Fillable Student Eligibility Verification for Previously University of the (University of the Incarnate Word)

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Student Eligibility Verification for Previously University of the (University of the Incarnate Word)

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University of the Incarnate Word
Office of Financial Assistance
Student Eligibility Verification for Previously
Discharged Loans
4301 Broadway, Box 308
San Antonio, TX 78209
Phone: (210) 829-6008
Fax: (210) 283-5053
finaid@uiwtx.edu
www.uiw.edu/finaid
Revised 11/2020
-
J
Name UIW ID
The National Student Loan Data System indicates that you have had federal student loans discharged (canceled/forgiven)
due to total and permanent disability. This form serves to reestablish your eligibility for federal student loan programs
when prior loans have been discharged. Completion of this form does not guarantee that you will qualify for the ederal
tudent oan rograms.
Step 1: Federal Student Aid Request
Please check the appropriate box which describes the types of federal financial aid you would like to to be considered for
at University of the Incarnate Word
Federal grants only (Complete Step 3)
Federal loans and federal grants (Complete Steps 2 and 3) **
** If your federal loans were conditionally discharged, they will be removed from their current conditional discharge status and the
Department of Education will reinstate the obligation to repay any conditionally discharged loans. (see discharge disclosure)
Step 2: Physician Certification
Instructions for Physician: You are asked to certify that the student named above can engage in substantial gainful
activity. The U.S. Department of Education defines “substantial gainful activity” as, “a situation in which a borrower is
sufficiently recovered to be capable of attending school, successfully completing a program of study, and securing
employment in order to repay the loan the borrower is seeking.”
Physician Name/Practice:
Address:
Phone Number/Email:
I certify in my best professional judgement that the above-named student is able to engage in substantial gainful
activity as defined by the U.S. Department of Education.
Physician Signature: Date:
Step 3: Student Certification
I acknowledge and agree that any future federal student loans that I obtain cannot be canceled or forgiven based on any
impairment present when the new loan is made, unless that impairment substantially deteriorates. My signature also
indicates that I acknowledge and agree to all the terms of the “Discharge Disclosures” provided on the second page of this
form.
Student Signature : Date:
DSCHRG
Discharge Disclosures
3-Year Post-Discharge Monitoring Period:
After the U.S. Department of Education approves your discharge request on the basis of your total and permanent disability (TPD), your loan holders will
transfer your federal student loans and/or Teacher Education Assistance for College and Higher Education (TEACH) Grant Program service obligation to the
Total and Permanent Disability Servicer for discharge. If you are approved for TPD discharge based on Social Security Administration (SSA) documentation
or a physician’s certification, you will be subject to a 3-year post-discharge monitoring period that begins on the date the discharge is approved
Note: The 3-year post-discharge monitoring period does not apply to borrowers who are approved for a total and permanent disability (TPD)
discharge based on a Veterans Administration (VA) determination of unemployability due to a service-connected disability.
Monitoring:
The Department will reinstate your obligation to repay your discharged federal student loans or complete your discharged TEACH Grant service obligation if
at any time during the 3-year monitoring period:
• You have annual employment earnings that exceed the Poverty Guideline amount for a family of two in your state, regardless of your actual family
size;
• You receive a new William D. Ford Federal Direct Loan (Direct Loan) Program loan, Federal Perkins Loan (Perkins Loan) Program loan, or TEACH
Grant;
• A disbursement of a Direct Loan, Perkins Loan, or TEACH Grant that you received before the discharge date is made, and you do not ensure the return
of the full amount of the disbursement within 120 days of the disbursement date; or
• You receive a notice from the SSA stating that you are no longer totally and permanently disabled, or that your disability review will no longer be the
5-year or 7-year review period indicated in your most recent SSA notice of award for Social Security Disability Insurance (SSDI) or Supplemental
Security Income (SSI) benefits.
In addition, during the 3-year post-discharge monitoring period, you must promptly notify or respond to the Department if:
• You receive annual earnings from employment that exceed the Poverty Guideline amount for a family of two in your state, regardless of your actual
family size;
• There is a change in your address or telephone number;
• You receive a request to provide the Department with documentation of your annual earnings from employment; or
• You receive a notice from the SSA that you are no longer totally and permanently disabled, or that your disability review will no longer be the 5-year
or 7-year review period indicated in your most recent SSA notice of award for SSDI or SSI benefits
If you have questions regarding the 3-year post-discharge monitoring period, you may call the Total and Permanent Disability Servicer Monday through
Friday at (888) 303-7818 from 8:00 A.M. to 8:00 P.M. (Eastern), visit https://disabilitydischarge.com/faqs, or email DisabilityInformation@Nelnet.net.
Reinstatement:
If your obligation to repay your federal student loans or complete your TEACH Grant service obligation is reinstated under the conditions described earlier,
you will again be responsible for repaying your loans or completing your TEACH Grant service obligation. However, you will not be required to pay interest
that would have accrued on the loans during the time your loans were discharged due to total and permanent disability.
If your obligation to repay your federal student loans or complete your TEACH Grant service obligation is reinstated, the Total and Permanent Disability
Servicer will notify you of the reinstatement by U.S. Mail and return your loans to the status that existed at the time you applied for a TPD discharge. The
notice will include
• The reason(s) for reinstatement
• An explanation that the first payment due date on the reinstated loans will be no earlier than 60 days after the date of the notification of reinstatement
• Information on how you may contact the Department if you have questions about the reinstatement or believe that the Department’s determination
was based on incorrect information
Eligibility for New Loans or TEACH Grants:
If the Department grants a TPD discharge of your federal student loans or TEACH Grant service obligation, you will not be eligible to receive a new Direct
Loan, Perkins Loan, or TEACH Grant in the future unless:
• You obtain a certification from a physician that you are able to engage in substantial gainful activity; and
• You sign a statement acknowledging that the new loan or TEACH Grant service obligation cannot be discharged in the future on the basis of any
injury or illness present at the time the new loan or TEACH Grant is made, unless your condition substantially deteriorates so that you are again
totally and permanently disabled.
In addition, if you request a new Direct Loan, Perkins Loan, or TEACH Grant during the 3-year post-discharge monitoring period described earlier, you must
resume repayment on the previously discharged loans or acknowledge that you are once again subject to the terms of your TEACH Grant service obligation
before you can receive the new loan or TEACH Grant.
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Student Eligibility Verification for Previously University of the (University of the Incarnate Word)

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Completed 2 February 2021

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