Get Ltd Employee Claim Form

Completing the LTD Employee Claim Form online can seem daunting, but with clear instructions, it becomes a manageable task. This guide will take you step-by-step through the process to ensure that your claim is submitted accurately and efficiently.

Follow the steps to successfully complete the LTD Employee Claim Form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor for easy online completion.
2. Begin by filling out your personal information in the designated fields. This includes your full name, social security number, and mailing address. Ensure that all information is typed clearly and accurately.
3. Next, provide details about your spouse and any dependent children if applicable. This includes their names and dates of birth if you answered 'yes' to any of the questions regarding children.
4. Indicate the dates relevant to your claim such as the date of the accident or the beginning of your sickness and the date you became totally disabled. Keep this information precise to avoid delays.
5. Describe your condition in your own words. If your disability is due to an accident or work-related incident, include the circumstances surrounding it for clarity.
6. List all attending physicians and hospitals along with their contact details so that any necessary verifications can be completed.
7. If you have applied for Social Security Benefits, indicate 'yes' and attach the required documentation as specified.
8. Continue to answer the questions regarding other insurance benefits, veteran status, and any other sources of income related to your disability.
9. Once you have completed the employee section, review the information for accuracy and clarity before signing and dating the form.
10. After finishing the employee portion, ensure your employer fills out their section completely. They should include employment details and any relevant income information.
11. Finally, verify that both sides of the form are completed fully. Once all information is accurate, you can save changes, download a copy, print the form, or share it as needed.

Start filling out your LTD Employee Claim Form online today to ensure your claim is processed smoothly.