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1001 Provisions of the Act

1001.01 Section 1(k)

of the Act provides, in part, that "... a day of unemployment, with respect to an 

employee, means a calendar day... with respect to which...he has, in accordance 

with such regulations as the Board may prescribe, registered at an employment 

office...".

1001.02 Section 12(h)

of the Act provides, in part, that "The Board may enter into agreements or 

arrangements with employers, and railway-labor organizations which are duly 

organized in accordance with the provisions of the Railway Labor Act, for 

securing the performance of services or the use of facilities in connection with the 

administration of this Act. . ."

1001.03 Section 12(i)

of the Act provides, in part, that "The Board may establish, maintain, and operate 

free employment offices, and may designate as free employment offices facilities 

maintained by (i) a railway labor organization which is duly authorized and 

designated to represent employees in accordance with the Railway Labor Act, or 

(ii) any other labor organization which has been or may be organized in 

accordance with the provisions of the Railway Labor Act, or (iii) one or more 

employers, or (iv) an organization of employers, or (v) a group of such employers 

and labor organizations, or (vi) a State, Territorial, foreign, or the Federal 

Government. . . . the Board shall prescribe a procedure for registration of 

unemployed employees at employment offices. Such procedure for registration 

shall be prescribed with a view to such registration affording substantial evidence 

of the days of unemployment of the employees who register. . ."

1002 Provisions of the Regulations

See section 325 of the Railroad Retirement Board's (RRB) regulations.

1003 Definitions

1003.01 Registration

To claim unemployment benefits for any day, an employee must: 

a. Register as unemployed by applying for unemployment benefits and 

employment service as required by the RRB's regulations and described 

in section 1006 of this article, 
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b. File a claim for benefits in accordance with the RRB's regulations (section 

1007), and

c. Provide any other information that the RRB needs to properly adjudicate 

their right to unemployment benefits. 

A registration exists with respect to any day for which the employee registers in 

accordance with the RRB's regulations as described above except:

a. If a registration has been made for a day of unemployment, and the claim

for that day is later withdrawn, the registration made for that day is not 

considered to have been withdrawn; and

b. If, at the time of establishment of an extended benefit period, it is apparent 

that beginning the extended benefit period with a particular day would 

clearly be to the employee's disadvantage, no registration is deemed to 

have been made with respect to that day; and

c. No registration is deemed to have been made for any day that would be 

the first day of a registration period in a benefit year:

1. In which the employee is not a qualified employee, or

2. In which benefits have already been paid to the employee for 130 

days of unemployment (unless the registration is made in an 

extended benefit period), or

3. In which unemployment benefits have already been paid to the 

employee in an amount equal to the employee's compensation in 

the base year (unless the registration is made in an extended 

benefit period).

1003.02 Filing

Filing is the delivery of an application or a claim form for unemployment benefits 

to an office of the RRB within the time prescribed by the RRB's regulations. An 

application must be received at an RRB office or postmarked within 30 calendar 

days of the first day that the employee intends to claim as a day of 

unemployment. A claim must be received or postmarked no later than 15 

calendar days after the last day of the claim form or the date the form was mailed 

to the employee, whichever is later. 

1003.03 Claim

An employee claims a day as a day of unemployment by registering for the day 

on a claim form provided by an office of the RRB.
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1003.04 Withdrawal of a claim

In the absence of fraud, a claimant may withdraw a claim to a day by informing 

the RRB in writing that they no longer wish to claim such day. Benefits paid to 

the employee for days which are being withdrawn must be repaid to the RRB. 

(See Section 1003.01)

1003.05 Normal Registration

A normal registration is made by an employee by filing an application or a claim 

for unemployment benefits with an office of the RRB within the time prescribed 

by the RRB's regulations.

1003.06 Advanced registration

An advanced registration is a registration filed prior to days claimed as days of 

unemployment on the claim form. Advance registration for days is not permitted.

1003.07 Delayed registration

A delayed registration is a registration made on a day after the last day on which

the claimant could have made a normal registration.

1004 Registered in Accordance With Regulations of the Board

For the purpose of Section 1(k) of the Act, which defines a day of unemployment, 

an employee has registered in accordance with the regulations of the RRB, with 

respect to a day, if:

a. A registration with respect to such day has been made by the employee 

(see section 1005);

b. A Form UI-1 for the benefit year which includes the days to be claimed, 

completed by the claimant, has been received in the field office serving 

their area or any other office of the RRB (see section 1006); 

c. The information required by the claim form with respect to such day has 

been received in the field office (see section 1007); 

d. Any other information required by the RRB to properly adjudicate the 

employee's right to unemployment benefits has been provided; and

e. The registration is normal or is acceptable as a delayed registration (see 

section 1008). 
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Note: Any questions regarding registration for unemployment benefits by 

claimants residing in a foreign country should be referred to the Bureau of Field 

Service.

1005 Determining Whether Registration Has Been Made

1005.01 Usual basis for determination

In the absence of evidence to the contrary, consider that an employee has 

registered for a day if they have signed for the day on Form UI-3 or other form 

provided by the RRB for registration.

1005.02 Signature

An employee has not registered for a day unless they signed for it on the claim 

form provided by the RRB. If a signature is recognizable as the signature of the 

claimant, it is acceptable whether made in writing, in printing, or by witnessed 

mark. If the claimant signs with a mark, two witnesses should also sign the form. 

If there is a change from written to printed signature, from signature to mark, or 

vice versa, an investigation will be necessary unless an adequate explanation is 

furnished.

1005.03 Existence of more than one registration

An employee who has made a registration with respect to a day may, after 

withdrawing their claim based on such registration, make another registration for 

the day. Thus, there may exist simultaneously more than one registration made 

by an employee with respect to a day, but not more than one claim to the day.

