Short-Term Disability Employee Request - teamsters145 2025

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The document is a Short-Term Disability Employee Request form that employees must complete to apply for short-term disability benefits. It includes sections for employee information, claim details, tax withholding, and authorization for healthcare providers to share medical information. The form outlines eligibility criteria for benefits related to non-occupational illnesses or injuries and specifies the need for physician statements and timely submission of claims.

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What justifies short-term disability?

To qualify for short-term disability benefits, an employee must be unable to do their job, as deemed by a medical professional. Medical conditions that prevent an employee from working for several weeks to months, such as pregnancy, surgery rehabilitation, or severe illness, can qualify to receive benefits.

How do I tell my boss I need short-term disability?

Notify your manager and your leave of absence specialist or local HR Office of your need for Short Term Disability (STD) at least 30 days in advance of your anticipated last day of work, if possible, to discuss your options.

How do I ask for short term disability?

If you are applying for short-term disability, you have to go through your employer, who will tell you what paperwork needs to be filled out. You will then have to make an appointment to see your medical provider to discuss your request and ask them to fill out the required paperwork.

What documentation is needed for short-term disability?

UPS EMPLOYEES ONLY: In addition to submitting your claim form to TeamCare, UPS employees must also call Aetna at 866-825-0186 to initiate your leave with UPS. General questions about your leave from UPS should be directed to Aetna at 866-825-0186.

How do I tell my boss I am going on short term disability?

Attending Physicians Statement (APS). This form provides us with specific medical information about your condition and expected recovery. Employers Statement. This form provides us with information on your claim and on your employment, salary, benefits, and other sources of income.

Can I ask my doctor to put me on short-term disability?

How do I ask my doctor for short-term disability? Employees who plan to apply for short-term disability should notify their attending physicians so they can gather the necessary forms and supporting records.

Short-Term Disability Employee Request - teamsters145 2025

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How to modify Short-Term Disability Employee Request - teamsters145 in PDF format online

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Got questions?

What justifies short-term disability?

How do I tell my boss I need short-term disability?

How do I ask for short term disability?

What documentation is needed for short-term disability?

How do I tell my boss I am going on short term disability?

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Can I ask my doctor to put me on short-term disability?

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Short-Term Disability Employee Request - teamsters145 2025

Here's how it works

How to modify Short-Term Disability Employee Request - teamsters145 in PDF format online

See more Short-Term Disability Employee Request - teamsters145 versions

Complete this form in 5 minutes or less

Got questions?

What justifies short-term disability?

How do I tell my boss I need short-term disability?

How do I ask for short term disability?

What documentation is needed for short-term disability?

How do I tell my boss I am going on short term disability?

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People also ask

Can I ask my doctor to put me on short-term disability?

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