Get Myteamcare Org

Filling out the Myteamcare Org form is an essential step for individuals seeking to report a short-term disability claim. This guide provides user-friendly steps to help ensure that the form is completed accurately and efficiently.

Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In Section 1, enter the participant’s ID, full name, date of birth, and complete address. If the disability is accident-related, provide the employer's name, date of accident, location, and details of how the accident occurred.
3. Indicate whether the disability is work-related and, if applicable, explain the circumstances. If there has been a denial from Workers’ Compensation, attach the denial and a notarized statement concerning the intent to appeal.
4. Sign the authorization statement allowing the disclosure of medical information and include a phone number for contact.
5. In Section 2, the treating physician must complete the patient's name, diagnosis, and dates of treatment. Ensure the physician specifies if the condition is due to employment and provides a timeline for treatment and recovery.
6. Section 3 requires the employer to document the employee's last day compensated and the actual return date. Include whether the employee was on layoff and any details regarding Workers’ Compensation claims.
7. After completing all sections, review the form for accuracy, ensure all required fields are filled, and obtain necessary signatures.
8. You can either save changes, download, print, or share the form as needed, before submitting it by mailing or faxing it to the specified addresses.

Complete your documents online today to ensure a smooth process for your short-term disability claim.