Disability Benefits Law-Claim Form (DB450) - Guardian Life 2026

1. Click ‘Get Form’ to open the Disability Benefits Law-Claim Form (DB450) in the editor.
2. Begin with Part A – Claimant’s Statement. Fill in your name, policy number, and social security number accurately. Ensure all details are correct.
3. Provide your address, date of birth, and marital status. Clearly indicate if you were married and provide details about your disability.
4. In section 7, specify the date you became disabled and whether you worked on that day. If applicable, include any wages earned since then.
5. List your last employer's name and address along with your occupation and employment dates. Include average weekly wages.
6. Answer questions regarding other benefits received during your disability period in section 10. Be thorough to avoid delays.
7. Finally, review all entries for accuracy before signing and dating the form at item 12. If someone else signs for you, ensure their details are included.

Start filling out your Disability Benefits Law-Claim Form (DB450) today using our platform for free!