3+ Disability Allowance Forms – PDF

There are various types of allowance benefits program that organizations and the State government offered for eligible individuals and one of the most known are the disability allowance benefits program. This allows eligible applicants to have a financial aid as they live with their disability which aims to make their lives easier and help them face financial and medical needs.

What Are Disability Allowance Forms?

Disability allowance forms are documents which are supplied to individuals who are categorized as persons with disabilities. The disability allowance form is often provided by organizations and social security associations who offer disability aid. Additionally, there are also business companies who allocate budgets for helping out their disabled employees such as for meeting the employee’s transportation needs and attending to the employee’s medical or assistance requirements.

Varieties of Disability Allowance Forms

The different varieties of disability allowance forms are intended to be used for each different allowance process and requests of eligible individuals. Below are some of the common varieties of disability allowance forms that organizations can create for their beneficiaries:

Disability Allowance Application Form – Before any individual will be provided with an amount for his disability allowance, he must first complete an application procedure by submitting the required documents along with a filled out disability allowance application form. This form is a type of application document which is specifically made to collect the particulars of an applicant who is eligible for the disability allowance. In the form, the applicant will be presented with a short instruction or tip of how he can complete the form. The first sets of particulars which should be disclosed by the applicant are his personal details such as his legal and alternative names, his date of birth, and addresses. Following his own particulars are the details of his spouse or partner who lives with him. His spouse’s name and date of birth are some of the information required to be stated in the form. After the basic particulars of the applicant and his spouse, their income details becomes the focus of the next section which should have their individual and joint income amounts. Other inclusions to be stated in the form are the entitlements, and the household budget or expenses of the applicant.

Disability Allowance Application Form

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Disability Allowance Assessment Form – This variety of disability allowance form is only intended to be filled out and submitted by an applicant’s medical practitioner or doctor. The form will serve as the applicant’s proof that he is indeed an individual who has a medical disability and can be qualified for the benefits or allowance program. To complete the form, the practitioner must supply the identification information of the applicant who is his patient along with the applicant’s date of birth. Then, the medical details of the applicant such as his specific disability and its length are to be stated in the form. After the general information of the disability, the practitioner will have to indicate whether a medical alarm will be ongoing to for the applicant or not, the details of the medical consultation that he conducted to the applicant, and whether the details of the disability have been clearly explained to the applicant or not. In the event that the applicant was not fully informed about his disability, the practitioner must state his reasons of why he chose not to speak to the applicant about the medical issues especially if the applicant is psychologically incapacitated. The identification or the license number of the practitioner, his full name, his clinic address, and his signature will complete the form.

Disability Allowance Assessment Form

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Size: 99 KB

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Disability Allowance Estimate Request Form – For those who are retiring from the jobs that they have served for numbers of years and have a disability, then this variety of allowance form is suitable to be filled out. There are four sections on the form wherein the first three sections are to be filled out by the applicant and the last section states the mailing address where the completed form is intended to be sent. The first section of the form collects the information of the user which should have his name, social security number, birth date, employer contact information, and his employer’s address. The second section of the form is about the retirement details of the user such as the date of when he expects his last salary payment to be given by his employer, the names of the user’s chosen beneficiaries along with their birth dates and percentage of benefits. The third section of the form is allotted for the estimation for the disability allowance of the user or the requestor. In this section, the name of the reciprocal system and the estimated final compensation amount are stated.

Disability Allowance Estimate Request Form

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Disability Living Allowance Form – Most users of this form are individuals who are legal guardians of disabled children below the age of sixteen years. The form is essential in applying for an allowance claim as well as for updating the child’s information if the child is already enrolled or a beneficiary of the program. In the form, the legal guardian must first fill out the child information section wherein the child’s full legal name, reference number, date of birth, sex, and current residential address are some of the details to include. A questionnaire is then incorporated in the form wherein the legal guardian will be able to prove the eligibility of the child for the benefit. The habits of the child with his family, the trips abroad that the child was able to take, the hospital where the child was admitted within the previous twelve months, as well as the name of the practitioner who handled the medical needs of the child are some of the pieces of information catered in the allowance questionnaire. For further details about the child’s disability, the guardian must fill out the statement section of the form and layout what the effects of the child’s illness or disability in how the child was living and even the ways of how the guardian was able to help the child throughout the phases of his life having the disability.

Disability Living Allowance Form

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Size: 344 KB

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What Are Forms Enclosed With a Disability Allowance Form?

Disability allowance forms can be accompanied by other types of documents which are related to the purposes and the objectives of the organization and the form itself. Below are three of the most common forms which are often enclosed with a disability allowance form:

  • Disability certificate form – This form is to be filled out by a medical practitioner who has administered a medical examination to the user of the disability allowance form. The purpose of the examination is to adequately verify and validate the disability claims of the user as well as to document the details of the disability or illnesses. The indications of the medical practitioner as to whether the condition of the form user or the applicant have met the disability requirement of the State is also stated in the certificate form along with the nature of the disability, duration of disability, visit verification, services and necessary treatments, and details of the practitioner which should have his name, number, practice name and address, signature and date.
  • Office statement form – Aside from the applicant and the practitioner who will be filling out the disability allowance form, the officer in charge for assessing the application along with all other submitted documents of the applicant is also responsible for completing a specific form which is known as an office statement form. This additional document will have the name of the officer assessing the application, more information about the applicant and the decision of the office. Moreover, the signatures of the processor, authenticator, and checker are also required to be affixed in the form and before signing, the checker must state the level of accuracy of the information whether it contains critical data or less critical information.
  • Medical consent form –  A medical consent form is significant for documenting the permission or the granted consent of the applicant along with his legal guardian for the intents of the organization. Some of the intents which are documented in the consent form include the needs of the organization of using the applicant’s information for the verification process in order to properly determine whether the applicant is a suitable and eligible candidate to be selected for the benefits program. In addition, a medical consent form can also be for permitting the organization to conduct a medical procedure to the applicant as part of the beneficiary selection process.

With the aforementioned details about disability allowance forms, any organization will be able to determine what type of variety and format they will be using as well as whether they will enclose additional documents to the form or not. Nevertheless, all the information that the organization will be collecting and recording from their applicants must always be kept confidential, specifically, the applicant’s medical and health information, unless consented and permitted by the applicant for purposes outside the application needs and processes to be mandated by the organization.

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