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"" Introduction
"" Qualification Requirements
"" Amount and Duration of Benefits
"" Eligibility Requirements
"" Medical Statements
"" Sick Pay and Supplemental Sickness Benefits
"" Disqualifications
"" Benefit Reductions
"" Personal Injury Settlements
"" Reconsideration and Waiver
"" When Sickness Benefits are Taxable
"" Instructions for Completing Forms
"" Notices
"" Important Reminders
RELATED LINKS
''" Benefit Forms and Publications
Sickness Benefits for Railroad Employees
UB-11 (11-06)
Medical Statements View the UB-11 in PDF

 
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To receive sickness benefits, you must have your doctor complete a statement of sickness in support of your claim. In addition, you may be asked to have your doctor provide the RRB with additional (supplemental) medical information in order to continue to receive your sickness benefit payments. How often supplemental medical information is required depends on several factors, including when you are expected to return to work. In determining when you may return to work, we consider your diagnosis, medical condition, age, normal occupation and the estimated disability period previously provided to the RRB by your doctor.

A statement of sickness may be completed by:

  • a licensed medical doctor trained in medical and surgical diagnosis;
     
  • a licensed dentist in cases of infirmity relating to the teeth and gums;
     
  • a licensed podiatrist if the infirmity relates to the feet;
     
  • a licensed chiropractor;
     
  • a licensed doctor of clinical psychology;
     
  • a certified nurse/midwife in cases of pregnancy, miscarriage, or childbirth;
     
  • a superintendent or other supervisory official of a hospital, clinic, or similar organization;
     
  • a Christian Science practitioner;
     
  • a Physician Assistant - Certified; or
     
  • a nurse practitioner.

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Chicago Illinois, 60611-2092
Telephone: (312) 751-7139 TTY: (312) 751-4701
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Date posted: 02/15/2007
Date updated: 02/15/2007