How to File for Short-Term Disability

When you're unable to work due to a non-work-related injury, a pregnancy, or recovering from an illness, TeamCare's Short-Term Disability Benefits are here to take care of you. If included in your plan, we provide weekly payments when you're unable to work. Members should refer to their Plan Benefit Profile to see if short-term disability benefits are included with their plan. For complete details on your benefits, please refer to My Profile.

To file for short-term disability and start receiving your weekly payments, follow these steps below.

Tip: If you work for UPS or TForce Freight, there are a few more steps you’ll need to follow. If you’re not a UPS or TForce Freight employee, you can skip those steps.

Before You Apply

To be eligible to receive short-term disability benefits, you must be:

Disabled as a result of a non-work-related injury or illness

Unable to work due to pregnancy

and

Receiving regular care from your doctor that interrupts your ability to work

and

Actively employed and covered by the Plan when you become disabled

For members who work for UPS:

• Call The Hartford: You will need to call The Hartford at 1-866-825-0186 to report your leave. A medical document supporting your leave must be provided. Once you’re on leave, medical documents must be sent to The Hartford every 60 days to recertify your leave — you can upload those documents at http://abilityadvantage.thehartford.com.

• If you work for UPS in New Jersey or New York, you must submit your claim through The Hartford either by calling 1-866-825-0186 to reach a The Hartford representative, or online at http://abilityadvantage.thehartford.com.

• If you work for UPS in California or Rhode Island, you must submit your claim through your state’s short-term disability program. Once approved, you must send a copy of the statement to TeamCare.

• For all other UPS employees, after you call The Hartford, you may proceed with the rest of the Short-Term Disability steps.

For members who work for TForce Freight:

• TForce Freight employees must call LifeWorks at 1-800-533-0550 or email tffleave@tforcefreight.com to initiate your leave. It is important that you contact LifeWorks immediately to ensure contributions are made for continued TeamCare benefits while on leave.

• If you are employed by TForce Freight in New York, submit a claim with Prudential Insurance Company of America by gong to the Disability Management Services website: www.prudential.com/mybenefits or call 1-877-367-7781 / fax 1-877-889-4885.

• If you are employed by TForce Freight in New Jersey, submit a claim with the state of New Jersey at Division of Temporary Disability and Family Leave Insurance website: https://nj.gov/labor/myleavebenefits or call 1-609-292-7060 / fax 1-609-984-4138. Once approved, you must send a copy of the statement to TeamCare.

• If you are employed by TForce Freight in California or Rhode Island, you must submit your claim through the state’s short-term disability program. Once approved, you must send a copy of the statement to TeamCare.

For all members:

Download the Form

When you’re ready to apply, you must complete the TeamCare Short-Term Disability Claim Form - Initial Report of Disability. You can download and print the form on the right, or call 1-800-TEAMCARE(1-800-832-6227) to request a claim form be mailed or faxed to you.

Short-Term Disability Claim Form — Initial Report of Disability

Download PDF

Complete the Form

1

Complete Part 1 yourself.
2

Give the form to your treating physician to complete Part 2.
Keep in mind that most providers will require you to come into their office for a visit to diagnose your disability, and some may charge an additional fee to complete the form. Contact your provider for their policy on completing disability forms.
3

Give the form with Parts 1 and 2 to your employer.

Once Parts 1 and 2 are complete, your employer will complete Part 3.

Submit the Form

Once the TeamCare Short-Term Disability Claim Form - Initial Report of Disability is completed, submit the form to TeamCare. You can submit the form one of three ways, outlined below. For the fastest turnaround time, we recommend scanning your completed form and sending to TeamCare via your Message Center.

Message Center

Scan your completed form. Once logged in, Navigate to the Message Center, compose your message, attach your scanned form, and send. You’ll receive confirmation once it has been received. Easy!
Message Center
Mail

We recommend making a copy of your form for your records. Mail the original to the following address:

TeamCare

Central States Health Fund

PO Box 5107

Des Plaines, Illinois 60017-5107
Fax

Fax your completed form to TeamCare directly at 1-847-518-9757.

After we receive your form, we’ll send you a confirmation message via the same channel through which you submitted it. For instance, if you’ve mailed your form, watch the mail for a letter from us confirming receipt. If you have not received confirmation within five business days, please contact a Benefits Specialist via your Message Center or by calling us at 1-800-TEAMCARE (1-800-832-6227).

Continuation Forms

After your disability payments begin, you may be asked to submit a Short-Term Disability - Continuation Form to TeamCare with updates from your physician. Complete and submit the Short-Term Disability - Continuation Form by following the same steps above. To avoid any delays in processing your payments, please submit forms as soon as possible.

If you have questions, please send a secure message through the Message Center or call a Benefits Specialist at 1-800-TEAMCARE (1-800-832-6227).