Get Accident & Sickness Claim Form - Iuoe Local 825 Funds Homepage

Completing the Accident & Sickness Claim Form is an essential step for members of IUOE Local 825 to receive their benefits. This guide provides a clear and supportive approach to filling out the form online, ensuring that you include all necessary information for a successful claim.

Follow the steps to complete your claim form successfully.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Enter your personal information, including your name, member ID number, and the date of your accident or illness. Ensure accuracy when filling in these fields.
3. Provide the date you first became unable to work due to your disability. Include the date you were first treated by a physician for your current condition.
4. Indicate whether the sickness or injury was related to your employment by selecting 'Yes' or 'No'. If applicable, provide details about the condition's relation to your job.
5. Complete the section for the attending physician's statement. This includes their diagnosis, any relevant concurrent conditions, and information about ongoing treatments.
6. Have your physician sign the form, ensuring their contact information is accurately provided. This step is crucial for validation.
7. Review the entire form for completeness and accuracy. Check all entries, making sure any additional documents, such as proof of payment details, are included.
8. Once satisfied with the completed form, save any changes. You can then download, print, or share the filled form as required.

Begin the process now by completing your Accident & Sickness Claim Form online.