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 **U.S. Railroad Retirement Board**
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 Statement of Sickness (Form SI-1b)
 Home
          Sickness Benefits for Railroad Employees
          Instructions for Completing Forms
          Statement of Sickness (Form SI-1b)
 Topics
    

      
              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
                                General Instructions
          Important Informtion
          Application for Sickness Benefits (Form SI-1a)
          Statement of Sickness (Form SI-1b)
          Statement of Authority to Act for Employee (Form SI-10)
          Claim for Sickness Benefits (Form SI-3)
          Notices
          Checking Your Benefits by Telephone
          Important Reminders Statement of Sickness (Form SI-1b)
							 
							
							
            The SI-1b, Statement of Sickness must be completed by your doctor or other qualified medical provider (see the section Medical Statements). If possible, have your doctor complete the statement while you are at his or her office, rather than leaving the form for completion. If you must leave the form for completion, explain to your doctor that the form is needed in order for you to receive bi-weekly benefit payments and that the form must be received by the Railroad Retirement Board within 10 days of the first day you became sick or injured or you may lose benefits.

Do not separate the SI-1b, Statement of Sickness from your SI-1a, Application for Sickness Benefits.
        ‹ Application for Sickness Benefits (Form SI-1a) | 
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                      Statement of Authority to Act for Employee (Form SI-10) ›To view and download PDF documents, you need the free Acrobat Reader. We recommend using the latest version. Viewers with visual disabilities can go to Adobe's Access Website for tools and information that will help make PDF files accessible.Get Adobe Acrobat Reader
To view and download PDF documents, you need the free Acrobat Reader. We recommend using the latest version. Viewers with visual disabilities can go to Adobe's Access Website for tools and information that will help make PDF files accessible.
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U.S. Railroad Retirement BoardWilliam O. Lipinski Federal Building844 North Rush Street
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 Last updated: 05/09/2017