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1325.5 General

The field office has overall responsibility for developing medical evidence as part of the 

disability claim. While instructions and guidance are provided here, the use of good 

judgment is equally important. Thorough and prompt development will facilitate the 

determination of the claim.

1325.5.1 Use of Evidence

Medical evidence submitted to the Railroad Retirement Board (RRB) becomes the 

property of the RRB unless otherwise specified. It is placed permanently into the claim 

file established for that claim number along with all other claim material, 

award/adjustment forms and correspondence for that claim number.

Disability claims examiners use the medical evidence in making a disability 

determination. If a joint freeze determination is required, a Social Security 

Administration disability claims examiner will also examine the medical evidence.

1325.5.2 Age and Relevance of Medical Evidence

Only recent medical records relating to the applicant's claimed disability should be 

developed. Evidence is considered to be recent when treatment or examination was 

within the last 12 months. However, it may be necessary to develop older evidence to 

establish that a child's disability began before age 22, or that a widow(er)'s disability 

began within the prescribed period.

1325.5.3 Protection of Medical Evidence Under the Privacy Act

Medical evidence submitted to the RRB is protected from disclosure to third parties by 

the provisions of the Privacy Act. See FOM-I 130 for the conditions under the Privacy 

Act that allow disclosure. Because of the sensitivity of medical evidence, a strict 

interpretation of the Privacy Act must be applied before releasing evidence in file or 

even disclosing the existence of such evidence in file. However, medical records 

maintained by the physician who conducted an examination either at RRB 

expense/direction or the applicant's, are the property of that physician and may be 

disclosed by the physician at his discretion.

1325.5.4 Access to Medical Evidence Under the Freedom of Information Act

The right of an individual to gain access to information about him held by an agency that 

was established in the Freedom of Information Act (FOIA) extends to medical evidence. 

That is, an applicant or annuitant may examine or obtain copies of medical information 

about himself. However, a physician's warning that release of the information would be 

harmful to the person must be respected. See instructions in FOM-I 130.40.8 for 

handling requests for copies of medical evidence in RRB possession.
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1325.10 Descriptions and Sources Of Medical Evidence

Medical evidence consists of reports and records from acceptable medical sources 

about the disability. This section lists possible sources for medical evidence and 

describes what the evidence from these sources should contain in order to facilitate the 

disability determination.

1325.10.1 Personal Physician Records

A. Description - Medical evidence from the applicant's personal physician which 

shows history, diagnosis, laboratory and clinical findings, treatment and response 

to treatment is most helpful in arriving at a proper disability determination. A 

statement or opinion that the applicant is disabled will not satisfy the requirement 

that he be disabled within the meaning of the Railroad Retirement Act or Social 

Security Act. However, the trend has been to give greater weight to the opinions 

of personal physicians who have treated a patient over a period of time.

Reports from personal physicians are acceptable in the following forms:

• Form G-250, Report of Physical Examination;

• Form G-250a, Medical Assessment of Residual Functional Capacity; 

NOTE: Form G-250a is ONLY used by Hearings Officers in the Bureau of 

Hearings and Appeals (BHA). 

• Form G-260, Report of Seizure Disorder (if epilepsy is alleged);

• Narrative report on the physician's business stationery; 

• Copies of the physician's patient records.

To be useful, the report should include the items listed in the paragraph above. It 

also should be noted that during appeals of disability denials, appellants often 

provide significantly more detailed personal physician reports than the reports 

from the same physicians submitted at initial application development. 

Obviously, it is important to get the best report possible the first time around.

B How to obtain - When it is established that a person intends to file an application 

for disability, he should be furnished one or more Form G-250 and, if a seizure 

disorder is alleged, Form G-260 with instructions to have it completed by his 

personal physician(s), making sure the physician(s) signs and dates the narrative 

sections. Field offices should not release Form G-250a unless specifically 

requested by a Hearings Officer in BHA. Form G-197, signed by the 

applicant/annuitant or authorized individual, shall also be released with Forms G250 and G-260.
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Field offices are encouraged to furnish Forms G-250 and G-260 before an 

application is filed, if possible. If the applicant can bring the completed and 

signed forms as well as any additional medical records with him when he files, 

the field office can better determine what additional evidence may be necessary 

and can begin the process of obtaining it sooner. However, do not refuse or 

delay an application for disability until the applicant furnishes personal physician 

records.

