Manulife GBF0002E: Initial Disability Medical Statement

Manulife group benefits uses its copy of the industry Initial Disability Insurance Medical Statement, file number GBF0002E, as the medical form for disability claims. Manulife's disability claims FAQ says the same statement serves both short-term and long-term disability claims. It takes the place of Manulife's older attending physician's statements, which its site no longer links.

Who completes it

The attending physician or other medical provider completes Section 2, the Medical Statement. The plan member and plan sponsor complete separate claim forms, which Manulife makes available after signing in to its plan member site.

Submitting and payment

Who pays
The industry version of this statement states that the patient is responsible for any fees related to its completion.

Good to know

  • Manulife no longer links its older statements, GL3238E (long-term disability and waiver of premium, 05/2019) and GL4221E (short-term disability, 06/2019).
  • The plan member and plan sponsor disability claim forms are not public; Manulife provides them through its plan member site after sign-in.
  • The industry statement covers diagnosis, treatment and response, hospitalization, investigations, symptoms, restrictions and limitations, prognosis and return-to-work goals.

Get the official form

Download the current version from the source each time; forms change without notice.

Initial Disability Insurance Medical Statement

Fill it with Vero

If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms change without notice, so download the current version from the official page before you fill it in.

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Frequently asked questions

Is Manulife's medical statement different for short- and long-term disability?

No. Manulife's disability claims FAQ states that the Initial Disability Insurance Medical Statement is the same for both long- and short-term disability claims, so the GBF0002E form is used whichever benefit the plan member is claiming.

Are Manulife's GL3238E and GL4221E forms still current?

Manulife no longer links those legacy attending physician's statements, GL3238E for long-term disability and waiver of premium and GL4221E for short-term disability, both dated 2019. Its disability claims FAQ links the industry Initial Disability Insurance Medical Statement instead.