SGLI Disability Extension Application Information
This document provides vital information about the Servicemembers' Group Life Insurance Disability Extension application process. It outlines eligibility requirements, application instructions, and important contact details for veterans. Ensure to follow these guidelines closely for a successful application.
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How do I fill this out?
To fill out the SGLI Disability Extension application, first review the eligibility criteria and required documentation. Complete each section of the application carefully, ensuring all information is accurate. Finally, submit your application via mail or fax as detailed in the instructions.

How to fill out the SGLI Disability Extension Application Information?
1
Review the eligibility requirements for the SGLI Disability Extension.
2
Complete the application form with your personal and disability information.
3
Attach necessary documents like your separation orders and VA rating decision.
4
Double-check your application for accuracy and completeness.
5
Submit your application to the Office of Servicemembers' Group Life Insurance.
Who needs the SGLI Disability Extension Application Information?
1
Veterans who have recently separated from service and are totally disabled.
2
Individuals who were covered by SGLI at the time of separation.
3
Individuals seeking to extend their life insurance coverage for up to two years.
4
Veterans who want to ensure their eligibility for additional benefits.
5
Dependents of veterans who may require documentation for claims.
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Utilize the text tool to fill in each required field accurately.
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Review your inputs to ensure everything is correct.
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Download the finalized document for submission.

What are the instructions for submitting this form?
To submit your SGLI Disability Extension application, you may mail it to OSGLI at PO Box 41618, Philadelphia, PA 19176 or fax it to 800-236-6142. Ensure that you include all required documents, such as your separation orders and VA rating decision. It is advisable to keep a copy of your application for your records.
What are the important dates for this form in 2024 and 2025?
Important dates for the SGLI Disability Extension application are critical to keep in mind. The submission period typically aligns with your separation from service. Ensure to apply within 1 year and 120 days following your separation date for the best chance of approval.

What is the purpose of this form?
The purpose of this form is to allow veterans who have been separated from service due to total disability to extend their Servicemembers' Group Life Insurance coverage. It ensures that disabled veterans maintain critical life insurance benefits during their transition into civilian life. Proper submission of this form is essential for securing the financial protection it offers.

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

- 1. First Name: Enter your first name.
- 2. Last Name: Enter your last name.
- 3. Social Security Number: Provide your social security number.
- 4. Date of Birth: Input your birth date in MM DD YYYY format.
- 5. Gender: Select your gender.
- 6. Address: Input your current residential address.
- 7. Email Address: Provide your email address for communication.
- 8. Date of Separation: Indicate your separation date in MM DD YYYY format.
- 9. Branch of Service: Select the branch you served in.
- 10. Work Status: Provide your current work status.
What happens if I fail to submit this form?
If you fail to submit this form, you may lose your eligibility for the SGLI Disability Extension. This can result in the lapse of crucial insurance coverage during a vulnerable time. Additionally, you may miss out on relevant benefits associated with the VGLI coverage.
- Loss of Insurance Coverage: Failing submission can lead to termination of vital life insurance benefits.
- Denial of Benefits: You may be denied access to other essential veteran benefits.
- Financial Strain: Without coverage, unexpected expenses may affect your financial stability.
How do I know when to use this form?

- 1. Extension of Coverage: To extend the life insurance coverage you had while serving.
- 2. Maintaining Accessibility to Benefits: To ensure that you remain eligible for future insurance benefits.
- 3. Transitioning to Civilian Life: To help navigate the financial challenges of moving into civilian status.
Frequently Asked Questions
Who is eligible for the SGLI Disability Extension?
Veterans who are totally disabled and had SGLI coverage at the time of separation can apply for this extension.
What documents do I need to submit with my application?
You must include your separation orders, recent Leave and Earnings Statement, and a copy of your VA rating decision.
How do I submit the completed application?
You can mail your completed application to OSGLI, PO Box 41618, Philadelphia, PA 19176, or fax it to 800-236-6142.
What happens if my application is denied?
If your application is not approved, you will receive a notification along with instructions on applying for VGLI coverage.
How long does the SGLI Disability Extension last?
Coverage lasts for a maximum of two years from your date of separation or until you can work.
What if I do not receive a billing statement for VGLI?
Contact OSGLI immediately if you do not receive your VGLI billing statement.
Can I apply if I have a 100% disability rating?
Yes, but a 100% disability rating does not automatically equate to unemployability.
Is there a deadline for applying?
To ensure eligibility, you should apply within 1 year and 120 days from your separation date.
How can I get help with my application?
For assistance, you can email sgli.extension@prudential.com or call 800-419-1473 during business hours.
What if I need additional space to fill out my work history?
You can use a separate sheet of paper to provide more details about your employment history.
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