If the applicant needs assistance in securing personal physician records, the field 

office may send Forms G-250 and G-260 to the doctor. Even though assistance 

in obtaining this evidence may be given, the RRB bears no responsibility for 

charges by the personal physician in furnishing it.

Based on experience with the particular physician, pend the request for a 

reasonable period, not to exceed 20 days. If no response is received, release

and image tracer Form RL-11c and notate Contact Log. Allow 10 days for a 

response to the tracer. If no response is received, the field office manager must 

decide whether additional tracing efforts are worthwhile. Document any further 

attempts at development; image any released letters and notate Contact Log.

If the field office manager decides to abandon further efforts to obtain the 

records, release a brief E-mail summarizing the actions taken and reason for 

abandonment to the DBD Group Mailbox or, if known, the personal E-mail inbox 

of the responsible Reconsideration Section (RECON) disability adjudicator if a 

review of an adverse initial determination was requested. (See FOM-I 1325.15.3

) 

1325.10.2 Records from Hospitals or Other Institutions

A. Description - Records from hospitals or other institutions, such as mental health 

facilities, sanitoriums, etc., are usually comprehensive in nature and can be 

enormously valuable. The most desirable hospital/institution record consists of a 

copy of the discharge summary or final report which includes history, clinical 

course, physical and laboratory findings, therapy and response. If such a report 

or summary is not available, a copy of admission history, physical findings, 

laboratory and x-ray findings, as well as diagnosis, should be obtained. The 

absence of specific values such as lab test results, blood pressure, etc., 

frequently necessitates a specialized examination that otherwise would not have 

been required.

B. How to obtain - Unless the applicant furnishes adequate records as described in 

A. above, the field office should request records directly from the hospital or 

institution. Form RL-11b should be used for requesting hospital or institution 

records for any disability applicant, including a disabled child. Release Form G197, signed by the applicant/annuitant or authorized individual, with Form RL11b. Medical evidence should be requested from the claimant's alleged onset of 

disability through the current date.
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Based on experience with the particular hospital or institution, pend the request 

for a reasonable period, not to exceed 20 days. If no response is received, send 

and image tracer Form RL-11c and notate Contact Log. Allow 10 days for a 

response to the tracer. If no response is received, the field office manager must 

decide whether additional tracing efforts are worthwhile. Document any further 

attempts at development; image any released letters and notate Contact Log.

If the field office manager decides to abandon further efforts to obtain the 

records, release a brief E-mail summarizing the actions taken and reason for 

abandonment to the DBD Group Mailbox or, if known, the responsible RECON 

disability adjudicator if a review of an adverse initial determination was 

requested. (See FOM-I 1325.15.3). 

There are provisions for the payment of hospital records if a bill is received. See 

FOM-I 1330.15.2. 

1325.10.3 Employer Records

Many railroad and non-railroad employers, through their medical departments or 

affiliated hospital associations, furnish valuable medical evidence at no cost to the RRB. 

Railroad employers can also inform us whether the applicant was disqualified from 

service because of physical/mental condition. This disqualification must be completed 

by the contact official designated for medical matters for a particular railroad employer. 

The RRB should request medical from an employer: 

1. At the time an initial disability application is filed to obtain medical records within 

the last 18 months (use Forms G-197 and RL-11D1); and

2. If an occupational disability applicant (see DCM 3.2.1) claims disqualification 

from railroad service (use Forms RL-11, G-197, and G-3EMP). 

RL-11D1

Medical evidence should be requested from an applicant's railroad and nonrailroad 

employer by the field office with an RL-11D1, Request for Medical Evidence from 

Employers, letter to obtain any medical evidence of an employee’s disability that they 

may have for the last 18 months. Form G-197, Authorization to Disclose Information to 

the Railroad Retirement Board, must be signed by the applicant or his/her authorized 

representative and attached to the RL-11D1 form.

