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Lincoln financial group short term disability claim form physician's statement

Lincoln Financial Disability Claim Form 2026

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The document is an 'Attending Physician's Statement' form used for Group Market Disability Claims by Lincoln Life Assurance Company. It requires completion by both the employee/claimant and the attending physician to assess eligibility for disability benefits. The form includes sections for authorization to release medical and employment information, details about the claimant's condition, treatment history, and any restrictions or limitations due to physical or psychiatric impairments. It emphasizes the importance of providing complete information to avoid delays in benefit determination.

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Click ‘Get Form’ to open the Lincoln Financial Disability Claim Form in the editor.
Begin by filling out the Employee/Claimant section, including your name, claim number, and Social Security number. Ensure all information is accurate to avoid delays.
In Part A, provide your authorization for information release. Carefully read the authorization statement and sign it at the bottom of this section.
Proceed to Part B, where your attending physician will complete necessary medical details. Ensure they include diagnosis, treatment dates, and any proposed treatment plans.
Review all sections for completeness. If any fields are left blank, it may delay processing. Use our platform’s features to easily edit or add information as needed.

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Versions	Form popularity	Fillable & printable
2013	4.8 Satisfied (94 Votes)
2009	4.3 Satisfied (125 Votes)

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