Local Lodge 263
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How to file for, RRB and Aetna Supplemental Sickness Benefits (Revised)2/17/2010 Revised: 2/17/2010
How to file a Claim for Benefits:
1. Pick up RRB Form UB-11 from your Local Chairman or download UB-11 from RRB.gov. Fill out the form in the center of the booklet. The first page must be filled out by you and the second page must be filled out by the Dr. removing you from service. Both forms can be mailed in to:
Railroad Retirement Board
Quorum Business Park
Suite 120
7508 Independence Blvd.
Charlotte, NC 28227-9409
The local phone number for RRB Charlotte is 877-772-5772
Personally I would get your Dr. to fill out the physicians form and fill out what you know for sure, leave the rest blank, drive to RRB in Charlotte, let them help you fill in the rest of the blanks and hand deliver them both.
RRB in Charlotte is located at:
Quorum Business Park is off Independence Blvd. East past K&W Cafeteria
7508 E. Independence Blvd., Suite 120
Charlotte, NC 28228-9409
Hours 9:00 AM thru 3:30 PM
Monday through Friday except Federal Holidays
Telephone (877) 772-5772
Fax (704) 344-6429
The people at RRB Charlotte are more than glad to help you with any questions you might have.
2. The notice of claim must be given within 20 days of the start disability or as soon as reasonably possible. If the employee does not submit his notice of claim within the prescribed 20 day period his/her claim will be denied unless they provide Aetna with sufficient information to establish, as determined by Aetna, that although he/she did not meet the 20 day time limit, he/she did submit their notice of claim as soon as reasonably possible.
3.Do Not mail in the Aetna form that is available from your local chairman, call them at 1-800-205-7651 to initiate your claim. Be prepared to answer lots of questions. Also have your Doctors full name, the doctors specialty, phone #, address and Fax # ready. As of Jan. 2010 Aetna can now do Direct Deposit.
To obtain additional info, contact:
The below statement pertaining to Aetna may not be current or correct!
Supplemental Sickness Plans
Francine Mondone RN, CRRN
AetnaDisability Manager
Phone:954/693-2700
Fax: 954/452-4145
Click Here For form UB-11
The link to form UB-11 is in the upper right corner at the above link. It is a pdf file that can be printed out.
Click to check on the status of your Aetna claim, you will have register at the site.
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