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PO Box 5031 White Plains NY 10602-5031

PO Box 5031 White Plains NY 10602-5031-2025

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The document provides a comprehensive guide for filing a New Jersey State Disability Benefit Claim through The Standard Benefit Administrators. It includes instructions for completing necessary forms, details on how to apply for benefits, information on other benefits that may affect the claim, tax withholding implications, and guidelines for notifying the administrators upon returning to work. Additionally, it contains specific forms for employees, attending physicians, and employers to complete as part of the claims process.

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Click ‘Get Form’ to open it in the editor.
Begin with the Employee’s Statement section. Enter your full name, Social Security number, and contact information accurately.
Answer the questions regarding your disability status, including whether it is work-related and your last active day at work.
In the Employment Information section, list all employers from the past 18 months, ensuring you provide accurate dates and job titles.
Complete the Attending Physician’s Statement by entering your physician's details and having them fill out their part regarding your diagnosis and treatment.
Finally, sign and date the Authorization form to allow The Standard Benefit Administrators to process your claim. Ensure all forms are sent to PO Box 5031 White Plains NY 10602-5031.

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2020	4.8 Satisfied (62 Votes)
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2019	4.4 Satisfied (159 Votes)
2018	4.2 Satisfied (55 Votes)
2012	4.1 Satisfied (31 Votes)
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