When Form RL-11D1 has been outstanding for more than 30 days, DBD will initiate 

tracer action by releasing an email to the claims representative (with a cc to the Field 

Office’s Group Mailbox) that released the form. NOTE: The DBD examiner will 

continue the sequential evaluation process while waiting for the results. The claims 

representative will trace with the employer using Form RL-11C, Letter Tracing Original 

Request for Medical Records. Document any further attempts at development; image 

any released letters and notate Contact Log.
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If the field office manager decides to abandon further efforts to obtain the records, 

release a brief E-mail summarizing the actions taken and reason for abandonment to 

the DBD Group Mailbox or, if known, the personal E-mail inbox of the responsible 

Reconsideration Section (RECON) disability adjudicator if a review of an adverse initial 

determination was requested. (See FOM-I 1325.15.3) 

G-3EMP

The RL-11, Letter for G-3EMP Disqualification Request for Medical Evidence from 

Railroad Employers, is used to request medical evidence from an applicant’s railroad 

employer, if the occupational disability applicant claims disqualification by his/her 

employer due to his/her physical/mental condition. Otherwise the RL-11D1 is used to 

request employer medical records. Some employers may attach other forms or reports 

in lieu of completing some or all items of the G-3EMP. Accept these attachments as if 

the information had been entered on the Form G-3EMP.

NOTE: Do not release Form G-3EMP if the employee does not meet the requirements 

for an occupational disability (see DCM 3.2.1).

Form G-197, Authorization to Disclose Information to the Railroad Retirement Board,

must be signed by the applicant or his/her authorized representative and enclosed with 

the RL-11 and G-3EMP forms. The field office assumes in these cases that a 

specialized examination will not be necessary.

The RL-11 letter requests a railroad employer to return the completed Form G-3EMP to 

the field office. This arrangement applies to all railroad employers. Use the completed 

Form G-3EMP to determine what additional medical evidence may be required, and 

develop accordingly.

When Form G-3EMP has been outstanding for more than 30 days, DBD will initiate 

tracer action by sending an e-mail to the field office servicing the area in which the 

contact official is located; that office will contact the proper railroad official to expedite 

completion of Form G-3EMP. Notate Contact Log.

1325.10.4 Records from Other Agencies

Sometimes an employee, widow(er), or child applicant for benefits under the RRA has 

also applied for benefits with another agency. By obtaining copies of medical evidence 

developed by that agency, we may be able to make a disability determination quicker, at 

less cost and more accurately than otherwise.

A. Social Security Administration (SSA)

1. Description - If an employee, widow(er), or child applicant has filed at SSA 

for Title II (Disability Insurance Benefits;(DIB) or Title XVI (Supplemental 

Security Income; SSI) benefits based upon a disability, the medical 

evidence and disability decision may be obtained from SSA. Such 

evidence may be sufficient for a rating under the RRA. SSA has 
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procedures for notifying RRB and sending copies of medical evidence 

when a rating is made on an employee whose earnings record is 

earmarked for railroad work. Unless you know that SSA medical evidence 

is in RRB files, the field office should request copies directly from SSA.

When you request medical records from SSA, also request the applicant 

to have Form G-250 completed by the personal physician as a record of 

the current medical condition. As a matter of customer service, field 

offices should always provide assistance to applicants, when needed, for 

medical evidence from their own medical sources even if we request 

evidence from SSA in order to avoid delaying a disability rating in case 

SSA is unable to provide their evidence. If Form G-250 cannot be 

secured, release a brief E-mail summarizing the actions taken and reason 

for abandonment to the DBD Group Mailbox or, if known, the personal Email inbox of the responsible RECON disability adjudicator if a review of 

an adverse determination was requested. Do not schedule specialized 

examinations unless requested by DBD or RECON. 

2. How to obtain - Release Form RR-5 to SSA's Great Lakes Programs 

Service Center as an email attachment (see DCM 11, RR-5 instructions). 

In addition, send a copy of the RR-5 to IMAGING. No tracer action by the 

field office is required.

When an applicant has applied for disability benefits at SSA, but hasn't 

been rated, you may be able to obtain copies of medical evidence from 

the state agency that makes disability determinations for SSA (usually 

titled something like Disability Determination Section of the Department of 

Human Resources for the applicant's state of domicile).

