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  • Duke Disability Program Request for Service Requirement Waiver Form

Duke Disability Program Request for Service Requirement Waiver Form

Proof of Prior Coverage (Long Term Disability Waiver Option)

If you had an employer-sponsored long term disability plan within 90 days of full-time employment to Duke, you may participate in the Duke Disability Program as of the first day of the month after your hire date (waiving the normal three-year waiting period). You can request that your immediate previous employer completes the Duke Disability Program - Request for Service Requirement Waiver form below. Waiver requests must be received in the Benefits Office within 90 days of your date of hire.

Form Name Format
file type icon Duke Disability Program Request for Service Requirement Waiver Form
PDF
file type icon Duke Disability Program Request for Service Requirement Waiver Form
Word

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Human Resources

Duke Human Resources
705 Broad St. Box 90496
Durham, NC 27705
Phone: (919) 684-5600
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