Long Term Disability Claim Form Instructions
This document contains the instructions and necessary forms for filing a claim for long-term disability benefits. It includes personal information, claim information, and an authorization to disclose information. Follow the steps carefully to expedite your claim processing.
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How do I fill this out?
Filling out this form can be straightforward if you follow the instructions. Complete all mandatory fields, provide accurate information, and attach any required documents. Here is a quick guide to get you started.
How to fill out the Long Term Disability Claim Form Instructions?
1
Complete all applicable areas of the claim form.
2
Include a copy of the legal representative document if applicable.
3
Sign the claim form.
4
Fax the form or retain the original for your records.
5
Contact MetLife for any questions.
Who needs the Long Term Disability Claim Form Instructions?
1
Employees who need to claim long-term disability benefits.
2
Authorized representatives filling out the form on behalf of the claimant.
3
Employers assisting their employees with disability claims.
4
Healthcare providers supplying medical information for the claim.
5
Legal advisors helping clients with the claim process.
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1
Open the Long Term Disability Claim Form in PrintFriendly's PDF editor.
2
Enter your personal and claim information in the designated fields.
3
Attach any required legal documents or supporting evidence.
4
Review the form for accuracy and make any necessary corrections.
5
Save and download the completed form for submission.
What are the instructions for submitting this form?
You can submit the completed form by faxing it to 1-800-230-9531 or mailing it to MetLife®, P.O. Box 14590, Lexington, KY 40511-4590. Ensure all required fields are filled, and supporting documents are attached to avoid delays. Retain a copy for your records, and reach out to MetLife at 888-444-1433 for any further assistance or questions.
What are the important dates for this form in 2024 and 2025?
The form does not specify particular dates for 2024 or 2025.
What is the purpose of this form?
The purpose of this form is to facilitate the process of claiming long-term disability benefits. It ensures that all necessary information is collected from the claimant, including personal details, medical information, and authorization to disclose health data. This comprehensive form streamlines the application process, making it easier for claimants to receive the benefits they are entitled to.
Tell me about this form and its components and fields line-by-line.
- 1. Personal Information: Includes name, employer, social security number, address, contact information, and marital status.
- 2. Claim Information: Details about the disability, including dates, related injuries or illnesses, treatment information, and physician details.
- 3. Reimbursement Agreement: Agreement for the claimant to reimburse any overpayments made by MetLife based on other disability benefits received.
- 4. Authorization to Disclose Information: Permission for various entities to disclose relevant personal, medical, and employment information to MetLife and associated parties.
What happens if I fail to submit this form?
Failure to submit this form correctly and promptly can result in delays or denial of your long-term disability benefits.
- Delayed Processing: Missing or inaccurate information can lead to delays in the processing of your claim.
- Denial of Benefits: Incomplete or incorrectly submitted forms may result in the denial of disability benefits.
How do I know when to use this form?
- 1. Long-Term Disability Claim: To file a claim for long-term disability benefits due to an injury or illness.
- 2. Authorized Representative: When an authorized representative is filing the claim on behalf of the employee.
Frequently Asked Question
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Open the form using PrintFriendly's PDF editor and begin entering your personal and claim information in the provided fields.
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You can email the form directly from PrintFriendly or generate a shareable link to send to recipients.
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Use PrintFriendly's editing tools to correct any mistakes before saving and downloading the completed form.
Is there a way to attach additional documents to the form?
Yes, you can attach any required supporting documents directly within the PDF editor.
Can I save my progress and return to it later?
While editing, ensure you save the document frequently. You can download and re-upload the form to continue editing later.
Do I need to fax the form after completing it online?
It's recommended to retain a copy for your records and follow the submission instructions, including faxing if required.
How do I contact MetLife for assistance with the form?
You can contact MetLife at 888-444-1433 for any questions regarding the completion of the form.
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