1006 Application for Unemployment Benefits and Employment 

Service

1006.01 Requirement

An application is required at the beginning of each period of unemployment in a 

benefit year unless:

a. The employee filed an application for an initial period of unemployment in 

a benefit year and has a subsequent period of unemployment within the 

same benefit year, or 

b. The employee had filed an application for benefits for a period of 

unemployment that began in the preceding benefit year and the period of 

unemployment continued into the next benefit year. 
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In either circumstance, the initial application will be treated as an application for 

days in the subsequent period of unemployment or as an application for days in 

the next benefit year, as the case may be. 

1006.02 Purpose

An application for unemployment benefits and employment service must: 

a. Furnish sufficient information to identify the individual who submitted the 

application; 

b. Assist the RRB in determining whether the applicant is a qualified 

employee and whether any of the information reported on the application 

affects eligibility for benefits; and

c. Assist the RRB in placing the employee in any suitable employment that 

may be available.

1006.03 Time for filing application

An employee may deliver or mail their application to any RRB office, but the 

application must be received or postmarked within 30 calendar days of the first 

day the employee intends to claim as a day of unemployment. 

1007 Claim Form

1007.01 Requirements

After an employee has applied for unemployment benefits in accordance with 

section 1006 of this part, they must claim a day as a day of unemployment by 

registering with respect to such day. Registration will be made on the claim form 

provided by the RRB to the employee. Upon registration, a claimant will furnish 

the information required by the claim form. Information is required if it is called 

for by the form and is needed to adjudicate the particular claim. Until the 

information required, no day with respect to which such information is needed will 

be considered as a day of unemployment.

1007.02 Claim period

A claim for unemployment benefits covers a period of 14 consecutive calendar 

days. 

1007.03 Time for filing

A claim for unemployment benefits must be filed at an office of the RRB no later 

than 15 calendar days after the last day of the claim period or 15 calendar days 

after the date on which the claim form was mailed to the employee, whichever is 
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later. To determine whether the time for filing the claim may be extended, 

consult section 1008 on delayed claims. None of the days in a claim that is not 

timely filed is considered to be a day of unemployment.

1007.04 Claim for new period of unemployment

An employee, who has applied for benefits in a benefit year and again becomes 

unemployed in the same benefit year, need not file a new application but may 

request a claim for benefits for days in the subsequent period by contacting the 

RRB. The request must be made no later than 30 calendar days after the first 

day for which the employee wishes to claim benefits. Upon receipt of a request 

for a claim, the field office will provide the employee with a claim form beginning 

no earlier than the 30th day before the date on which the employee requested 

the claim form, unless the delay may be excused applying the standards in 

section 1008.

1007.05 Claims delayed due to denial

If an employee makes an initial application and claim for benefits but does not file 

ongoing claims because of an initial determination denying their application or 

claim for benefits and if, upon review, the denial is reversed by an authorized 

reviewing official, the employee has 30 days from the date of the notice of 

reversal in which to file a claim or claims for benefits for the days they would 

have claimed as days of unemployment but for the initial determination denying 

benefits. The reviewing official will notify the employee of the 30-day time limit 

imposed by the RRB's regulations.

1007.06 Claim required for waiting period

The requirement to file a claim for unemployment benefits includes filing a claim 

for the non-compensable waiting period required in each benefit year.

1008 Delayed Registration

1008.01 Acceptability

An application or claim for unemployment benefits will be considered timely filed 

if the employee can show a reasonable effort to file the form on time but was 

prevented from doing so by circumstances beyond their control. Lack of 

diligence, forgetfulness, or lack of knowledge of the time limit for applying will not 

be considered a circumstance beyond the employee's control. The employee 

must file the application or claim within one year of the day(s) to be claimed as a 

day or days of unemployment, and not later than 30 days after the circumstance 

or condition which caused the delay was removed. The one-year deadline does 

not apply where the delay was caused by denial of benefits. (AIM 1007.05)
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1008.02 Reasonable causal relationship

There must be a reasonable causal relationship between the failure to register 

normally and the circumstances or conditions which caused the delayed 

registration. The circumstances or conditions need not be such as would make it 

impossible to register; it is sufficient if the claimant would not reasonably be 

expected to register under such circumstances or conditions. 

1008.03 Written statement of explanation

The claimant must submit a written statement to an office of the RRB explaining 

why they did not make a normal registration for the day(s) for which they make a 

delayed registration. The statement must be signed by the claimant; however, a 

statement is to be regarded as signed by the claimant if it is attached to, or is in 

the form of a notation on, a form or other document that the employee signed.

1008.04 Investigation

If the claimant registers for a day on which they failed to make a registration 

because of employment, because of sickness, or because of death or serious 

illness in the claimant's immediate family, it may be necessary to investigate 

whether:

a. the claimant's failure to register on such day is in fact attributable to such 

circumstance or condition, and

b. if it is found that the claimant failed to register because of such condition, 

any day on which the condition existed can be considered as a day of 

unemployment.

1008.05 Lack of diligence

The following conditions or circumstances are among those considered 

attributable to lack of diligence on the part of the claimant:

a. Laziness or inertia;

b. Forgetfulness;

c. Carelessness;

d. Lack of ordinary prudence or foresight.

