Get Educator Choice Disability Claim Packet, 11268.pdf

Completing the Educator Choice Disability Claim Packet, 11268.pdf is an essential step in applying for long-term disability benefits. This guide will provide you with clear, step-by-step instructions to effectively fill out the form online, ensuring that all necessary information is accurately presented.

Follow the steps to successfully complete your disability claim packet

1. Press the ‘Get Form’ button to access the Educator Choice Disability Claim Packet and open it in your online editor.
2. Fill in the Employee's Statement section entirely. Include your full name, Social Security number, address, and contact information. If a question is not applicable, write 'NA' to indicate that it was not overlooked.
3. Provide details in the Employment section, including your job title, employer's name, and dates related to your employment. Clearly describe the nature of your disability and how it affects your work.
4. In the Sickness/Injury section, thoroughly describe your condition, its onset date, and whether you have a history of similar issues. Use an additional page if necessary to ensure clarity.
5. List all attending physicians in the designated section including their names, specialties, contact details, and treatment dates. If multiple physicians treated you, additional lines can be used.
6. Complete the Hospital Information section if applicable, providing the hospital name, admission dates, and reason for your hospitalization.
7. In the Benefits From Other Sources section, indicate if you are receiving benefits from Social Security, Workers’ Compensation, or any other sources. Attach relevant documentation as needed.
8. Fill out the Vocational section with your highest grade completed, degree earned, and a summary of your work experience. Ensure the last salary and dates of employment are correct.
9. Carefully read the fraud notice and certify your answers are complete and truthful before signing and dating the form.
10. Once all sections are filled out, save your changes, and prepare to download, print, or share your completed form.

Ensure a smooth filing process by completing your Educator Choice Disability Claim Packet online today.