B. Department of Veterans Affairs

1. Description - In addition to obtaining medical evidence from VA hospitals 

where applicants may have been treated, medical evidence may be 

available from the VA regional office if the veteran is receiving VA 

disability benefits. Since the veteran may be receiving benefits based on 

a condition unrelated to the disabling condition, the evidence VA has may 

not be current. Judgment should be used to determine the usefulness of 

such evidence.

2. How to obtain - The field office should request copies of medical evidence 

by sending Form RL-11a to the VA hospital or regional office where the 

applicant was treated or examined. Note that the applicant or authorized 

individual must sign the enclosure Form G-197, authorizing the VA to 

release medical evidence to the RRB.

Pend the request for a reasonable period not to exceed 30 days. If no 

response is received, send and image Form RL-11c to trace the request; 
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notate Contact Log. Allow 15 days for a response to the tracer. If no

response is received, the field office manager must decide whether 

additional efforts are worthwhile. Document any further attempts at 

development; image any released letters and notate Contact Log.

If the field office manager decides to abandon further efforts to obtain VA 

records, release a brief E-mail summarizing the actions taken and reason 

for abandonment to the DBD Group Mailbox or, if known, the responsible 

RECON disability adjudicator if a review of an adverse initial determination 

was requested. (See FOM-I 1325.15.3) 

C. Worker's Compensation/Public Disability Benefit/Public Service Pension

1. Description - Medical evidence should be requested from an agency that 

pays worker's compensation, a public disability benefit, or a public service 

pension based on disability, when the applicant has received or expects to 

receive such payment. However, evidence should be requested only if the 

agency is considered a "key" source. A key source would have records of 

treatment or examination of the employee since or shortly before the 

earliest possible disability onset date.

A branch of the armed forces that is paying a military disability retirement 

benefit will probably not be a key source for medical evidence. The 

veteran will usually have more recent records at a VA facility. Request 

medical evidence from a service organization only if it is the sole source of 

evidence, and the condition on which the disability benefit is based began 

at or near the alleged disability onset date.

Do not request medical evidence from the paying agency if the applicant 

has been rated disabled or denied a disability by SSA, because that 

evidence will probably be included in SSA's records.

2. How to obtain - Use Form RL-11d to request medical evidence. The 

applicant's or authorized individual’s signature is required on Form G-197, 

as well as the claim number of the Worker’s Compensation/public 

disability benefit or public service pension. Form G-214 (Worker's 

Compensation and Public Disability Benefit Questionnaire) requests the 

benefit claim number and the name and address of the agency paying 

benefits. Form G-208 (Public Service Pension Questionnaire) does not 

request that information. When a Form AA-17b applicant also completes 

Form G-208, add the public service pension claim number and the 

address of the agency paying benefits in the remarks section of Form G208.

Send the Form Letter RL-11d to the address shown on Forms G-214 or G208. Send all requests for Federal civil service records to the following 

address for the Office of Personnel Management:
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Office of Personnel Management

Chief of Disability Claims Division

1900 E Street NW

Room 3468

Washington, DC 20415

If you do not receive a report after 30 days, use Form RL-11c to trace your 

request; notate Contact Log. If the evidence has not been received within 

15 days of the tracer, the field office manager must decide whether 

additional efforts are worthwhile. Document further attempts at 

development; image any released letters and notate Contact Log.

If the field office manager decides to abandon further efforts to obtain the 

records, release a brief E-mail summarizing the actions taken and the 

reason for abandonment to the DBD Group Mailbox or, if known, the 

responsible RECON disability adjudicator if a review of an adverse initial 

determination was requested. (See FOM-I 1325.15.3) 

D. Other Agency or Institution

1. Description - An applicant may be receiving other welfare type benefits 

based on disability. Medical evidence may be available from the paying 

agency. Usually agencies are willing to provide copies of medical 

evidence because benefits they pay will be reduced by benefits paid by 

RRB.