1008.06 Circumstances or conditions beyond an employee's control

Consider that any of the following circumstances or conditions for failing to make 

a normal registration affect the claimant directly and are not attributable to any 
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lack of diligence on the claimant's part and that the required reasonable causal 

relationship exists.

a. The employee is away from home for an extended period of time working, 

searching for work, complying with instructions from the RRB to apply for 

work, or being held over or is lying over after completing a job in 

anticipation of a possible call for work;

b. The employee is away from home for an extended period of time due to a 

death or serious illness in their immediate family;

c. The employee was given misinformation by a railway labor official or an 

employee of the RRB (see .08);

d. The employee filed for sickness benefits, but was later determined to be 

able to work;

e. The employee registered in accordance with the provisions of a state 

unemployment compensation law and is thereafter informed by the state 

agency that they are not eligible. (see .09);

f. The employee attempted to file their form on time, but the form was lost or 

destroyed (see .11);

g. The employee is directly affected by any other circumstance or condition 

which caused him or her to fail to make a normal registration. This may 

be grounds for an acceptable delayed registration if evidence shows that 

the required reasonable causal relationship exists and that such 

circumstance or condition directly affects the employee and is not 

attributable to any lack of diligence.

1008.07 Efforts to file timely

It should be considered that an employee made a reasonable attempt to file for 

unemployment benefits timely and delayed registration should be accepted if any 

of the following circumstances exist:

a. The employee mailed the form within a reasonable time for it to be 

received at a RRB office timely, but the form is delayed in the mail. (The 

postmark date is considered to be the date the employee mailed the form

and can be used as the filing date, unless there is evidence that the form 

was actually mailed earlier.)

b. The employee calls or writes to an office of the RRB within the time 

prescribed for filing the form.

c. The employee provides the RRB with the incorrect type of claim form or 

an application.
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1008.08 Misinformation

The receipt of misinformation constitutes acceptable grounds for delayed 

registration when it is shown that: 

a. There is a causal relationship between the misinformation and the 

claimant's failure to register, 

b. The delayed registration was the direct result of complying with the 

instructions as they understood them, and 

c. The misinformation was given by a railway labor official or an employee of 

the RRB. (Failure on the part of a labor official or an RRB employee to 

give proper instructions in answer to an inquiry is tantamount to the giving 

of misinformation.)

1008.09 Registration for state unemployment benefits

An employee may register in accordance with the provisions of a state 

unemployment compensation law and later be informed that they are not eligible 

for benefits under state law. The attempt to register for benefits with the state is 

an acceptable reason for delayed registration. Evidence that the employee 

registered and was denied is required. The employee may furnish evidence in 

the form of (1) a registration card showing dates on which they registered with 

the state agency, and (2) a notice of ineligibility sent by the state agency. If the 

employee cannot furnish such evidence, it may be requested from the state. If 

the evidence shows that the claimant did register with the state agency, delayed 

registrations should be taken for all the days the claimant wishes to claim as 

days of unemployment which are included in the periods for which the claimant 

registered in accordance with the provisions of the state law and which are prior 

to the day on which they were properly instructed to register under the Railroad 

Unemployment Insurance Act.

1008.10 Lost or destroyed claim form

If it appears that a claim form for a day(s) is lost or destroyed, the claimant may 

re-register for each of the days within one year of the last of day for which they

signed on the form. Re-registrations are acceptable if, after full investigation, it is 

clear that the employee in fact made a normal or acceptable delayed registration 

for such days.

1009 Form Letters Prescribed

The following form letters are hereby prescribed:

• ID-10
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• ID-10a

• ID-10b

• ID-10t

• ID-10u

• ID-10y

• UD-10z

1021 Provisions of the Act and the Regulations

1021.01 The Railroad Unemployment Insurance Act

a. Section 1(h) of the Act provides, in part, that 'The term registration period' 

means ... the period which begins with the first day with respect to which a 

statement of sickness is filed ... or the first such day after the end of a 

registration period which will have begun with a day with respect to which 

a statement of sickness was filed... and ends with the thirteenth day 

thereafter."

b. Section 1(k) of the Act provides, in part, that "... 'a day of sickness', with 

respect to any employee, means a calendar day ... with respect to which 

... in accordance with such regulations as the Board may prescribe, a 

statement of sickness is filed within such reasonable period, not in excess 

of ten days, as the Board may prescribe ..."

c. Section 1(l) of the Act provides, in part, that "The term 'statement of 

sickness' means a statement with respect to days of sickness of an 

employee ... executed in such manner and form by an individual duly 

authorized ... to execute such statement, and filed as the Board may 

prescribe by regulations."

d. Section 12(i) of the Act provides, in part, that "The Board shall provide a 

form or forms for statements of sickness and a procedure for the 

execution and filing thereof. Such forms and procedure shall be designed 

with a view to having such statements provide substantial evidence of the 

days of sickness of the employee. Such statements may be executed by 

any doctor (authorized to practice in the State or foreign jurisdiction in 

which he practices his profession) or any officer or supervisory employee 

of a hospital, clinic, group health association, or other similar organization, 

who is qualified under such regulations as the Board may prescribe to 

execute such statements. The Board shall issue regulations for the 

qualification of such persons to execute such statements. When so 

executed by any such person, or in the discretion of the Board, by others 
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designated by the Board individually or by groups, they may be accepted 

as initial proof of days of sickness sufficient to certify for payment a claim 

for benefits.

1021.02 Regulations 

See 20 CFR 335.

1022 Explanation of Terms

1022.01 Filing 

Is the delivery of a properly executed form to an office of the RRB.

1022.02 Normal filing

Is the delivery of a properly executed form to an office of the RRB by mailing 

such form to an office of the RRB within the time specified in the instructions on 

the form or by sending the form so that it is received within the prescribed time.

1022.03 Conditional filing

Includes the delivery of a properly executed form to an office of the RRB within a 

reasonable time in the case of an employee:

a. who made such efforts to file the form within the prescribed time as a 

reasonable person could be expected to make in the same situation but 

was prevented from doing so by circumstances beyond their control; or

b. who registered for the day in question as a day of unemployment in 

accordance with Part 325 of the regulations, but whose claim for such day 

as a day of unemployment was denied on the grounds that they were not 

able to work on such day.

