Get Ky Nys-std-5782 2013-2025

This guide provides a detailed and user-friendly approach to completing the KY NYS-STD-5782 claim form for disability benefits. By following the steps outlined below, users can effectively fill out the form online with clarity and accuracy.

Follow the steps to accurately complete the KY NYS-STD-5782 online.

1. Click ‘Get Form’ button to obtain the KY NYS-STD-5782 form and open it in the online editor.
2. Complete all applicable areas of Section 1, which must be filled out by the employer. Include details such as the employer's name, address, phone number, contact person, employee's name, job title, and other relevant details.
3. In Section 2, the employee must provide personal details including their name, social security number, date of birth, marital status, and the nature of the disability (illness or injury). Ensure all fields are completed clearly.
4. Proceed to Section 3 to be completed by the attending physician. The specialist should verify the patient's disability and treatment details, including diagnosis codes and treatment plans.
5. After completing all applicable sections, review the entire form to ensure accuracy. This includes verifying all signatures and required authorizations for medical disclosure.
6. To expedite processing, fax the completed KY NYS-STD-5782 form to MetLife using the provided fax number. Retain the original for your own records.
7. Users can save changes, download or print the form for their records, or share it as necessary once completed.

Complete your KY NYS-STD-5782 form online today to ensure your claim is processed efficiently.