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Texas Income Protection Plan for State Employees, ERS

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Disability Claim Form

The Disability Claim Form is what you will complete to give us information about your disability, including your treating providers and your date of disability. We must receive the form within 12 months of the date that your total disability began. The original form must be completed and signed by you and faxed or mailed to TIPP Customer Care (fax number and address are shown on the form).


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