This info is copied from a company procedure.  Please use this as a guideline.  Company procedures change frequently, so this info may not be up to date.  If you are going to be out, please contact your local manger and confirm you are following the correct procedure.
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Effective 01-01-07 Frontier's disability carrier is PRUDENTIAL for
Short Term and Long Term Disability (STD and LTD).

The process for Worker's Compensation Claims is the same as Short Term Disability, with the exception of the accident/incident report, which is completed by the employee and a supervisor. 

The following are instructions to assist with filing a STD claim
Notify your supervisor if you (employee) are going to miss work. This must be done the first day and all consecutive days, unless otherwise advised by your supervisor.

After your second consecutive day of absence (3rd day out) call PRUDENTIAL at 1-800-842-1718 to start a claim.  The following information will be required for the Telephone Claim Submission:
1.        Company Name  (Frontier)
2.        Policy Number/Control Number (# 44190)
3.        Employee Name & Social Security Number
4.        Date of Birth
5.        Job Title
6.        Doctor's Name & Telephone Number
7.        A brief description of employee medical condition
8.        Employee last day worked and your first day out due to this condition
9.        If the absence is work related
10.        Date employee is expected to return to work

Present the Disability Authorization Form (HIPAA Authorization Form) to physician. The Company will not see any information submitted by the employee to Prudential.

This form should be kept on hand and can be obtained the following ways:
From home PC:
http://www.Prudential.com/inst/gldi
Click on Employee forms
Under Disability Claims heading, click on Medical Authorization
Fill out and print form   (*Note Control Number #44910)
From work PC:
The LINK: Click on the HR tab, then HR Home and HR Forms.
Click on Prudential's Telephonic Claim Submission Brochure.

A doctor's note will be required after the third day, even if you return to work before the start of STD. Submit a Medical Certification Form to your supervisor.

If an absence is the result of a relapse from an original disability, employee must call Prudential on the first day out. Prudential may be called up to 2 weeks in advance of a planned disability absence.

Upon approval of your STD from Prudential, you will be notified (by mail) stating when your benefits start and end. You may also call Prudential 24x7 at 1-800-842-1718 or visit their website at http://www.Prudential.com/inst/gldi to obtain the status of your claim. It is recommended that you check the status of your claim 3 days after notifying Prudential of illness.



Approval is generally three to five business days, once Prudential receives the three critical elements of the claim. Which are:
1.        Medical information (employee telephone contact with Prudential)
2.        Signed Disability Authorization Form/HIPAA Form (employee signs & brings to doctor)
3.        Employer statement (sent automatically by the Company to Prudential)

The process for FMLA does not change. Original paperwork must be submitted to Kathy Slocum, Dir, HR.

Employee is responsible for calling Prudential to initiate a claim
and calling Prudential when they return to work.