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 Program Letter 2017-02
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          Program Letter 2017-02
 Program Letter 2017-02
							 
							
							
            PDF Image
      
            PL 17-02 (317.3 KB)
      
  To
              Chief Executives Officers and Medical Contact Officials

  Subject
              New Form RL-11D1, Request for Medical Evidence from Employers

            **This applies to Disability Applicants only.**

**Please share this notice with all individuals within your organization who are responsible for medical matters.**
 
Effective **February 1, 2017**, the Railroad Retirement Board (RRB) will ask employers (covered and non-covered) to furnish copies of any medical records that you may have on the employee within the last 18 months. Attached is a copy of the new Form RL-11D1, *Request for Medical Evidence from Employers* (https://www.rrb.gov/pdf/aandt/pl17-02_Attachment.pdf).  Form RL-11D1 is a newly created letter used in initial filing for disability applicants or any time medical records are necessary to assist the RRB in determining whether disability benefits are payable. 
 
The form will be mailed by an RRB field office and it will be accompanied with a copy of the applicant's signed Form G-197, *Authorization to Disclose Information to the Railroad Retirement Board*.  The certifying official should return Form RL-11D1 to the Disability Benefits Division certifying that they have attached medical evidence **or** that they have no medical evidence for the employee.  The official should also sign, date, and provide their contact information.

For Questions and Answers (Q&A) regarding the new Form RL-11D1, go to http://www.rrb.gov/aandt/pl/pl1702_Q&A.asp.
 
If you additional questions, please contact Lavette Fargo in Policy and Systems at (312) 751-4617 or Lavette.Fargo@rrb.gov.
      
      Published by: 
            Quality Reporting Service Center
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            Phone: (312) 751-4992 | 
      
           Email: QRSC@rrb.gov
      
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 Last updated: 12/13/2017