Short Term Disability Claims Tracker
This log can help you track unemployment benefits due to you during a period of short-term disability because of illness or injury. There is room to note your maximum daily and annual payment.
Recently added
Downloads are subject to this site's terms of use.
Description
Short-Term Disability Claims
Fields: Injury, day rate, date of injury, annual max, date, week(s) claimed, paperwork submitted, benefit received, follow-up complete.