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A disability certificate form is filled by people who have met with an accident and due to which they have been disabled in some manner and would like to seek medical claims from an insurance company.
You can Download the Disability Certificate Form, customize it according to your needs and Print. Microsoft® and Microsoft Excel® and Microsoft Word® are registered trademarks of Microsoft Corporation.


Usually the insurance company asks the disabled person to complete this form which then needs to be given to a registered doctor, physician, surgeon, therapist etc.
The doctor has to fill the form too after explaining how the accident affected your disability. Only after the authorized doctor assesses your condition properly and connects the accident with your disability, you can send the form back to the insurance company, who will then review the case.





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