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- Absence must be reported to supervisor
- Print the “Reporting Your Disability Claim” sheet and sign the Authorization to Release Information section. If the employee has Kaiser, Kaiser has a separate medical release form. The form must be provided to the employee’s physician or medical care provider as soon as possible. This form gives the employee’s doctor permission to send the employee’s medical files to Liberty Mutual.
- If reporting online, the claim must be reported via www.mylibertyconnection.com. Use the Company Code “University” when setting up access to the site.
- If reporting via paper forms, print and complete the form. Fax forms directly to Liberty Mutual Insurance at (877)-664-7264.
- Liberty Mutual Insurance requires completed copies of: employee claim form, UC statement, and employee’s medical records from your physician
- Maintain a record of the assigned Liberty Mutual claim number. The status of the employee’s claim can be securely checked online at www.mylibertyconnection.com or by calling the Case Manager at 1-800-838-4461.
Employer Paid Basic Disability Insurance – Provides short-term income if you are unable to work due to a disabling injury, illness or pregnancy. Employee must be under a doctor’s care and the illness or injury must not be work-related, unless the employee has a denied worker’s compensation claim.
Voluntary Short Term Disability Insurance – Provides income if the employee is unable to work due to a disabling injury, illness or pregnancy. The employee must be under a doctor’s continuous care and may be eligible to supplement their worker’s compensation benefits. Income from this plan is coordinated with income from the Basic Disability Insurance Plan and in case of work-related injury or illness, with Worker’s Compensation Benefits
Long Term Disability Insurance – starts after six months of disability begin date