FREE 8+ Sample Short Term Disability Forms in PDF | MS Word

Short Term Disability is when an employee is sick or injured and is unable to go to work for a certain period of time. An employee can apply for Short Term Disability Benefits if he has already gone beyond the sick days provided by his company. This type of insurance pays a portion of the employee’s salary over a specific period of time. Generally, the benefit pays around 40 to 60 percent of the employee’s weekly gross income for a maximum of 52 weeks. There are also certain Disability Forms used for differently abled people.

Short Term Disability Insurance Form

Short Term Disability Claim Form Sample

Short Term Disability Application Form

Short Term Disability Tax Form Example

A Short Term Disability Form has three sections.

• Employment information section filled out by the employer
• Details about the accident that led to physical injury filled out by the employee
• Medical information filled out by the attending physician (This should include the diagnosis and how long the employee needs to recuperate and get back to work.)

Types of Short Term Disability Forms

• Short Term Disability Application Form: This has all the three sections stated above. A medical certificate or medical records signed by the attending physician have to be included as well. For the employee to be eligible, he should be a full-time employee who has worked for the employer for a certain amount of time.
• Short Term Disability Tax Form: If the employer pays for the coverage, taxes would still have to be taken out of the employee’s pay. This form would have to be filled out so that the employer can withhold tax from the pay you will receive.
• Extension Form for Short Term Disability: If the original amount of time set by your physician to rest is not enough, you would need to fill out this form to extend your leave. This would have to be approved and signed by the physician with proof and medical records showing that you have not yet recovered.
• Voluntary Short Term Disability Form: This is used to cover disabilities that are not job-related or injuries that are not incurred in the workplace.

A Short Term Disability Insurance is usually paid for by the employer. If the employee has reached the maximum period of coverage for a Short Term Disability Insurance, he may then apply for a Long Term Disability Insurance. In this case, you may need Disability Parking Forms. There are also Child Disability Forms for application of benefits and allowances for children with disabilities.

Extension Form for Short Term Disability

Printable Voluntary Short Term Disability Form

Short-Term Disability Proof of Loss Form

Free Short Term Disability Income Benefit Form

Short Term Disability Leave Request Form

As we all know, financial security is very important, and in that sense, insurances are very important as well. This is why Short Term Disability Insurance is important. When we are unable to work and provide for our family due to an illness or injury, which are both unforeseeable events, it is always best to be prepared and still have financial security during those times. For this, you may also need Social Security Disability Forms for social security coverage of your disability.