Please wait while your request is being processed.
Please use this secure online form to initiate your Short Term Disability or Medical Leave Claim submission.
Once you submit your disability/medical leave claim information to us, we will contact your employer for eligibility information within 1-2 business days.
When employer information is received, we will call your physician for your medical information. We encourage you to contact your physician to provide authorization to release your medical information to Guardian. Here is an Authorization to Obtain Information form that you can complete to provide authorization. If we unable to obtain information over the phone, we will fax a request to your physician which may delay the processing of your disability/medical leave claim.
If you have an attending physician statement, employer statement or award letter for any other source of income that you may be receiving, you can upload documents on Step 4. Or you can fax the documents to (610) 807-8270.
If you have any questions concerning completion of this form, please contact Disability Claim at (800) 268-2525 Monday - Friday 8:00AM - 5:30PM EST.
Group/Plan ID: Please enter Group/Plan ID.
Employee Information
Enter your Member ID as shown on your ID card, your TaxID or your Employee ID from your Employer.
Employer Information