1022.04 Mailing date

Is the date on which a form or notice is received by the United States Postal 

Service.

1022.05 Day of infirmity

Is a day on which, according to a statement of sickness, an employee is affected 

by an injury, illness, sickness, or disease described in the statement of sickness. 

There is said to be a statement of sickness with respect to such day. In this title, 

the term "infirmity" encompasses pregnancy, miscarriage, and childbirth as well 

as injury, illness, sickness and disease.
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1023 Summary of Requirements

1023.01 Claim for Sickness Benefits

For the purpose of section 335.2 of the regulations, which prescribes the manner 

of claiming sickness benefits, an employee has made a claim for sickness 

benefits, if:

a. Statement of sickness filed

A properly executed statement of sickness with respect to any day, 

acceptable in accordance with the RRB's regulations, is filed on behalf of 

the employee at an office of the RRB; and

b. Application for sickness benefits

An application for sickness benefits, properly executed on a form 

prescribed by the RRB, and the information required by the form have 

been received at the office of the RRB where their statement of sickness 

is on file; and

c. Claim form

A properly executed Form SI-3 for a registration period including a day 

with respect to which a statement of sickness is filed, and the information 

required by such form, are received at an office of the RRB.

1023.02 Form Prescribed for Statement of Sickness

A statement of sickness is to be filed on a form provided by the RRB (Form SI-1b 

or SI-7) or on a form or official stationery provided by a hospital, clinic, group 

health association, or other similar organization for transcription of medical 

records of such organization.

1023.03 Filing within the Prescribed Time

No day is to be considered as a day of sickness unless a statement of sickness 

with respect to such day is filed within the time prescribed for statements of 

sickness, and no day is to be considered as a day of sickness unless a claim 

form with respect to a registration period including such day is filed within the 

time prescribed for claim forms.
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1023.04 Persons who may Execute Statements of Sickness

A statement of sickness may be executed by any person who is qualified under 

section 335.3 of the regulations of the RRB to execute such statements, or by 

others designated by the RRB.

a. Qualified doctors

A person is qualified to execute statements of sickness if they are: 

1. A doctor trained in medical and surgical diagnosis and licensed to 

practice professionally in the State or foreign jurisdiction where the 

statement is executed, or

2. A licensed dentist if the infirmity relates to the teeth or gums, or

3. A licensed podiatrist or chiropodist if the infirmity relates to the feet, 

or

4. A chiropractor licensed to practice professionally in the State or 

foreign jurisdiction in which the statement is executed, or

5. A licensed clinical psychologist having a doctoral degree (Ph.D. or 

Psy.D.) in psychology.

b. Physician assistant - certified (P.A.C.)

A physician assistant- certified is qualified to execute statements of 

sickness. Physician assistants-certified diagnose, manage, and treat 

patients across a broad range of common illnesses and injuries while 

working under the supervision of a practicing, licensed medical doctor.

c. Nurse Practitioners (NP)

A nurse practitioner is qualified to execute statements of sickness. Nurse 

Practitioners are registered nurses with advanced education and clinical 

expertise that qualifies them to diagnose and treat illnesses and injuries.

d. Employee Assistance Professionals (EAP) and Substance Abuse 

Professionals (SAP)

A Substance Abuse Professional (SAP) is a person who evaluates 

employees who have violated a Department of Transportation (DOT) drug 

and alcohol regulation and makes recommendations concerning 

education, treatment, follow-up testing, and aftercare. 
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An employee assistance professional (EAP) or a substance abuse 

professional (SAP) is qualified to execute statements of sickness in cases 

where an employee is unable to work due to drug and/or alcohol-related 

infirmities. The EAP or SAP must be certified by one of the following 

certifying organizations: 

• the National Association of Alcohol and Drug Abuse Counselors 

(NAADAC) 

• the Certified Employee Assistance Professionals (CEAP)

• the International Certification Reciprocity Consortium/alcohol and 

Other Drug Abuse (ICRC) or the 

• National Board for Certified Counselors, Inc. and Affiliates/Master 

Addictions Counselor (NBCC). 

e. Certified nurse mid-wives

A certified nurse midwife is qualified to execute statements of sickness in 

cases where pregnancy, miscarriage or childbirth makes the employee 

unable to work or makes working injurious to the employee's health.

f. Other qualified persons

A person is qualified to execute statements of sickness if they are a 

superintendent or other supervisory official of a hospital, clinic, group 

health association, or similar organization where:

1. all examinations and treatment are conducted under the supervision 

of licensed doctors trained in medical and surgical diagnosis, or 

under the supervision of licensed chiropractors, or under the 

supervision of others authorized to execute statements of sickness, 

and

2. medical records are maintained for each patient.

g. Persons designated by the RRB

1. The RRB has designated duly authorized and accredited Christian 

Science practitioners to execute statements of sickness.

2. A person may be designated by the RRB if there are circumstances 

which warrant such designation. (See AIM-1031.)
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1024 Statement of Sickness

1024.01 Information relating a statement of sickness to a day 

It is to be considered that there is a statement of sickness with respect to a day 

when a form provided by the RRB for making statements of sickness or a form 

otherwise acceptable in accordance with the RRB's regulations, together with 

any required supplemental doctor's statement, has been properly executed and 

information has been furnished:

a. Describing an infirmity affecting an employee, and

b. Indicating when the employee became affected, or was found to be 

affected, by such infirmity, and

c. Indicating that the employee was continuously affected by an infirmity from 

the time when they became affected or was found to be affected, by the 

infirmity described in the statement of sickness, up to and including such 

day.

