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Privacy Act Notice
To receive
sickness benefits you must apply for them and furnish information. Information
that the RRB asks you to furnish is used to determine if you are eligible for
benefits and the amount of benefits payable to you. Although furnishing
information, including your social security number, is voluntary, the RRB cannot
pay you benefits without this information. The RRB's authority for requesting
information is Section 5(b) of the Railroad Unemployment Insurance Act.
The RRB may routinely furnish information from its records to other
government agencies and to other persons or companies (see list below) for the
purpose of administering the Railroad Unemployment Insurance Act, the Social
Security Act, or other benefit programs under Federal or State laws.
The RRB may routinely furnish information to the following individuals,
organizations, and/or agencies:
- The U.S. Treasury Department and the U.S. Postal Service, to issue benefit
payments and to report non-delivery, forgery, theft or loss of a benefit
payment.
- A person or company which the claimant reports may award pay for time lost
or some similar payment for the same period for which the RRB pays benefits.
- Persons or companies named by the claimant as liable for paying damages
for the same injury or illness for which the RRB pays sickness benefits.
- The Internal Revenue Service for use in administering Federal tax laws.
- A private collection agency, the General Accounting Office, the Department
of Justice, or the Internal Revenue Service for the collection of an
overpayment.
- Employers or insurance companies for use in administering supplemental
benefit or health insurance plans.
- Law enforcement agencies and the Department of Justice for investigating
or prosecuting a violation of law.
- Employers to verify entitlement to benefits and to provide notice of
benefit payment determinations.
- State unemployment agencies to verify entitlement to benefits.
Other than information that may be disclosed routinely, no information about
your claim may be disclosed without your consent.
Computer Matching and Privacy Protection
Act Notice
In addition to the uses of information described in the
preceding Privacy Act Notice, information you provide may be used, without your
consent, in automated matching programs. These matching programs are a computer
comparison of Railroad Retirement Board records with records kept by other
Federal agencies or State and local governmental agencies. Information from
these matching programs can be used to establish or verify a person's
eligibility for benefits and for repayment of benefits or delinquent debts.
What Are Computer Matching Programs?
Computer matching programs compare our records with those of other Federal,
State, or local government agencies. All agencies may use matching programs to
find or prove that a person qualifies for benefits paid for by the Federal
Government.
How Do Computer Matching Programs Affect
You?
On forms that you fill out for us you give us facts about yourself.
Sometimes, we check the facts you and others give us. We use computer matching
to do the checking. The law allows us to check this way even if you do not agree
to it. We can also give any facts we have about you to other governmental
agencies for them to use in their computer matching programs.
Paperwork Reduction Act Notice
To receive sickness benefits, you must complete an application and claim form(s).
You may also be asked to complete other forms. Some of these forms are listed
below along with estimates of how long we think it takes to complete them. The
estimates include time for reviewing the instructions, getting the needed
information, and reviewing the completed form. Federal agencies may not conduct
or sponsor, and respondents are not required to respond to, a collection of
information unless it displays a valid OMB number. If you wish, send comments
regarding the accuracy of our estimates or other aspect of the forms, including
suggestions for reducing completion time, to the Chief of Information Resources
Management, Railroad Retirement Board, 844 N. Rush Street, Chicago Illinois
60611-2092. Be sure to include the form title and control number (in
parentheses) with your comments.
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SI-1a
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Application for Sickness Benefits
(3220-0039)
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10
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SI-1b |
Statement of Sickness
(3220-0039) |
8 |
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SI-3
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Claim for Sickness Benefits
(3220-0039)
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5 |
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SI-10 |
Statement of Authority to Act for Employee
(3220-0034)
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6
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ID-7h |
Notice of Non-Entitlement to Sickness Benefits and Information
on Unemployment Benefits
(3220-0039) |
5 |
Nondiscrimination on
the Basis of Disability
Under Section 504 of the Rehabilitation Act of 1973 and
Railroad Retirement Board (RRB) regulations, no qualified person may be
discriminated against on the basis of disability. RRB programs and activities
must be accessible to all qualified applicants and beneficiaries, including
those who are vision or hearing impaired. Disabled persons needing assistance
(including auxiliary aids or program information in accessible formats) should
contact the nearest RRB office. Complaints of alleged discrimination by the RRB
on the basis of disability must be filed within 90 days in writing with the
Director of Administration, Railroad Retirement Board, 844 North Rush Street,
Chicago, Illinois 60611-2092. Questions about individual rights under this
regulation may be directed to the RRB's Director of Equal Opportunity at the
same address.
RRB HelpLine 1-800-808-0772
The
RRB HelpLine in an automated telephone service available 24 hours a day, 7 days
a week. You can call the RRB HelpLine toll-free from either a touch-tone or
rotary telephone to get the following information about your unemployment or
sickness benefits:
- the amount and date of your latest benefit payment, and the claim period
for which the payment was made;
- information about your last 5 benefit payments; and
- confirmation of whether we've received your latest claim, application, or
supplemental doctor's statement.
We update the RRB HelpLine once each weeknight with payment information; we
update information about applications, claims, and supplemental doctor's
statements as we receive the forms. You will need your social security number
and your Personal Identification Number (PIN) to get information about your
benefit payments and claims. Your PIN is printed on the back of each claim form
we mail to you. Each claim will also have a record of your last 3 payments.
Use the record of payments, the RRB HelpLine and the tables below to keep track
of your claims and payments.
Fraud and Abuse
Hotline
Call the
toll-free Hot Line if you have reason to believe that someone is
receiving railroad unemployment or sickness benefits to which he or she
is not entitled. The Hot Line has been installed by the Railroad
Retirement Board's Inspector General to receive any evidence of fraud or abuse
of the RRB's benefit programs.
The toll-free Hot Line number is 1-800-772-4258. Or you may send your complaints in writing
to the RRB, OIG, Hot Line Officer, 844 North Rush Street, Chicago, Illinois
60611-2092.
Please do not call the Inspector General's Hot Line with questions about
eligibility requirements, delayed claims, or similar problems. Such matters
should be directed to the nearest RRB field office..
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