Get Allstate Continuing Disability Form - Peoplesbenefitsolutions.com

Filling out the Allstate Continuing Disability Form can be a straightforward process if you follow the steps carefully. This guide will help you navigate each section of the form effectively to ensure that your application is complete and accurate.

Follow the steps to successfully complete the form

1. Press the ‘Get Form’ button to obtain the form and access it in your preferred viewing tool.
2. Start by providing your full name, including your last name and first name, as well as your Social Security number to identify your application uniquely.
3. Input your address along with your city, state, and zip code to ensure you receive communication related to your claim.
4. Enter your date of birth and provide additional personal information, including your height, weight, and contact number.
5. Specify your occupation and monthly earnings. Indicate the date you became unable to work due to your medical condition.
6. If applicable, note the date of your accident or first symptoms and indicate whether your condition is work-related.
7. Describe your current medical condition and the reasons for your inability to work. Be as detailed as possible.
8. List any other income or benefits related to your medical condition, such as Social Security or workers' compensation. Include the source and amount.
9. Document all physicians you have seen in the past five years, including their addresses and specialties, as well as any hospital confinements.
10. List all pharmacies used in the past five years to provide further context to your medical history.
11. Sign and date the authorization section to permit the release of your medical information, and ensure all information is accurate before submitting.
12. Once completed, save your changes, and you will have the option to download, print, or share your form.

Complete your Allstate Continuing Disability Form online to ensure your application is submitted promptly.