1024.02 Execution 

A form provided for making statements of sickness or otherwise acceptable in 

accordance with the RRB's regulations, is to be regarded as properly executed if:

a. It is signed by a person who may execute statements of sickness and

b. There is information indicating that the employee whose infirmity is 

described in the statement of sickness was examined by a qualified doctor 

or by a person designated to execute statements of sickness, during the 

period when the employee was affected by such infirmity.

1024.03 Acceptable Form SI-1b 

Form SI-1b is acceptable if there is information as follows:

a. Employee's name

A name or other information sufficient to identify the applicant is entered 

on the form. If this information is not shown on the form, consider that a 

statement of sickness has not been filed.

b. Information relating to infirmity

An entry on the form describes an infirmity and indicates the applicant has 

been examined by a qualified doctor or other person authorized to execute 
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statements of sickness. Medical evidence obtained in accordance with 

AIM-31 is also acceptable.

c. Day of infirmity

One or more days on which the employee was affected by such infirmity 

are indicated. Sufficient indication is given by:

1. an entry on Form SI-1b of the date on which the employee became 

sick or injured; or

2. an entry on Form SI-1b of a date on which the employee was 

examined or treated; or

3. an entry on an accompanying Form SI-1a showing the date on 

which the employee became sick or injured.

NOTE: In cases involving pregnancy, miscarriage or childbirth, an entry of 

the date the patient became unable to work, or an entry of the date of 

delivery and a date the employee can safely resume work in her 

occupation is required.

d. Evidence of execution

1024.03(d)

A signature has been entered in the space for "Signature of Doctor" and 

there is evidence that the person who signed is one who may execute 

statements of sickness. It may be considered that there is such evidence 

if:

1. the signature is followed by the letters "M.D.", "D.O.", "D.C.", 

"P.A.C.", "NP", "F.N.P" or "A.R.N.P", "C.S.", "C.S.B.", or "C.S.D." 

(When the letters "C.S.", "C.S.B." or "C.S.D." appear after the 

signature on a Form SI-1b, it may be considered, in the absence of 

evidence to the contrary, that the form was executed by a duly 

authorized and accredited Christian Science practitioner.); or

2. the signature is followed by the letters "D.D.S." or "D.M.D." if the 

infirmity is of the teeth and jaws; or

3. the signature is followed by the title "Podiatrist" or "D.P.," if the 

infirmity is of the foot or ankle and is within the podiatrist's field of 

treatment; or

4. the signature is followed by the letters "Ph.D." or "Psy.D." indicating 

that the person who executed the form is a clinical psychologist 

holding a doctoral degree in psychology, if the infirmity is of a 
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mental, emotional, or behavioral nature within a psychologist's field 

of treatment, or

5. in the case of infirmity due to drug or alcohol use, the signature is 

followed by any of the following letters:

"E.A.P," or “CEAP” indicating that the person who executed the 

form is an employee assistance professional or a 

"S.A.P" Substance Abuse Professional 

“NCAC I” National Certified Addiction Counselor

“NCAC II” National Certified Addiction Counselor

“MAC” Master Addiction Counselor

“AODA” Alcohol and Other Drug Addiction Counselor

“AAODA” Advanced Alcohol and Other Drug Addiction Counselor

“CCS” Certified Clinical Supervisor

“CPS” Certified Prevention Specialist

“CCJP” Certified Criminal Justice Addiction Professional

“NCC” National Certified Counselor

“CADAC” or” LADAC” Certified Alcohol Drug Abuse Counselors not

“CPADAC” or LPADAC” P is for provisional not yet certified.

6. the signature is followed by the letters "C.N.M." indicating that the 

person who executed the form is a certified nurse midwife, and the 

diagnosis is childbirth, pregnancy, or miscarriage, or

7. the person who signed has supplied their official title as a 

supervisory official, and the name of a hospital, clinic, group health 

association, or similar organization is also provided; or

8. the person who signed is one who has been designated by the 

RRB to execute statements of sickness; or

9. the employee is confined to a hospital or the address of the person 

who signed is shown as that of a hospital as described in section 

1023.04c; or
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10. the person who signed is listed in the American Medical Directory 

or was properly identified at the time a previous statement of 

sickness executed by him or her was examined.

If there is any information that the person who signed the medical report is not 

authorized to execute statements of sickness, or if comparison of dates on the 

form indicates that the employee was not examined by a person authorized to 

execute statements of sickness during the period of infirmity, do not consider that 

a proper statement of sickness has been filed.

A medical report signed by a Doctor of Optometry (O.D.) is not an acceptable 

statement of sickness.

1025 Filing Statements of Sickness

1025.01 Prescribed Time for Filing

A statement of sickness with respect to any day is to be filed not later than the 

ninth day after such day.

1025.02 First Day of Normal Filing Period 

The period within which an acceptable statement of sickness is normally filed 

begins with:

a. The ninth day prior to the day when the form was received in any office of 

the RRB, or

b. The seventh day prior to the day when the form was mailed to and office 

of the RRB. (See AIM-1030.)

1025.03 Normally Filed

If the first day of infirmity or any subsequent day of infirmity occurs on or after the 

first day of the normal filing period, consider that a statement of sickness has 

been filed normally within the prescribed time.

1025.04 Further Consideration

If the first day of infirmity is prior to the first day of the normal filing period, 

consideration is to be given to any evidence of conditional filing in accordance 

with AIM-1029.
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1026 Application for Sickness Benefits

1026.01 Requirement 

No benefits are to be paid for any claim based upon a statement of sickness until 

a properly executed application for sickness benefits containing information 

required by the form is received.

1026.02 Execution 

An application for sickness benefits is properly executed if it is signed by the 

applicant or signed by someone who may properly act on behalf of the applicant 

in accordance with AIM-23.

1026.03 Information Required 

The information required by the form has been furnished if there is sufficient 

information:

a. To identify the applicant; and

b. To make any required determination of base year wages; and

c. To identify the period of sickness to which the application relates.

