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DH University of Michigan For Benefits Administration Use Only Hire Date: Current Option Code: New Option Code: Effective/Event Date: Input Elections: Expanded Long-Term Disability Application With

How to fill out expanded long-term disability application

How to fill out expanded long-term disability application:

1. Gather personal information: Collect all necessary personal details, such as full name, contact information, date of birth, and social security number.
2. Employment history: Provide information about your previous and current employment, including the names of the companies, job titles, dates of employment, and a brief description of your duties.
3. Medical information: Fill out the medical section of the application, which includes details about your medical condition, diagnosis, treatment, and any healthcare professionals involved in your care. Be thorough and include all relevant medical documentation.
4. Functional limitations: Describe how your medical condition limits your ability to perform daily activities and work-related tasks. Be specific and provide examples to support your claims.
5. Supporting documentation: Include any additional documentation that supports your application, such as medical records, test results, treatment plans, and statements from healthcare providers.
6. Complete the financial section: Provide information about your income, including wages, benefits, and any other sources of financial support. It is important to be accurate and truthful in this section.
7. Review and submit: Carefully review the entire application to ensure all information is accurate and complete. Once reviewed, submit the application according to the instructions provided by the disability insurance provider.

Who needs expanded long-term disability application?

1. Individuals who are experiencing long-term disability and wish to apply for insurance benefits.
2. Those who have a disability or medical condition that significantly affects their ability to work and earn income.
3. Individuals who want to access long-term disability benefits to help cover their living expenses and medical costs during periods of disability.

For pdfFiller’s FAQs

What is expanded long-term disability application?

Expanded long-term disability application is a form that individuals use to apply for extended benefits for their disability after their regular disability benefits have expired.

Who is required to file expanded long-term disability application?

Individuals who have reached the end of their regular disability benefits and wish to continue receiving benefits for an extended period of time are required to file an expanded long-term disability application.

How to fill out expanded long-term disability application?

To fill out an expanded long-term disability application, individuals need to provide specific personal and medical information as requested on the form. They should carefully read and follow the instructions provided and ensure that all required sections are completed accurately.

What is the purpose of expanded long-term disability application?

The purpose of an expanded long-term disability application is to request an extension of disability benefits beyond the regular benefit period for individuals who continue to meet the eligibility criteria for additional benefits.

What information must be reported on expanded long-term disability application?

On an expanded long-term disability application, individuals must report personal details such as their name, address, social security number, as well as provide information about their medical condition, treatments received, healthcare providers, and any other relevant documentation or supporting evidence.

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