Securely submit your Employee's Statement online

Browse to the location where you saved your Employee's Statement and select it Note:Only Adobe Acrobat (.PDF) documents can be submitted online. Up to five documents can be submitted at a time (maximum individual document size is 8MB) Choose File 1 No files currently selected for upload
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Plan number (optional)

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First name

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Last name

Phone number and extension (if applicable) <span id="PhoneNumberScreenReader" class="sr-only">Screen readers, enter numbers only. Do not add hyphens, brackets and extension text because they are added automatically.</span>

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Select the Canada Life Disability Management Services Office that manages your claim

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Security check

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Get an audio challenge. The captcha is updated and the audio challenge is automatically played. Use the play sound again link to replay the current audio challenge. Use the link, get a new challenge, to change the audio. Enter your response to the audio challenge in the type what you hear text box.

I certify that the statements made in the attached document are true and complete. I have read and agree with the Terms and Conditions. Click the Terms and Conditions link before accepting the Terms and Conditions.

Your online submission of this form indicates that you have read, understood and agreed to these Terms and Conditions. If you do not agree with these Terms and Conditions, do not submit your form online.If you have any questions about submitting your document online, contact us at 1-855-755-6729.For Internet Explorer users, you may close your session by clicking Close or Cancel. For other browser users, you must close your session by clicking the close ("X") symbol in the upper right corner of your browser.