North Carolina Disability Benefits

Thank you for visiting the North Carolina's Disability Benefits Web page.  This Web page was established to provide an overview of the newly created disability forms and training documents to help members and employers understand the process and what information is needed for each form.

• DIPNC Overview (Short-Term; Preliminary Long-Term; Extended Short-Term and Long-Term)

• DIPNC Short-Term for Employer Administration

• Disability Retirement Overview (state and local)

• The Disability Process
  
  

• Training & Education Modules 
  • Short-Term and Preliminary Long-Term Disability
  • Long-Term Disability
  • Extended Short-Term Disability
  • Disability Retirement
  • Short-Term Employer Reimbursement

• Quick Reference Charts

  • Disability Quick Reference

  • Disability Forms Description

• Employer Forms
  • Form 714: Requesting Reimbursement and Service Credit for the Short-Term Period

• Contact Us:  Members with questions regarding the forms or the disability process should contact the Division’s Member Services.
  

• Frequently Asked Questions
  

Disability Process Checklist

To help guide you through the process, the following is a checklist of required forms listed in the order that they must be submitted.  Click on the form number to retrieve the form.  Mock-ups are available above in the "Training and Education" section to assist you with completing the form.

• For members of Teachers' and State Employees' Retirement System vested on or before January 1, 1988

- Form 7 - Requesting Disability Retirement Benefits
- Form 7A - Medical Report for Eligibility Review
- Job Description (Provided by employer)

• For members of Teachers' and State Employees' Retirement System vested after January 1, 1988

  • Short-Term and/or Preliminary Long-Term application includes:

- Form 701 - Requesting Short-Term Benefits Through the Disability Income Plan of North Carolina
- Form 700 - Requesting Employer Information Required for Member Disability Income Plan Benefits
- Job Description (Provided by employer)
- Form 703 - Medical Report for Eligibility Review of Short-Term Disability Benefits
- Form 7A - Medical Report for Eligibility Review

• Extended Short-Term or Long-Term application includes:

- Form 704 - Requesting Additional Benefits Through DIPNC
- Form 701 - Requesting Short-term Benefits Through the Disability Income Plan of North Carolina
- Form 700 - Requesting Employer Information Required for Member Disability Income Plan Benefits
- Job Description (Provided by employer)
- Form 703 - Medical Report for Eligibility Review of Short-Term Disability Benefits
- Form 7A - Medical Report for Eligibility Review
- Form 711 - Determining and Recording Short-Term Disability Benefits