1026.04 Acceptable Form SI-1a 

Form SI-1a is acceptable if there is information as follows:

a. Employee's name

A name identifying the applicant has been entered on the form, or the form 

is received with some other form having information sufficient to identify 

the applicant.

b. Information required for determination of base year wages

Sufficient information is given for any required determination of the 

applicant's base year compensation.

c. Information relating to infirmity

Entries on Form SI-1a correspond with entries on Form SI-1b or with other 

information relating to the period of infirmity for which the Form SI-1a is 

required. Despite entries on Form SI-1a, consider that the Form SI-1a 

corresponds with the period of infirmity if Form SI-1a and SI-1b are 

received attached.
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d. Signature

An acceptable signature is entered on the form. A signature is acceptable 

if:

1. It appears to be the signature of the applicant; or

2. It appears to be the mark of the applicant and is witnessed by an 

RRB representative, or by a person authorized to execute a 

statement of sickness, or by two other persons; or

3. It is recognizable as the signature of someone who may properly 

act on behalf of the applicant in accordance with AIM-23.

1027 Claim Form

1027.01 Forms to be Sent

A claim form will ordinarily be sent to an individual for the first registration period 

beginning with a day with respect to which a statement of sickness is filed on 

their behalf. When the individual has filed a claim for any registration period, a 

claim form will be sent to the individual for the next registration period beginning 

with a day with respect to which a statement of sickness is filed. These forms will 

be sent as prescribed in AIM-11, Title II.

1027.02 Execution

A claim form is to be regarded as properly executed if it is signed by the claimant 

or if it is signed by someone who may properly act on behalf of the claimant.

1027.03 Information Required

Information is required by a claim form if it is called for by the form and if it is 

needed to adjudicate the claim. Some of the information called for need not be 

furnished in connection with a particular claim either because it has been 

previously furnished or because other information furnished shows that it is not 

applicable. Until the required information is received by the adjudicating office, 

no day with respect to which such information is needed is to be considered as a 

day of sickness.

1027.04 Acceptable Form SI-3

A Form SI-3 is acceptable if the information needed to adjudicate the claim has 

been furnished. The need for information called for by the items on a Form SI-3 

is as follows:
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a. Days claimed

The entries on the claim form must show clearly which days are claimed. If 

the entries are unclear, the claimant may be contacted by telephone or 

letter for clarification. If entries are missing or incomplete, the form is to 

be returned to the claimant for proper completion.

b. Wages and other payments

If no entry has been made regarding any wages or other payments 

received by the claimant, or if an entry has been made and is apparently 

incorrect, information with respect to these items need not be obtained 

except as specifically provided under applicable instructions in the AIM or 

DPOM/FOM.

c. Signature

An acceptable signature must appear on the form. A signature is 

acceptable if:

1. It appears to be the signature of the claimant; or

2. It appears to be the mark of the claimant and is witnessed by an 

RRB representative, or by a person authorized to execute a 

statement of sickness, or by two other persons; or

3. It is recognizable as the signature of someone who may properly 

act on behalf of the claimant.

1028 Filing Claim Forms

1028.01 Prescribed Time for Filing

An employee's claim for sickness benefits is to be filed within 30 days after the 

last day of the registration period or within 30 days after the day on which the 

claim form was mailed to the employee, whichever is later.

1028.02 Normally Filed

A claim for sickness benefits with respect to any registration period is normally 

filed if:

a. The claim form was received at an office of the RRB within 30 days after 

the later of (i) the last day of the registration period shown on the claim 

form or (ii) the day such claim form was mailed to the employee, or
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b. There is evidence that the claim form was mailed to an office of the RRB 

in accordance with the instructions on the form and was received there.

1028.03 Further Consideration 

If a claim form is not normally filed, consideration is to be given to any evidence 

of conditional filing in accordance with AIM-1029.02.

1029 Determination on Conditional Filing of Forms

1029.01 Consideration if Form not Normally Filed

a. Statement of sickness

When a Form SI-1b with respect to a particular day was mailed later than 

the seventh day after such day and was received at an office of the RRB 

later than the ninth day after such day, consider the possibility that a 

statement of sickness was conditionally filed within the prescribed time, 

provided that it is received within two years of the first day for which the 

employee wishes to claim benefits.

b. Claim Form

When a claim form is not normally filed, consider the possibility that the claim is 

conditionally filed within the prescribed time, provided that it is received within 

two years of the first day for which the employee wishes to claim benefits.

1029.02 Employee prevented from Filing by Circumstances Beyond their

Control

An employee's statement of sickness or claim form is conditionally filed within the 

prescribed time, if the employee made a reasonable effort to file within the 

prescribed time but was prevented from doing so by circumstances beyond their

control, and if such statement or claim was received at an RRB office within a 

reasonable time following the removal of the circumstances that prevented the 

employee from filing the form.

For the purposes of this provision, if a statement of sickness is not received 

within the prescribed time (10 days) but is received within 30 days of the first day 

that an employee intends to claim as a day of sickness, the RRB will consider 

that the employee made a reasonable effort to file the statement within the 

prescribed time, unless affirmative evidence shows that the delay was not the 

result of circumstances beyond the employee's control.
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a. Effort

1. An employee is expected to make an effort to file within the 

prescribed time, except in situations where the employee's physical 

or mental condition prevents such an effort. An effort to file a form 

is to be considered in relation to the employee's situation. Any 

action which might reasonably be expected to result in the filing of 

an employee's statement of sickness or claim form within the 

prescribed time would be considered as a proper effort, provided 

that the employee, upon finding that such action is ineffective, takes 

other appropriate action.

