Medical Report for Disability Eligibility (Form 7A)

July 26, 2024
Categories: Forms Tags: Benefits, Disability Income, Employee, Short-term Disability

Medical Report for Disability Eligibility (Form 7A)

Purpose: Use this form to request medical eligibility for short-term disability coverage under the Disability Income Plan of North Carolina.

Email Contact: benefits@charlotte.edu

Last Updated: July 26, 2024