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Amazon physician statement form

Amazon physician statement form pdf 2025

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The document is a Short Term Disability Claim Statement that outlines the legal disclosures required by state law regarding fraudulent claims. It provides instructions for claim submission, including sections to be completed by the employer, claimant, and attending physician. The document emphasizes the importance of accurate information to avoid penalties and delays in processing claims for short-term disability benefits.

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Versions	Form popularity	Fillable & printable
2014	4.8 Satisfied (233 Votes)
2013	4.1 Satisfied (74 Votes)

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Does Amazon pay for short term disability?

Amazon provides both short-term and long-term disability coverage at no cost to you. Both plans provide partial income (60% of eligible salary up to certain limits) if you become medically disabled. There is a 7-day waiting period for short-term disability (STD) benefits; benefits are then paid for up to 26 weeks.

Can Amazon fire you for disability?

Employees are protected from discrimination at work because of a disability. A disability is a physical or mental condition that limits a major life activity, including (for example):

Does Amazon pay for own injury or illness?

In each state in which Amazon operates, the company is required to comply with the states workers compensation laws. If you work for Amazon and suffer any injury at work, you are able to qualify for workers compensation benefits once your injury causes you to miss three days of work in California.

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How long is long-term disability for Amazon?

If you continue to be disabled after 180 days on short-term disability, the long-term disability plan will kick in and begin paying benefits. Amazons long-term disability insurance pays up to covered eligible monthly pay, capping at $25,000 a month or $300,000 per year (including salary + RSUs) for up to 24 months.

Does Amazon pay for medical leave of absence?

1. Eligible employees may take up to 12 workweeks of unpaid, job-protected leave under the Family and Medical Leave Act (FMLA) in a rolling 12-month period for specified family and medical reasons.

Amazon physician statement form pdf 2025

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