Disability Claim Packet - Orange County Board of County Comissioners, 2047 641718-2026

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The document provides instructions and forms for applying for disability benefits through Standard Insurance Company, specifically for employees of the Orange County Board of County Commissioners. It outlines the steps to complete the claim application, including necessary forms from both the employer and treating physician, as well as information on potential reductions in benefits due to other income sources. Additionally, it includes fraud notices specific to various states and an authorization form for obtaining and releasing personal health information.
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  1. Click ‘Get Form’ to open the Disability Claim Packet in our editor.
  2. Begin by reviewing the Employer’s Statement on page 2. Ensure your employer completes this section before you proceed.
  3. On page 4, fill out your part of the claim form. Provide accurate personal information and sign where indicated.
  4. Have your treating physician complete the Attending Physician’s Statement on the same page. If multiple physicians are involved, ensure each one fills out a separate form.
  5. Read the Claim Form Fraud Notice on page 5 carefully and provide it to your physician along with their statement.
  6. Sign and date the Authorization form, then compile all completed forms and send them to The Standard at the address provided.

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