File A Claim: Short-Term Disability

Aflac Initial Short Term Disability Form

Aflac’s Initial Claim Forms will be used for starting a new claim in the case of a disability due to sickness, injury, or pregnancy.

  • Step 1: Download claim forms by clicking the link below or simply call us at 631-991-6050 so we can email, fax, or mail them to you.
  • Step 2: Complete the Employee section labeled “Initial Disability Claim Forms”, you will then have your Doctor complete their section labeled “Physicians Statement”
  • Step 3: Send both completed forms back to us by either mail, email, or fax. We will complete the Employer’s section for you and process all the information to our dedicated team at Aflac.

 Click the button below to download the form to file a claim.

Aflac Continuing Short Term Disability Form

Aflac’s Continuing Claim Forms will be used for Continuing an already existing claim in the case of a disability due to sickness, injury, or pregnancy is extended past the date on your intial claim.

  • Step 1: Download claim forms by clicking the link below or simply call us at 631-991-6050 so we can email, fax, or mail them to you.
  • Step 2: Complete the Employee section labeled “Continuing Disability Claim Forms”, you will then have your Doctor complete their section labeled “Physicians Statement”
  • Step 3: Send both completed forms back to us by either mail, email, or fax. We will complete the Employer’s section for you and process all the information to our dedicated team at Aflac.

 Click the button below to download the form to file a claim.

Boston Mutual Short Term Disability Forms

Boston Mutuals Initial Claim Forms will be used for starting a new claim in the case of a disability due to sickness, injury, or pregnancy.

  • Call Boston Mutual directly at 877-274-1958 to start the claim process. They will then send you the appropriate claim forms to you.

Paul Revere / Colonial Initial Short Term Disability Forms

Colonial’s Initial Claim Forms will be used for starting a new claim in the case of a disability due to sickness, injury, or pregnancy.

  • Step 1: Download claim forms by clicking the link below or simply call us at 631-991-6050 so we can email, fax, or mail them to you.
  • Step 2: Complete the Employee section labeled “Section 1 – Claiment Section”, you will then have your Doctor complete their section labeled “Section 3 - Physicians Statement”
  • Step 3: Send both completed forms back to us by either mail, email, or fax. We will complete the Employer’s section for you and process all the information to our dedicated team at Paul Revere / Colonial.

 Click the button below to download the form to file a claim.

Paul Revere / Colonial Continuing Short Term Disability Forms

Colonial’s Continuing Claim Forms will be used for Continuing an already existing claim in the case of a disability due to sickness, injury, or pregnancy is extended past the date on your intial claim.

  • Step 1: Download claim forms by clicking the link below or simply call us at 631-991-6050 so we can email, fax, or mail them to you.
  • Step 2: Complete the Employee section labeled “Section 1 – Claiment Section”, you will then have your Doctor complete their section labeled “Section 3 - Physicians Statement”
  • Step 3: Send both completed forms back to us by either mail, email, or fax. We will complete the Employer’s section for you and process all the information to our dedicated team at Paul Revere / Colonial.

 Click the button below to download the form to file a claim.

Trustmark Short Term Disability Forms

Trustmark Initial Claim Forms will be used for starting a new claim in the case of a disability due to sickness, injury (outside of work), or pregnancy.

  • Step 1: Download claim forms by clicking the link below or simply call us at 631-991-6050 so we can email, fax, or mail them to you.
  • Step 2: Complete the forms entirely, when finished, submit them directly to Trustmark. The fax number and email address will be at the bottom of the forms

 Click the button below to download the form to file a claim.

If you need to continue an existing claim the Continuing claim forms will be sent to you from Trustmark directly.

UNUM Initial Short Term Disability Forms

UNUM’s Initial Claim Forms will be used for starting a new claim in the case of a disability due to sickness, injury, or pregnancy.

  • Step 1: Download claim forms by clicking the link below or simply call us at 631-991-6050 so we can email, fax, or mail them to you.
  • Step 2: Complete the Employee section labeled “Section 1 – Claiment Section”, then you will have your Doctor complete their section labeled “Section 3 - Physicians Statement”
  • Step 3: Send both completed forms back to us by either mail, email, or fax. We will complete the Employer’s section for you and process all the information to our dedicated team at UNUM.

 Click the button below to download the form to file a claim.

UNUM Continuing Short Term Disability Forms

UNUM’s Continuing Claim Forms will be used for continuing a claim in the case of a disability due to sickness, injury, or pregnancy.

  • Step 1: Download claim forms by clicking the link below or simply call us at 631-991-6050 so we can email, fax, or mail them to you.
  • Step 2: Complete the Employee section labeled “Section 1 – Claiment Section”, then you will have your Doctor complete their section labeled “Section 3 - Physicians Statement”
  • Step 3: Send both completed forms back to us by either mail, email, or fax. We will complete the Employer’s section for you and process all the information to our dedicated team at UNUM.

 Click the button below to download the form to file a claim.