(a) If information relating to an employee's infirmity is received 

at an office of the RRB within the time prescribed for filing a 

statement of sickness or claim form, or is mailed to an office 

of the RRB within the time specified, it is to be considered 

that the employee made a proper effort to file a statement of 

sickness or claim form. Any correspondence indicating that 

the employee is sick and wants to claim sickness benefits is 

considered as a communication relating to the employee's 

infirmity.

(b) If an employee is confined in a hospital and sends in an 

application for sickness benefits during confinement or 

shortly after being released, it is to be considered that the 

employee made a proper effort to file a statement of 

sickness with respect to the days when they were in the 

hospital.

(c) If an employee in the circumstances described in "b" above 

entered the hospital within seven days after the first day 

which they wish to claim as a day of sickness, consider that 

the employee made a proper effort to file a statement of 

sickness with respect to all the days which they wish to 

claim.

(d) An employee's action to obtain Forms SI-1a and SI-1b 

shows an effort to file. If an employee's statement of 

sickness is received within a reasonable time after the date 

they took action to obtain the forms, the statement of 

sickness may be considered filed with respect to the seventh 

day prior to the date of such action. Forms supplied by a 

field office will normally be notated by the field office with an 

entry showing the date the forms were provided to the 

claimant.
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2. A claimant who delivers or mails a claim on the last day which they

claim or on any subsequent day before the normal filing period for 

the claim has ended has made a reasonable effort to file the form 

within the prescribed time.

b. Circumstances beyond employee's control

An employee is considered as prevented from filing a statement of 

sickness or claim form by circumstances beyond their control when:

1. The employee is confined to home or to a hospital and the delay in 

filing is attributable to this confinement. This condition is met where 

the employee is confined:

(a) to a hospital and their statement of sickness is filed within a 

reasonable time after leaving the hospital, unless there is 

information that the employee did not make a proper effort to 

file a statement of sickness.

(b) to home, is bedridden, or confinement otherwise prevented 

timely filing a statement of sickness.

2. The employee's statement of sickness is in the possession of their

doctor or in the possession of a hospital. It is considered that this 

circumstance exists if:

(a) the employee gave or sent the form to a doctor or hospital 

for execution within the normal time for mailing, and the form 

was not returned within the normal filing period; or

(b) a supervisory official of the hospital states that the delay in 

filing was caused by the hospital; or

(c) the doctor states that the delay in filing was caused by him 

or her; or

(d) the application or claim form, mailed with the statement of 

sickness, was dated within the normal period for mailing and 

was mailed from a hospital in which the employee was 

confined or to which they sent the form for execution; or

(e) the date the statement of sickness was signed by the doctor 

or hospital official is within 30 days of the date the 

application was signed by the employee and the forms are 

received at an office of the RRB within 10 days of the date of 

the doctor's signature on Form SI-1B, unless there is 

evidence that the doctor delayed the forms beyond the 10 

days. The employee is considered to have made a proper 
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effort to file a statement of sickness with respect to the 

seventh day before the application was signed.

NOTE: Anytime a SI-1B is received more than 30 days after the SI1A, a filing date needs to be entered on the SI-1B screen on RUCS. 

3. Information in a doctor's statement shows that the employee could 

not sign forms. (If the delay in filing the form was due to the 

employee's inability to sign forms, it should be determined whether 

the statement is supported by medical evidence.)

4. Forms for applying for sickness benefits are not available at a place 

where such forms are ordinarily kept for distribution; or a form 

(either statement of sickness or claim form) which was sent to the 

employee by an RRB office was not received by the employee. In 

the absence of evidence to the contrary, an employee's statement 

may be accepted as correct.

5. Within the normal time for mailing the form, the employee gave it to 

someone who they could reasonably trust to mail it, and that person 

failed to mail it within the time specified.

6. The employee was given misinformation by someone whom they

could reasonably expect to furnish correct information.

7. The employee misunderstood the instructions on the form.

8. There is evidence that the employee's infirmity caused physical 

weakness, mental incapacity, or extreme anxiety, such that the 

employee could not be expected to take effective action toward 

filing a statement of sickness.

1029.03 Registration for unemployment benefits

An employee's statement of sickness with respect to any day is considered as 

conditionally filed within the prescribed time if:

a. The employee registered for the day in accordance with the regulations of 

the RRB; and

b. The employee's claim to the day as a day of unemployment was denied 

on the grounds that the employee was not able to work on such day; and

c. A properly executed statement of sickness was received within a 

reasonable time.

For the purpose of this subsection, consider that the statement of sickness was 

received within a reasonable time, if it was obtained in connection with the 
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adjudication of the employee's claim for unemployment benefits or was received 

within the time prescribed for the filing of a sickness claim form or forms sent to 

the employee when they were notified of the denial of their claim to the day as a 

day of unemployment.

1029.04 Obsolete Form Filed

If an employee files an obsolete statement of sickness form with the prescribed 

time and after being so informed, files the proper statement of sickness form 

within a reasonable period of time thereafter, the proper form is to be considered 

as conditionally filed within the prescribed time. If the obsolete form contains 

sufficient information to make a determination concerning inability to work, the 

obsolete form is to be considered an acceptable statement of sickness. 

1029.05 Reasonable Time

Except as provided in AIM-1029.03, a statement of sickness or claim form is 

considered as received within a reasonable time if it is received at an office of the 

RRB within ten days after: 

a. The date on which an RRB office mailed a reply to a communication 

relating to the employee's infirmity; or

b. The date on which a communication relating to the employee's infirmity, 

not requiring a reply was mailed to an office of the RRB.

c. The first day on which circumstances or conditions preventing the 

employee from filing the form no longer exist.

