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How do I fill this out?

To fill out this form, start by contacting your supervisor to inform them of your absence. Next, print the document and complete the Authorization to Release Information section, leaving it with your healthcare provider. Finally, report your claim online at www.MyLincolnPortal.com or by calling for assistance.

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How to fill out the Lincoln Financial Group Disability Claims Reporting?

  1. 1

    Contact your supervisor to report your absence.

  2. 2

    Complete the Authorization to Release Information section.

  3. 3

    Report your claim via www.MyLincolnPortal.com.

  4. 4

    Keep a record of your claim number.

  5. 5

    Check the status of your claim online or by calling.

Who needs the Lincoln Financial Group Disability Claims Reporting?

  1. 1

    Employees facing serious illnesses requiring disability claims.

  2. 2

    Supervisors needing to understand leave reporting procedures.

  3. 3

    Human Resources staff handling employee claims.

  4. 4

    Individuals on maternity leave who need to report absences.

  5. 5

    Family members assisting in filing claims for sick relatives.

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What are the instructions for submitting this form?

To submit this form, please ensure all fields are completed accurately. Submit your claim online via www.MyLincolnPortal.com, or you may choose to fax it to 1-800-XXX-XXXX. Ensure you provide your supervisor and HR with a copy for their records.

What are the important dates for this form in 2024 and 2025?

Make sure to be aware of the open enrollment dates for 2024 and 2025 offerings to avoid missing any deadlines related to filing claims or updating information.

importantDates

What is the purpose of this form?

The purpose of this form is to guide employees through the process of reporting a disability claim or leave of absence. It ensures that the necessary information is provided to facilitate timely processing of claims. Additionally, it serves to educate employees on their rights and responsibilities under the short-term disability policy.

formPurpose

Tell me about this form and its components and fields line-by-line.

This form includes several critical fields necessary for processing disability claims.
fields
  • 1. Employee Signature: The employee must sign here to authorize the release of medical information.
  • 2. Date: The date the authorization is signed.
  • 3. Print Employee Name: The employee's name must be printed clearly for identification.

What happens if I fail to submit this form?

If this form is not submitted correctly, it may result in delays in processing your claim. Failure to provide necessary information could lead to denial of benefits.

  • Delayed Benefits: Without timely submission, you may experience delays in receiving benefits.
  • Claim Denial: Incomplete forms can lead to outright denial of your disability claim.
  • Lost Information: Failure to keep track of your claim number may complicate follow-ups.

How do I know when to use this form?

You should use this form when you need to report a serious illness, disability, or maternity leave that affects your ability to work. It is also applicable when needing to care for a sick family member.
fields
  • 1. Serious Illness: Use this form when you are facing a serious medical condition yourself.
  • 2. Disability Reporting: Employ this claim for reporting short-term disability needs.
  • 3. Family Care Leave: Submit this form to take leave when caring for an ill family member.

Frequently Asked Questions

How do I report a claim using this form?

You can report a claim through the online portal at www.MyLincolnPortal.com or by calling customer service for assistance.

What information do I need to fill out this form?

You will need your physician's details, the reason for your leave, and your last day worked.

Can I edit this PDF on PrintFriendly?

Yes, you can easily edit the PDF using our intuitive editing tools available on the platform.

Is it possible to sign this form online?

Absolutely! You can digitally sign the PDF directly within PrintFriendly.

How do I share the edited PDF?

After editing, you can share the PDF via email or social media using the share options.

Can I view the status of my claim online?

Yes, you can track the status of your claim by logging into www.MyLincolnPortal.com.

What if I forget my claim number?

Make sure to keep a record of your claim number after reporting it; this is essential for follow-up.

Is this form necessary for all types of leave?

This form is specifically for reporting disability claims and certain types of medical leave.

Where do I submit this form?

You can submit the completed form online at MyLincolnPortal.com or by calling their service line.

Can multiple family members use this form?

Yes, family members can use this form to report claims related to their own or another person's serious medical condition.

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