Disability Claims Reporting – New York

Disability/Paid Family Leave Claims Related to COVID-19:

Disability/Paid Family Leave Claims NOT Related to COVID-19:

In all cases, the employer and employee each have portions of the documents that need to be filled out with medical practitioners sometimes being required as well. The completed form(s) can be sent to us via e-mail at; fax at 570-825-0611; or mail at: P.O. Box 1368, Wilkes-Barre, PA 18703-1368. Be sure to sign and date the document(s) before returning to us.


© WestGUARD Insurance Company
CareersAffiliatesPrivacy PolicyOther Disclosures
A+ Superior