File a Claim: Long-Term Disability

Hartford & Aetna Long Term Disability Forms

Hartford’s Long Term Disability Claim Forms will be used for starting a new claim in the case of a disability due to sickness or injury after the 6-month elimination period.

  • 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 “Application for Long Term Disability Income Benefit”, you will then have your Doctor complete their section labeled “Attending Physician Statement - Initial Report”
  • Step 3: Send both completed sections back to us by either mail, fax, or email. We will then process and complete the rest of the application for you and process all the information to our dedicated team at The Hartford.
    • Our Fax Number is – 631-454-6423
    • Our Email is –
    • Our Address is – One Huntington Quadrangle Suite 1C09 Melville, NY 11747

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