One More Step Required

Thank you for completing and submitting the Employee’s Statement of Claim for Benefits. In order to complete the claim filing process, an Employer’s Statement of Claim for Benefits form (completed by your employer) and an Attending Physician’s Statement form (completed by your physician) are also required. Please have the physician that is supporting your claim for disability benefits fully complete the Attending Physician’s Statement form and return to us. For your convenience, this form can be printed via the following link.


Attending Physician's Statement


You will receive an email shortly from DocuSign to obtain your electronic signature. Please review your email and proceed through the DocuSign process. Once completed your information will be provided to us for review. Instructions for the DocuSign process, including how to save information for your records, can be found below.

Click here for the instructions regarding the DocuSign Process


We can be reached at (800) 356-9601 or MNLCustomerCare@MadisonLife.com if you have any questions.