Disability Certification Form 2023 – 2024

Disability Certification 2023 - 2024

Student Name*

First

Last
Student ID (all 7 digits required)*
Section A

A student who has had previous loan discharged due to a total and permanent disability are eligible to receive Federal Pell grant funds.
Federal Direct Student Loans*
- I DO NOT plan to apply for Federal Direct Student Loans.
- I DO plan to apply for Federal Direct Student Loans.
Section B
Department of Education regulations state that a student who had a prior loan discharged due to a total and permanent disability who wishes to take out another Federal Loan must complete the following

1. Obtain a physician’s certification:
This certification must indicate that you are eligible to engage in “substantial gainful activity” as defined by the U.S.Department of Education. It does not have to include a detailed medical history.*
- I have a physician certification on file from a prior year
- I DO NOT have a physician certification on file and will submit certification from my doctor to verify my eligibility.
Upload your physician certification
Drop files here or

Accepted file types: pdf, doc, docx, Max. file size: 20 MB.

We currently only accept pdf, doc, and docx

2.Provide a Borrower Statement (Required for each new loan)

Borrower Statement Certification:

This is to certify I previously had a student loan(s) discharged due to a total and permanent disability. I further certify my understanding that my student loan obligation(s) may not be cancelled in the future on the basis of my disability unless the condition substantially deteriorates to the point where I meet the definition of total and permanent disability. Also, I understand before my new student loan will be approved, I must obtain a physician’s statement that indicates that I may now engage in “substantial gainful activity”.

Student Signature*

Disability Certification Form 2023 – 2024

Disability Certification 2023 - 2024

Section A

Section B