get Form’ button to obtain the form and open it for editing.
2. Complete Section I, which must be filled out by or on behalf of the employee. Enter the name of the employee, date of birth, social security number, employee number, and address. Make sure to include the employer's name, the department last worked, and the date last worked.
3. Indicate the organization representing the user and provide the next scheduled workday. Users must also specify their occupation and the date they became disabled.
4. Enter the supervisor's name, their contact number, and the employee's rate of pay. List all treating physicians and include their contact details.
5. Specify the cause of the disability, selecting whether it was due to an accident or sickness. Answer questions about work status, providing details when returning to work, and indicating if any vacation pay has been received since the last day worked.
6. If the disability resulted from an accident, complete Section II by detailing if the accident occurred at work, the date, and explanation of the event. Indicate if any off-track vehicles were involved or if a traffic accident occurred.
7. Proceed to Section III. Confirm if the user has applied for sickness benefits under the Railroad Unemployment Insurance Act and provide details regarding any other income benefits applicable while disabled.
8. Finally, sign and date the form, ensuring that all provided information is accurate and complete.
9. Users can save changes, download, print, or share the completed form as necessary.

Complete the Aetna Notice Of Disability Form - NRLC online to ensure your claim is processed efficiently.