First rehab life 2026

See details

4 out of 5

27 votes

The document is a Notice and Proof of Claim for Disability Benefits, providing instructions for claimants who become sick or disabled while employed or within four weeks after termination. It outlines the necessary steps to complete the claim form, including filling out personal information, detailing the nature of the disability, and obtaining a health care provider's statement. The document emphasizes accuracy in reporting and the importance of submitting the claim within thirty days of becoming disabled.

Here's how it works

01. Edit your form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out first rehab life with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click 'Get Form' to open the first rehab life document in the editor.
Begin with Part A - Claimant's Statement. Fill in your name, Social Security Number, and address accurately. Ensure all details are correct.
Provide your contact number and date of birth. Indicate your marital status by checking 'Yes' or 'No'.
Describe your disability clearly, including how, when, and where it occurred. Specify the date you became disabled and whether you worked that day.
List your last employer(s) along with employment dates. Include average weekly wages and any union information if applicable.
Complete questions regarding any other benefits you may be receiving during this period of disability.
Sign and date the form at the end of Part A. If someone else is signing on your behalf, provide their details as required.

Start filling out your first rehab life claim today for free using our platform!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is ShelterPoint customer service reputation?

TrustedChoice.coms Final Review We award ShelterPoint final rating of 2.5 out of 5 stars.

What is the phone number for ShelterPoint paid family leave?

at 1-800-365-4999 or email customerservice@shelterpoint.com. You can also send your inquiries using our Contact Form.

How long does ShelterPoint take to process a claim?

If we have everything we need to review your claim, and it is payable, you will receive mail from us including a check for your first benefit payment. For the majority of claims, you can generally expect to receive this after about a calendar week after we receive your properly and fully completed claim.

What kind of insurance is ShelterPoint?

About ShelterPoint Life Insurance Company Since 1972, our founding entity has grown into New Yorks largest1 carrier of statutory Short-Term Disability (called DBL, short for Disability Benefits Law), and has provided state-mandated Paid Family Leave2 (PFL, for short) since 2018.

Does ShelterPoint do direct deposit?

We offer Direct Deposit Payments for continuous New York DBL/PFL claims where benefit payments are being issued directly to the claimant/employee! Sign up on your claim form at time of claim, or register for our claim portal to change your payment preferences online once you receive your claim number.

Security and compliance

At DocHub, your data security is our priority. We follow HIPAA, SOC2, GDPR, and other standards, so you can work on your documents with confidence.

Learn more

Related forms

be ready to get more