Follow the steps to complete your claim form with ease.

1. Click ‘Get Form’ button to obtain the AVMA LIFEDisability Claim Form and open it in your preferred editor.
2. Begin by completing the Member’s Statement section with accurate information. Make sure to include your name, address, social security number, certificate number, and other relevant personal information.
3. Next, indicate your employment status by checking 'Yes' or 'No' regarding self-employment. Provide details related to your employer, your date of birth, and your contact information.
4. Fill in the details about your disability. Answer whether your disability is due to an accident and provide specific dates and information surrounding the event.
5. Document your income by providing your average monthly earned income, including gross and net amounts. Include any information related to collateral assignments if applicable.
6. In the section requesting information about any other benefits you are receiving or have applied for, indicate relevant policies and amounts. This includes disability income policies and retirement benefits.
7. Review and sign the declaration at the bottom of the form on Page 3, confirming that all information provided is accurate. Additionally, ensure that the Authorization for Release of Information on Page 4 is properly signed and dated.
8. Make sure that your medical provider has completed their statement. This part is crucial for your claim's evaluation as it will include details about your medical condition and treatment.
9. Once all sections of the form are completed, save your changes. You can also download, print, or share the completed form as necessary.

Ensure your claim is filed accurately by completing the AVMA LIFEDisability Claim Form online today.