2. How to obtain - Form RL-11d can be used to request medical records from 

the agency paying benefits. The applicant or authorized individual must 

sign enclosure Form G-197, authorizing the release of medical data to the 

RRB. Pend the request for a reasonable period not to exceed 30 days. If 

no response is received, send Form RL-11c to trace the request; notate 

Contact Log. Allow 15 days for a response to the tracer. If no response is 

received, the field office manager must decide whether additional efforts 

are worthwhile. Document any further attempts at development; image 

any released letters and notate Contact Log.

If the field office manager decides to abandon further efforts to obtain the 

records, release a brief E-mail summarizing the actions taken and reason 

for abandonment to the DBD Group Mailbox or, if know, the responsible 

RECON disability adjudicator if a review of an adverse initial determination 

was requested. (See FOM-I 1325.15.3) 

1325.10.5 Evaluation of Existing Source Evidence

Available medical evidence should be evaluated for its adequacy for a proper disability 

determination; that is, it must be substantial in quality and quantity, and it must reflect 

the applicant's current condition. Quality and quantity should be judged based on the 
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information for the particular body system contained in FOM-I 1320, and on the 

requirements for the impairment as shown in FOM-I Article 13, Appendix B. 

EXAMPLE: Congestive heart failure, an impairment of the cardiovascular system, 

should show congestion around the heart cavity such as edema or enlargement of the 

heart, which can only be detected in a chest x-ray. Appendix B shows that an EKG is 

also required to diagnose this disease. Therefore, recent existing source evidence must 

show that these two procedures have been performed and that the results indicate 

congestive heart disease. Furthermore, consideration must be given to the possibility 

that the applicant's condition has improved and that a current examination may be 

needed to reflect current condition.

Assistance in evaluating evidence on hand may be obtained by telephone from a 

disability claims examiner in the Disability Benefits Division (DBD). If the medical 

evidence from existing sources appears sufficient (FOM-I 1325.20.3), forward it to DBD 

per instructions in FOM-I 1325.20.6. A disability claims examiner will review the 

evidence and advise if any additional development is necessary. If it appears that 

existing evidence will not be adequate, DBD will arrange for a specialized examination 

through QTC Medical Services, Inc. 

1325.10.6 Specialized Medical Examinations

If the medical evidence obtained from the above sources does not appear sufficient for 

disability rating purposes, DBD will arrange for a specialized medical examination 

through QTC Medical Services, Inc. QTC will be responsible for obtaining the 

requested examinations and forwarding the examinations directly to DBD. DBD will be 

responsible for approving the examination and for vouchering payment.

 

1325.15 Applicant's Responsibility

While the field office has overall responsibility for gathering medical evidence, the 

applicant is expected to submit or assist the field office in obtaining existing medical 

evidence in support of his claim for disability. It is also the applicant's responsibility to 

furnish information about his condition and treatment he has received.

1325.15.1 Railroad Retirement Board Regulations

Railroad Retirement Board (RRB) regulations state that the applicant or his 

representative is responsible for obtaining and submitting the evidence required to 

prove eligibility for, or right to continue to receive annuity payments. With regard to 

medical evidence to support a disability claim, the applicant's responsibility is not 

absolute.
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Unlike other types of evidence, medical evidence is not always easily obtainable nor is it 

inexpensive. Disabled persons are less likely to be able to help themselves. Therefore, 

the applicant's responsibility for medical evidence must be balanced with humaneness.

Furthermore, it is administratively to the RRB's advantage to be able to obtain reports in 

the form and content which fulfill the adjudicatory and other needs of the RRB. The 

decision making process is made more efficient and accurate by our ability to secure 

institutional records and examination reports directly from the provider.

In summary, the claimant must submit or notify the RRB of the existence of all evidence 

which relates to the claimed disability that may or may not support the applicant’s 

claimed impairment(s), to the extent the claimant is aware of that evidence. The RRB 

will assist him when necessary in obtaining the required evidence. The applicant's 

responsibility also includes his cooperation with the field office in securing evidence.

1325.15.2 Evidence an Applicant Should Submit

It is reasonable to require the applicant to obtain and submit personal physician records 

if such records exist. By doing so, the applicant's responsibility is established and good 

faith is demonstrated, which gives the RRB a basis for efforts to develop additional 

evidence.

