How to Fill Out and Submit the MetLife Leave of Absence Form

To file a MetLife leave of absence form, start through the MyBenefits portal at metlife.com/mybenefits, or call 888-608-6665 if online filing isn’t available to you.¹ The paperwork has two main parts: a section you complete with personal and employment details, and an Attending Physician’s Statement your doctor completes. Getting both parts right the first time is the single best way to avoid delays.

Which Leave You’re Filing For

Before you open the form, be clear on what you’re requesting, because the type of leave shapes what you’ll fill in and what protections apply.

FMLA leave provides up to 12 weeks of unpaid, job-protected leave per year for a serious health condition, a new child, or caring for a family member. MetLife verifies eligibility on behalf of your employer.²
Short-term disability (STD) replaces part of your income during a non-work-related illness or injury, generally 40 to 70 percent of pre-disability earnings for up to about six months.³
Long-term disability (LTD) picks up after STD ends, typically after a waiting period of 90 days or more.⁴

Many employees file FMLA and short-term disability at the same time, since FMLA protects the job while STD replaces income. The specific STD and LTD benefit amounts, waiting periods, and definitions of “disability” come from the group policy your employer bought, not from a government standard.

What to Gather Before You Start

Pulling this together before you open the form cuts down on back-and-forth. The employee section asks for:⁵

Full name, Social Security number, date of birth, home address, phone, and email.
Your company-assigned employee ID number, which links the claim to your benefits profile.
The date your disability began, whether it stems from illness or injury, whether it’s work-related or auto-related, and a description of what keeps you from doing your job.
Names, phone numbers, specialties, and treatment dates for every provider who has treated you for this condition in the past 12 months.⁶
Federal tax filing status and number of exemptions, because MetLife withholds taxes from benefit payments.

You’ll also sign a HIPAA authorization so MetLife can request your medical records directly from your providers. Without that signature, the form won’t move.

Filling Out the Employee Section

Most of the employee portion is routine, but a few fields trip people up.

The disability description asks you to explain, in your own words, what prevents you from performing your job duties. Be specific. “Back pain” tells a claims examiner nothing. “Herniated disc at L4-L5 causing numbness in my left leg, making it impossible to stand or sit for more than 15 minutes” gives the reviewer something concrete, and it should line up with what your doctor writes in the physician’s statement.

If an injury caused the condition, you’ll provide the date, time, and how it happened. For a work-related injury, workers’ compensation may be the primary coverage rather than your employer’s disability plan, and MetLife asks the question to route the claim correctly. Mark “automobile-related” as yes if a car accident caused the condition, since auto insurance may cover part of your lost income.

The form includes a fraud statement at the bottom that you sign separately from the main signature. A missing signature on either line is one of the most common reasons MetLife sends paperwork back.

The Attending Physician’s Statement

This is the section that makes or breaks most claims. Your doctor fills out the Attending Physician’s Statement (APS), and an incomplete or vague one is the most frequent cause of delays and denials. Bring a copy of the blank form to your appointment rather than hoping the office will track it down.

The APS asks your physician to document:⁷

First and most recent treatment dates, whether the cause is illness, injury, or pregnancy, whether the patient was advised to stop working, and any hospitalizations.
Primary and secondary diagnosis codes (ICD codes), reported symptoms, clinical findings, the treatment plan, any surgeries done or planned, and current medications with dosages.
Functional restrictions broken down by how many hours per day you can sit, stand, walk, climb, bend, reach, and perform fine finger movements, plus lifting and carrying capacity in weight ranges from under 10 pounds to over 100 pounds.
Prognosis, including any return-to-work date and whether that return is full-time, part-time, or with modified duties.

Your physician also needs to submit office notes and diagnostic test results (X-rays, MRIs, lab work) with the statement. MetLife’s examiners compare the functional restrictions your doctor lists against the physical demands of your job description, so vague or overly conservative numbers hurt your claim. If your doctor writes that you can sit for six hours a day and your job is entirely desk-based, MetLife will likely question whether the disability prevents you from working.

How to Submit the Form

MetLife accepts completed claims through several channels. The MyBenefits portal is the fastest. You can upload scanned documents or clear photos by going to Claims Center, then the Claim Detail Page, then the Details Tab, and selecting “Add Comment/Document.”¹ LTD claim forms can be completed digitally and submitted by email or fax.⁴ If you aren’t eligible to file online, call 888-608-6665 to file by phone and get instructions for submitting documents by mail or fax.

Whichever method you use, save a confirmation receipt, tracking number, or fax transmission report. If MetLife later says it never received your paperwork, that receipt is your proof. Keep copies of every page you submit, including the signed APS and the HIPAA authorization.

After You Submit

Federal regulations set the outer limits on how long MetLife can take to decide. Under ERISA, the plan administrator must notify you of its decision on a disability claim within 45 days of receiving it. If circumstances beyond its control require more time, MetLife can extend that period by up to 30 days, and then by another 30 days if necessary, with written notice before each extension expires explaining why.⁸ The worst-case maximum is 105 days from receipt of your complete claim.

MetLife communicates decisions by phone and in writing. An approval notice includes your total benefit amount and payment method, and you can set up direct deposit through MyBenefits to get paid faster.¹ A denial notice must give specific reasons and tell you how to appeal.⁹

During the review, MetLife may ask you to attend an independent medical examination (IME) with a doctor it selects. Declining can jeopardize your claim, so treat the request seriously even though the examiner works for the insurance company, not for you. Take notes during the appointment on what questions were asked, what tests were performed, and how long it lasted.

If Your Claim Is Denied

A denial isn’t the end. ERISA entitles you to a full and fair review of any denied claim.⁹ For disability claims, MetLife must decide your appeal within 45 days of receiving it, with one possible 45-day extension if circumstances require it.⁸

Read the denial letter carefully before you respond. If MetLife says the medical evidence was insufficient, ask your doctor to provide additional records, updated clinical findings, or a supplemental narrative addressing the specific gaps the letter identified. If the denial relied on an IME that contradicted your treating physician, your doctor can write a rebuttal letter explaining why the IME conclusions are wrong.

Put everything into the appeal. If you eventually challenge a denial in federal court under ERISA, the judge generally reviews only the evidence that was in the administrative record when MetLife made its final decision. New evidence raised for the first time in court may not be considered.

1
MetLife. MetLife Disability Claims Guide: Status, Forms, and Filing
2
U.S. Department of Labor. Family and Medical Leave (FMLA)
3
MetLife. Short-Term Disability Insurance: What Is It and How May It Help?
4
MetLife. MetLife LTD Claims
5
MetLife. Short Term Disability Claim Form
6
MetLife. Disability and Absence Management
7
MetLife. Attending Physician Statement
8
eCFR. 29 CFR 2560.503-1 – Claims Procedure
9
Office of the Law Revision Counsel. 29 USC 1133 – Claims Procedure