🩹 Fax Short-Term Disability Claim Forms

Fax your disability claim, $2.99

Where Your Claim Form Goes

Most short-term disability plans offered through an employer are run by an insurance company, and the claim forms go to that insurer, not to your employer's payroll office and not to a government agency. The fax number is different for each insurer and often for each employer plan, so please take it from the claim packet, from the Attending Physician Statement, or from HR. California is the important exception among the state programs: its SDI program does not take faxes at all, so you file online or by mail there.

The Attending Physician Statement is the part your doctor fills out. In many cases the doctor's office faxes it straight to the insurer, which is the simplest route. If the office gives the completed form back to you instead, you send it with your own section, using the number on the packet. Some insurers also allow claims by phone or by upload. For example, a MetLife short-term disability sheet lists filing by phone, with forms by fax, mail or upload, but that sheet carries a 2022 date, so please use the number on your own current packet.

State Disability Programs: Which Ones Take Fax

A few states run their own disability insurance programs, and each one has its own route. This table shows what each state's official pages say:

In New Jersey, medical providers can use the online M-01 portal, which the state prefers, or fax Part C of the DS-1 to the same number, 609-984-4138. In New York, if you were unemployed for more than 4 weeks before the disability began, the DB-450 must be mailed to the WCB Disability Benefits Bureau, PO Box 9029, Endicott, NY 13761-9029. In Hawaii the State does not pay benefits itself, so the employer's insurer handles the claim.

Fax your disability claim, $2.99

Deadlines for Filing and for a Decision

The filing deadline depends on where your claim goes. California SDI says to file no earlier than 9 days and no later than 49 days after your disability begins, and the physician certification is also due within 49 days. New Jersey TDI asks you to file within 30 days of the first day of disability, and a late claim needs a reason. When New Jersey asks for the medical section, it is due within 14 days of the request. New York asks for the DB-450 within 30 days of the first day of disability. Rhode Island allows 90 days from the first week out of work, and Hawaii allows 90 days, with nothing paid on a claim filed more than 26 weeks late.

For employer plans run by insurers, federal rules give the insurer 45 days to decide a disability claim, and it can extend that twice by 30 days. If the claim is denied, you have at least 180 days to appeal, and the appeal decision is due within 45 days, with up to 45 more. Your plan's own letters give the exact dates for your claim.

If your employer has also asked for FMLA paperwork, that is a separate form that goes to HR, and our guide to faxing FMLA certification to HR explains it.

What to Put on the Cover Page and Each Page

A cover page helps your claim reach the right file at the insurer. Write the insurer's name and "short-term disability claims", your full name, your employer's name, your claim number if you already have one, the policy or group number if the packet shows one, your phone number, and the total number of pages. Keep the cover page free of medical details, because anyone near the receiving fax can read it.

On every page, write your name and claim number at the top and number the pages, for example 3 of 8. Send every page of the form, including pages that are partly blank, and check that the signature lines are signed and dated. Scanning in black and white keeps dates and signatures easy to read.

Fax your disability claim, $2.99

How to Send It and What It Costs

Go to OverseasFax, select United States, and type all 10 digits of the fax number with no leading 1. For New Jersey TDI that is 6099844138. The +1 is added for you, and if you type a 1 at the start, the box removes it. The pay button turns on only when 10 digits are entered. There is more detail in our guide on how to fax a US number online.

The price is $2.99 for up to 3 pages and $0.99 for each extra page. A cover page plus a seven-page claim packet is 8 pages, which comes to $2.99 + 5 x $0.99 = $7.94. You see the total before you pay, there is no account to create, and nothing is printed on your document. You can send from a phone or a computer, which helps when you are recovering at home.

Your Record, Privacy and If the Fax Fails

Delivery usually takes a few minutes. You then receive a confirmation email that shows the destination number, the page count and the time the fax went through, in US Eastern Time. Please keep that email, because it is your record of exactly when it was sent, which helps if a filing date is ever questioned. If the fax cannot be delivered, the full amount goes back to your card automatically, and you can check the number and send again.

OverseasFax is not HIPAA compliant and does not sign a business associate agreement, so it is a tool for you to send your own claim, not a service for a medical office. If the insurer needs to fax forms back to you, our sister service GetAFax.com gives you a private US fax number for 24 hours for $5, for up to 30 pages, and each fax arrives in your email as a PDF.

If your claim is denied and you appeal, the appeal may go to a different address or fax, so please use the one on the denial letter. Our guides to faxing your health insurance company and faxing workers' comp documents cover related claims, and the US fax guide lists other forms people send from home.

Frequently Asked Questions

Related Guides

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📖 US Fax Guide