If an applicant has not seen a physician from whom relevant evidence can be obtained, 

he should not be refused the opportunity to file a disability claim. Non-medical factors 

will be used in such a case to determine if further development of medical evidence at 

RRB expense is warranted.

Assistance should be provided to an applicant who needs help in getting a report from 

his doctor. See FOM-I 1325.10.1.B. 

Any other records or reports in the applicant's possession should be accepted. If he 

volunteers to obtain records from other sources, you may prefer to allow him to do so. 

Consideration must be given to the most expedient means of obtaining the kind of 

records we need without imposing too great a burden on the applicant.

1325.15.3 Abandonment for Lack of Cooperation

Development of medical evidence should not be abandoned for lack of cooperation from 

the applicant until the field office manager has determined that:

• The applicant has been contacted in person or by telephone;

• The importance of his cooperation to his claim has been explained;

• The lack of cooperation is willful as opposed to unintentional or uncontrollable; AND

• The applicant is not likely to cooperate further.
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If the applicant cannot be contacted in person or by telephone, send a letter to his last 

known address advising that his claim is still pending and requires his cooperation; 

request that he contact the field office within 2 weeks. Abandon if no response is 

received in that time period.

When a case is abandoned, the field office manager should submit a report covering 

actions taken and the reason for abandonment to the DBD group mailbox or, if known,

directly to the Reconsideration Section disability adjudicator if a review of an adverse 

initial determination was requested. The claim will be decided based on the information 

and evidence that has been developed.

1325.20 Field Office Responsibility

Field offices are responsible for fully developing claims for benefits under the RRA, 

including disability claims, so that these claims may be properly adjudicated by the 

Disability Benefits Division (DBD). The objective is to submit a complete package with 

sufficient supporting medical evidence as soon as possible.

1325.20.1 Assisting the Applicant

In addition to giving information and advice to the applicant, the field office must obtain 

certain information from him in order to help him pursue his claim. The applicant's trust 

and cooperation must be gained. You should explain the sequence of events, how 

decisions are made and when and how he will be notified of the disability determination. 

A field office is in the position to assure a cooperating applicant that the RRB is doing its 

part in developing and carefully considering his claim and to encourage a noncooperating applicant. Once a determination is made, the applicant may come back to 

the field office for explanation or to request reconsideration or later to appeal.

NOTE 1: It is important to make the applicant aware of possible delays that can occur 

due to circumstances that arise during the disability determination process. For 

example, an applicant should be informed that medical procedures, such as surgery, 

which occur subsequent to the application for a disability annuity can require additional 

medical evaluation before a disability decision is made. In some instances this will 

require a three month waiting period and additional medical examinations to determine 

the effect the surgery had on the disabling condition.

NOTE 2: Disability applicants residing outside the United States pose special 

challenges for field offices and there is a possibility of significant delays as a result of 

obtaining required evidence. Consequently, field office personnel are encouraged to 

attempt to anticipate issues which may delay a disability rating.

Many applications from individuals residing outside the United States involve those 

residing in Canada or Mexico. When an application from a resident of Canada or 

Mexico is filed, field office personnel should routinely ask the applicant whether (s)he 

lives within approximately 100 miles of the United States and, if so, if (s)he owns a valid 

passport and is able to travel to the United States if it is determined that a specialized 
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examination and/or testing is needed. However, assure the applicant if a specialized 

examination and/or testing becomes necessary that reasonable attempts will be made 

to schedule it as close as possible to their residence. Regardless, notify DBD of the 

applicants’ answers through APPLE (FOM-I 1581.11.4), Form G-626, Form G-230, or 

E-mail in all situations. It is also highly recommended that Contact Log be updated.

1325.20.2 Obtaining Medical Evidence Directly from the Source

FOM-I 1325.10 describes different types of medical evidence and shows which ones 

that the field office should generally obtain directly from the source of that evidence.

1325.20.3 Reviewing Evidence for Sufficiency

Throughout the disability development process the field offices have to review medical 

evidence for sufficiency in two respects:

• Does it represent the best evidence available from that source?

