Annual Requirements for Disability Benefits

To ensure that your benefit(s) continue without interruption, you must submit all required forms to ETF by the due date.

Learn more about disability benefit annual reviews and requirements for:

• Disability Retirement Benefits
• Long-Term Disability Insurance (LTDI)
• Duty Disability Benefits
• Income Continuation Insurance (ICI)

Disability Retirement Benefits and Long-Term Disability Insurance (LTDI) 

Mailing and due dates for the annual requirements are listed in the tables below. You must submit your documents to ETF by the due date or your disability benefit will be suspended and possibly terminated. 

If you have any questions regarding the annual process or need help completing and submitting the form(s), contact your designated disability case manager. You may also call ETF at 1-877-533-5020 and ask to speak with a disability case manager. 

Earning Statements

Each year, you are required to complete the Annual Earnings Statement for Disability Benefits (ET-5905). This process determines if you exceeded the annual earnings limit in the prior year. 

Medical Recertification

You may be required to provide annual medical evidence that you continue to be disabled. This process determines if you meet the statutory definition of disabled and if medical recertification must continue. The Recertification Medical Report (ET-5909) must be completed by you and your physician. 

Duty Disability Benefits

Mailing and due dates for the annual requirement are listed in the table below. You must submit your documents to ETF by the due date or your disability benefit will be suspended and possibly terminated. 

If you have any questions regarding the annual process or need help completing and submitting the form, contact your designated disability case manager. You may also call ETF at 1-877-533-5020 and ask to speak with a disability case manager. 

Annual Income Statement

Your duty disability benefits are subject to reductions (offsets) based on other income you receive. Each year, you must complete the Annual Income Statement (ET-5910) and submit corresponding tax documents. This process determines if offsets to the benefit are correct and if you have been overpaid or underpaid in the previous year.

 

Income Continuation Insurance (ICI)

Mailing and due dates for the annual requirement are listed in the table below. You must submit your documents to ETF by the due date or your disability benefit will be suspended and possibly terminated. 

If you have any questions regarding the annual process or need help completing and submitting the form, contact The Hartford at 1-800-960-0052 and ask to speak with your disability claim manager. 

ICI Annual Income Certification

Your ICI benefits are subject to reductions (offsets) based on other income you receive. Each year, you will receive an ICI Annual Income Certification (DTPA-5905) from our third-party administrator, The Hartford.  This process determines if offsets to the benefit are correct and if you have been overpaid or underpaid in the previous year.