Disability Benefits Templates

This Form is used for employees in Massachusetts to file a claim for their workplace injuries or illnesses.

This form is used for Russian-speaking employees in New York to submit a claim for compensation.

This Form is used for filing a notice and providing proof of claim for disability benefits in New York for individuals who speak Polish.

This form is used for filing a notice and providing proof of claim for disability benefits in New York. It is available in Chinese for the convenience of Chinese-speaking residents.

This form is used for filing a notice and proof of claim for disability benefits in New York. It is specifically for individuals who speak Italian.

This form is used for notifying and providing proof of a claim for disability benefits in New York. It is available in Haitian Creole.

Use this form if you are an adult and are claiming disability benefits. You can fill out the form yourself or have a representative help you out. It can be any person who is aware of your health issues, but it cannot be your doctor.

Use this form to contest a decision regarding disability benefits by providing new information on your or the claimant's impairment.

A parent or guardian living in the United Kingdom is supposed to fill out this form when they would like to claim a Disability Living Allowance (DLA) for their children.

If you are a worker residing in the UK this form must be filled out when you are required to provide information about your illnesses, disabilities, or health conditions.

The purpose of this form is to gather information about an individuals' health conditions and disabilities in order to figure out whether they are eligible for certain types of personal independence payment benefits.

This form is used for ordering the appointment of counsel for disability cases in Kentucky.

This Form is used for issuing a judgment on disability matters in the state of Kentucky.

This form is used for applying for temporary disability benefits in New Jersey.

This form is used for obtaining a Certificate of Coverage under the Canada Pension Plan for individuals covered by the Agreement on Social Security between Canada and Sweden. It is available in English, French, and Swedish.

This Form is used for filing an occupational disease claim in the state of Utah. It is the official form required for workers who have contracted a disease as a result of their job.

This form is used for granting consent in a Social Security case in Oklahoma.

This form is used for applying for medical assistance in Pennsylvania for workers with disabilities.

This Form is used for reporting the suspension of benefits in the state of Utah.

This Form is used for applicants in Alabama to provide an affidavit of disability.

Individuals may use this type of document as a reference to dispute an unsatisfactory ruling of an insurance company regarding a long-term disability.

An employee who was denied proper insurance coverage to protect their financial standing during a temporary inability to do their job as a result of injury or illness may use this sample as a reference.

This form is used to apply for disability benefits from the Canada Pension Plan (CPP) or the Quebec Pension Plan (QPP). It is available in both English and French.