• Does the accumulation of medical evidence appear to provide enough evidence for 

a disability determination to be made?

If the evidence is not sufficient in either respect, then decisions must be made as to 

whether to re-request the needed evidence or what additional evidence must be 

obtained.

Medical evidence should also be reviewed for the following:

• Completeness of reports and forms;

• That the evidence pertains to the applicant;

• Reports are signed and dated;

• Applicant's name and claim number are shown on each item (not necessarily each 

page).

1325.20.4 Contracting for Specialized Examinations

When it is decided that all existing medical evidence that can be obtained does not 

provide sufficient evidence for a disability determination, Disability Benefits Division 

(DBD) staff must arrange for specialized examinations to be conducted at RRB 

expense.

1325.20.5 Following-up, Tracing, Carrying Through

Several initiatives have been taken to speed up the development of medical evidence. 

Since the field office is no longer responsible for tracing, forwarding or submitting bills 

for consultative examinations, more energy can be directed at the development of 
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treating source medical evidence and non-medical evidence. Therefore, the field office 

should adhere to the tracing requirement found in the Code of Federal Regulations 

(Section 220.45(b)).

While a disability claim is being developed, the application with all available evidence 

should be submitted to Disability Benefits Division (DBD) as soon as it is taken. The 

field office should keep its file in its pending file with call-up dates while waiting for the 

outstanding evidence to assure that time is not wasted. Requests for evidence should 

be pended for up to 20 calendar days. If there is no response after 20 calendar days, 

send and image a tracer or second request and pend it for 10 calendar days. (See 

FOM-I 1325.10 for specific information regarding forms/letters and the type of evidence 

requested.) The tracer or second request will have more effect if it is also supported by 

a telephone call to the provider. Notate Contact Log. If a response is still not received 

in 10 calendar days (unless experience indicates that a longer period is advisable in a 

particular case), the field office manager must either decide that additional tracing 

efforts are worthwhile or abandon efforts to secure that piece of evidence. Document 

any further attempts at development; image any released letters and notate Contact 

Log. Refer to FOM-I 1325.15.3 for procedures when abandoning for lack of cooperation 

from the applicant.

It is the field office's obligation to carry a disability claim to completion. When the office 

has completed its development, when submitting the last piece of evidence, it should so 

indicate on the transmittal to DBD or the Reconsideration Section (RECON) (if the case 

is at that level of adjudication) that no further evidence will be submitted.

When the field office cannot complete its development and the case is abandoned, the 

field office manager shall send a brief E-mail summarizing the actions taken and reason 

for abandonment to the DBD Group Mailbox or, if known, the RECON disability 

adjudicator if a review of an adverse initial determination was requested. 

1325.20.6 Transmittal of Disability Application and Medical Evidence

Procedures for submission of applications and medical evidence differ as to whether the 

application is for a monthly disability annuity or for a disability freeze in order to gain 

other benefits, such as early Medicare, O/M, early VDB, etc. However in all instances, 

all medical evidence being obtained, whether attached or to be submitted should be 

listed individually on the transmittal sheet (G-626 or G-230). 

A. Application for monthly disability annuity

1. Application - An application for a monthly disability annuity should be 

submitted to DBD as soon as possible.

At the time the application is submitted, it is important to indicate on the 

transmittal (Form G-626) whether all medical evidence is attached or 

additional medical evidence is being developed. The transmittal should 

include a list of all medical evidence attached and all medical evidence to 
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be submitted. If consultative examination(s) are scheduled through QTC 

Medical Services, Inc., the type(s) of examination(s) or examination(s) 

number should be noted in the "Remarks" section of the transmittal. In 

addition, when an order is made on FMIS a screen print of the information 

is automatically generated. This screen print should be included with the 

application package. If all evidence is attached, indicate in the "Remarks" 

section of the transmittal. Items of medical evidence being developed that 

are not shown in the check boxes as "To Be Submitted" should be listed in 

the "Remarks" section of the transmittal. If specialized examinations have 

been or will be scheduled, indicate which exams and the dates the exams 

were ordered through QTC Medical Services, Inc. 

