Disability benefits claim forms
How to make a claim
Use these forms to claim income benefits if you have short-term, long-term or early referral services disability coverage through your employer or plan sponsor.
To make a claim for coverage through your employer/plan sponsor, follow these steps:
Step 1: Complete a consent form.
Download this form and fill it out in Adobe Reader XI or higher - Opens in a new window (not your browser), and save.
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Use this form to permit Canada Life to collect, use and exchange info about your claim with your health care providers, employers and others.
Step 2: Complete an employee statement.
Download the statement, fill it out in Adobe Reader XI or higher - Opens in a new window (not your browser), and save.
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Use this form to apply for disability benefits. It contains instructions for making a disability claim, including what you’ll need from the doctor.
Step 3: Request a completed physician’s report.
Select the most appropriate form for your condition and ask your doctor to complete it.
If you’re missing work because you have a COVID-19 diagnosis or pending test, you can complete this step yourself, without a doctor’s help.
Note: The signatures are still required but we’ll contact you later to complete these. You can submit your claim without them for now.
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Use this form to make a disability claim because of cancer conditions. You’ll need your doctor to fill in some sections.
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Use this form to make a disability claim because of cardiac conditions. You’ll need your doctor to fill in some sections.
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Use this form to make a disability claim if you have a diagnosis of COVID-19, or if you have symptoms and are waiting for test results.
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Use this form to make a long-term disability claim if your disability is caused by a condition that doesn't fit in another category. You'll need your doctor to fill in some sections.
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Use this form to make a disability claim because of mental health conditions. You’ll need your doctor to fill in some sections.
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Use this form to make a disability claim caused by musculo-skeletal conditions. You'll need your doctor to fill in some sections.
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Use this form to make a claim for short-term disability or for early referral services. You’ll need your doctor to fill in some sections.
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Use these forms if you want to download disability claim forms for all medical conditions. You'll need your doctor to fill in some sections.
Step 4: Submit your claim.
Go to our online claims process, where you will attach all 3 of these forms as part of the submission.
You’ll need to add a few more details about yourself and your plan.
Select submit once you’re done.
If you have questions about submitting online, call us at 1-855-755-6729.
It’s best to submit online, but you have options if you can’t.
You can mail or fax your forms to your local disability management services office. Please be aware that the response might be delayed right now.
Waiting for a response?
If you have questions about your claim or want to know its status, call or email your local disability management services office.