Get Aflac Initial Disability Claim Forms To Print

Filling out the Aflac Initial Disability Claim Forms can be a straightforward process when approached step by step. This guide aims to assist users in accurately completing the form to ensure timely processing of their claims.

Follow the steps to accurately complete the claim form.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Begin by providing your personal information in the policyholder's statement section. Ensure to specify if the disability is due to a sickness or an injury. If applicable, provide the date symptoms first appeared or details surrounding the injury.
3. Indicate the location of the injury, whether on or off the job, and provide the date the employer was notified if the injury occurred at work. Remember to address any related workers' compensation claims and submit the necessary documentation if applicable.
4. Fill in the current income information you are receiving, including Social Security and state disability, specifying the dates these benefits began and ceased.
5. Complete the hospitalization details, if relevant, including admission and discharge dates, the hospital's name and contact information.
6. Specify the first date of disability and address whether the disability is related to your employment. If it is, provide details regarding the worker’s compensation status and any associated benefits.
7. Record the number of hours you worked per week before the disability began and include your gross annual income. If self-employed, provide relevant tax records.
8. Answer questions related to returning to work. Indicate if you have returned, the expected date of return, and your working capacity (full-time, part-time, or light duty).
9. Detail any additional income you may be receiving as a result of the disability. Consider including information on whether you are utilizing salary continuance or vacation pay.
10. Complete the diagnosis section, including primary diagnosis and any ICD codes. Also, provide specific details regarding symptoms, treatments, and consultations with other physicians.
11. Fill in the prognosis part with treatment frequency, any expected release dates for returning to work, and specific physical impairments.
12. Indicate which activities of daily living the patient is unable to perform and whether they require personal assistance. Identify if the disability is permanent.
13. After thoroughly reviewing the completed form for accuracy, save your changes. You can then download, print, or share the form online as needed.

Complete your Aflac Initial Disability Claim Forms online today to ensure your claim is processed without delay.