If the initial employee disability application is received from a third-party 

facilitator (i.e. “Mr. Jones’ Office Services” or an attorney/law firm), please 

make a brief notation in the Remarks section of Application Express 

(APPLE) as an alert to the Disability Benefits Division (DBD) examiner. 

The notation should include the name of the third-party facilitator, as well 

as any known contact information such as their address/phone number. 

See FOM1 110.100.3 for further instructions.

2. Medical evidence - Submit all available medical evidence with the 

application. Each piece of medical evidence must be date stamped

Any additional medical evidence received should be date stamped and 

submitted to DBD under cover of Form G-180D. Be sure the employee's 

claim number is shown on the Form G-180D and each item of medical 

evidence attached. Also on the Form G-180D, indicate in "Remarks":

• What medical evidence is attached;

• What medical evidence is still being developed; and

• Expected date outstanding evidence will be submitted. 

NOTE: If the medical evidence is being submitted to DBD by fax, it is not 

necessary to send copies of the medical evidence to headquarters. The 

faxed medical evidence is sufficient for the file kept in headquarters.

After initially pending the case for 20 calendar days, follow up on any 

additional medical evidence being developed at 10 calendar day intervals 

until the case is closed.

B. Application for disability freeze (DF) only.- When an application for a DF only is

being developed from an annuitant on the rolls or from an applicant who is also 

filing an application separately for a monthly annuity not based on disability, it is 
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not necessary for the application for DF only to reach DBD before the complete 

medical evidence package. Also, if medical evidence is being developed for a 

disabled child for inclusion in the O/M, hold the O/M application(s) until all 

development is completed. No action can be taken on the application until a 

determination is made with respect to the disability. The filing date of the 

application will protect any retroactivity.

Field offices should hold DF or O/M applications for alleged disabled children 

only until all evidence, medical and non-medical, is gathered and ready for 

submission. The application and supporting evidence should be submitted 

together under cover of the appropriate transmittal, Form G-230 or Form G-659a. 

The "Remarks" section of the transmittal should list all medical evidence being 

submitted. The "Remarks" section of the transmittal should be prominently 

marked in red with a statement such as "Application for Freeze Only," 

"Application for Medicare Only" or "Application for Inclusion of DAC in O/M," to 

indicate that this is not an application for a monthly annuity.

1325.20.7 Abandonment of Disability Development

No phase of disability development should be abandoned until the field office manager 

has determined that all avenues have been explored and further action would be 

unproductive. When the manager decides the case should be abandoned, submit a 

report to the DBD group mailbox or, if known, directly to the Reconsideration Section 

examiner covering development actions taken and reasons for abandonment. See 

FOM-I 1325.15.3 before abandoning a case for lack of cooperation from the applicant.

1325.25 Disability Benefits Division Responsibility

The Railroad Retirement Act (RRA) charges the Railroad Retirement Board (RRB) with 

responsibility to make decisions with regard to eligibility for benefits under the provisions 

of the RRA. RRB regulations and Board orders assign this responsibility to the 

Disability Benefits Division (DBD). In order to have complete and accurate case records 

to make disability determination decisions, the RRB will obtain and consider all 

evidence that may or may not support the applicant’s claimed impairment(s). For 

effective and efficient operations in carrying out this responsibility, the section is 

administratively organized into components with division of responsibility.

1325.25.1 Disability Benefits Division

DBD makes determinations as to whether the disability provisions of the RRA are met. 

Inherent in that responsibility is the decision whether evidence submitted is sufficient for 

a determination to be made. Therefore, disability claims examiners in the section will 

review medical evidence submitted by field offices for sufficiency. If the examiner 

decides that additional evidence is necessary, (s)he will send an E-mail to the field 

office requesting specific evidence, or the examiner may order a specialized 

examination through QTC Medical Services, Inc. 
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Disability claims examiners are available for advice and guidance to field offices. They 

also should be consulted when problems arise with assignments sent to field offices.

1325.30 Field Service Responsibility

Through Field Service, field offices may obtain guidance and assistance on procedural 

and policy matters. Interaction between field offices and the section will lead to 

improved procedures and policies, and will help identify training needs which the section 

should fulfill.