Get Short Term Disability Application - Boilermaker Benefits

This guide provides a clear and supportive overview of the process for completing the Short Term Disability Application for Boilermaker Benefits online. Follow the steps outlined below to ensure your application is thoroughly and accurately filled out to facilitate your claim submission.

Follow the steps to complete your Short Term Disability Application online.

1. Press the ‘Get Form’ button to access the Short Term Disability Application and launch it in your online editor.
2. Begin with member information. Fill in your full name, date of birth, home address, phone numbers, social insurance number, and local lodge information.
3. Indicate your work status since the date of your disability. Answer the questions regarding your disability start date, your expected return to work date, and any work done since the disability started.
4. Proceed to the disability information section. Indicate whether your disability is due to an accident and provide detailed information regarding the occurrence.
5. Fill in the treatment section. Record the date you were first treated by a physician for your disability and provide the names and contact information of all treating physicians.
6. Complete the pension/disability information section, identifying any claims filed or benefits currently received from designated sources. Provide requested details, including benefit amounts.
7. Read and accept the authorization statement regarding the collection and sharing of personal health information. Add your signature and date.
8. In the attending physician's statement, ensure your physician provides the required information about your current condition and treatment. Their signature will also be necessary.
9. After completing all sections, review your application for accuracy. Save your changes, and you can then download, print, or share the completed form.

Take the next step toward completing your application and ensure your Short Term Disability claim is processed promptly.