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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering the Patient Name, Insured ID Number, and Date of Birth in the designated fields. Ensure accuracy as this information is crucial for processing.
  3. Fill out the Patient Address section with complete details including Street, City, State & Zip Code.
  4. For the Provider section, answer questions regarding workplace-related conditions and provide explanations where necessary. This helps clarify the patient's situation.
  5. Complete the Diagnosis section by entering Primary and Secondary Conditions along with their respective DSM or ICD Codes.
  6. In the Patient Assessment Measures section, input WHODAS Scores and any other relevant assessment measures. Attach additional test results if required.
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The weekly maximum may change annually. The SFPPL weekly maximum is $721 per week, bringing the combined weekly maximum to $2,402.
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Short-term disability insurance typically pays between 40-70% of your gross income until you return to work or until the end of your benefit period. Benefits periods typically last 13-26 weeks and not more than 1 year.
The Hartfords former life and annuity business was sold to Talcott Resolution on May 31, 2018. Talcott Resolution now is an independent, standalone company and no longer is affiliated with The Hartford.
Since 1984, The Hartford has offered affordable auto insurance rates and insurance coverages to nearly 40 million AARP members. With a national average 4.8-star rating from 36,000+ reviews from real customers of The Hartford, were constantly one of the top-ranked car insurance companies for AARP members.
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Short-term Disability insurance is provided to full- and part-time colleagues at no cost effective on the first day of the month after 30 days of employment. This benefit provides 60% of base salary for up to 26 weeks. Benefits begin after one week of Paid Time Off (PTO) has been used, based on weekly standard hours.
The average Short Term Disability Analyst base salary at The Hartford is $65K per year.
The Short-term Disability benefit is 50% of your eligible earnings if you have up to two years of service and 60% of your eligible earnings if you have two or more years of service. For STD events, please contact The Hartford.

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