Printable Forms: Great West Life Long Term Disability Claims
Long Term Disability Income Benefits
- The plan member must complete the Employee Statement in order to claim for Long Term Disability benefits. The plan member’s physician must complete the Attending Physician’s Initial Statement Long Term Disability Income Benefits form.
Application for Group Long Term Disability Benefits – Employer’s Statement
- The plan sponsor must complete this form in order for the employee to claim for Long Term Disability Benefits
Employment and Insurance Information/ Job Description Long Term Disability
- The plan sponsor must complete this form in order for the employee to claim for Long Term Disability Benefits.
- This form is used to claim life insurance and/or Accidental Death Benefits for plan member or plan member’s eligible dependents.