1029.06 Time Limit on Conditional Filing

A form is not considered filed within the time prescribed with regard to it unless it 

is received at an office of the RRB within two years of the day in question. If a 

form is not received within two years of the first day for which the employee 

wishes to claim benefits, take action as follows:

a. All days prior to two-year limit

If all days for which an employee wishes to claim sickness benefits are 

earlier than two years prior to the date the form is received at an office of 

the RRB, the form is not to be considered filed within respect any day.

b. Some but not all days prior to two-year limit

If some but not all days for which an employee wishes to claim sickness 

benefits are earlier than two years prior to the date the form is received at 
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an office of the RRB, submit a request for opinion to the Office of 

Programs - Policy &Systems (OP-P&S).

1029.07 Circumstances not beyond employee's control 

The phrase "circumstances beyond their control" does not include an employee's 

forgetfulness, lack of knowledge of the sickness benefit program or the time limit 

for filing for sickness benefits, or any other lack of diligence by the employee.

1030 Determining the Date on Which a Form or Communication 

Was Mailed

The postmark date is considered to be the date on which such form or 

communication was mailed. If there is no postmark on such a document, the 

postmark date on the envelope in which the document was received is 

considered to be the mailing date. However, experience sometimes shows that 

the date of postmark is later than the date of mailing. If mail from the locality 

where the document was mailed is often postmarked on the day after it is mailed, 

and if the time shown in the postmark is in the morning, it may be considered that 

the document was mailed on the day before the date of the postmark. If there is 

no postmark, the mailing date is considered to be the second business day prior 

to the date on which the document was received in an office of the RRB.

1031 Action When Employee Cannot Get Statement of Sickness 

Executed

1031.01 Designation of Person to Execute Statement

If an employee does not submit an acceptable statement of sickness and they

cannot get a statement executed because a person who may execute statements 

of sickness is not available to examine or treat the employee, the adjudicating 

office is to submit the case through channels for consideration of designating a 

person to execute a statement of sickness.

1031.02 Special Medical Examination

Occasionally, there may be information that an employee cannot get a statement 

of sickness executed although a person who may execute statements of 

sickness is available to examine or treat the employee. In such case, the 

adjudicating office may arrange for a medical examination in accordance with 

AIM-31. When such an examination is made and the employee's claim to 

benefits is based on medical evidence obtained at the expense of the RRB,

consideration is to be given in accordance with section 12(n) of the Act, to 

deducting a reasonable charge from benefits payable. Prior approval for any 

such deduction is to be obtained from the Chief of Sickness and Unemployment 

Benefits Section.
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Appendices

Appendix A - Examples of Earliest Initial Filing Date

Examples Showing The Earliest Date With Respect To Which A Statement Of 

Sickness May Be Considered Filed.

Each example is based on June 30 as the last day of employment and a two-day 

interval between mailing of forms and receipt in the Board office.

Example 1

7/08 Employee sends letter to an 

office of the RRB: "Please send 

me sickness application form."

Filed with respect to July 1. 

Written inquiry shows effort to file. 

SI-1a/b received "within a 

reasonable time" after they were 

sent to claimant.

7/10 An office of the RRB sends SI1a/b.

7/17 Employee mails completed forms 

to an office of the RRB.

Example 2

7/12 Employee sends letter to an 

office of the RRB: "Please send 

sickness application blank. I 

can't get one here. Yesterday I 

tried three different places - all 

out."

Filed with respect to July 4. 

Claimant reports no effort made to 

file prior to July 11.

7/15 An office of the RRB sends SI1a/b.

7/23 Employee mails completed forms 

to an office of the RRB.

Example 3

7/08 Employee obtains SI-1a/b from 

field office.

Filed with respect to July 1. Action 

of obtaining forms shows effort to 

file.

7/10 Employee mails completed forms 

to an office of the RRB.
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Example 4

7/10 Employee calls at field office, 

says "I just found out about 

sickness benefits. Where do I 

apply?" Field office furnishes 

forms.

Filed with respect to July 3. Action 

of obtaining forms shows effort to 

file Claimant's statement indicates 

delay not due to circumstances 

beyond the claimant's control.

7/14 Employee brings completed 

forms to field office.

Example 5

7/12 Employee mails completed SI-1a 

to an office of the RRB. 

Filed with respect to July 1. 

Statement of sickness within 30 

days of July 1 clear evidence that 

delay the result of circumstances 

beyond claimant's control.

7/16 Employee mails SI-1b, 

completed by doctor on the same 

date.

Example 6

7/10 Employee calls at field office and 

obtains forms. 

Filed with respect to July 1. 

Statement of sickness is received 

within 30 days of July 1 with no 

clear evidence that delay was not 

the result of circumstances beyond 

claimant's control.

7/11

Employee brings completed 

forms to field office.

Example 7

7/12 Employee mails letter to an office 

of the RRB: "I just found out 

today about sickness benefits. 

Send me forms."

Filed with respect to July 18. 

Effort made to file on July 12. 

However, statement of sickness 

was not received within 10 days 

after forms were furnished. The 

forms are not considered as 

having been received within a 

reasonable time.
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7/14 An office of the RRB sends 

forms.

7/25 Employee mails completed forms 

to an office of the RRB.

Example 8

7/12 Employee mails letter to an office 

of the RRB: "I just found out 

today about sickness benefits. 

Send me forms.

Filed with respect to July 5. Effort 

made to file on July 12. Delay 

attributable to doctor.

7/14 An office of the RRB sends 

forms.

7/25 Employee mails completed forms 

to an office of the RRB and 

writes: "I took form to the doctor 

to sign on July 20 but he was 

sick and couldn't see me until 

today.

Example 9

7/10 Form SI-1a signed. No evidence 

to show when forms were 

obtained.

Filed with respect to July 1. 

Statement of sickness is received 

within 30 days of July 1 with no 

clear evidence that delay was not 

the result of circumstances beyond 

claimant's control.

7/26 Form SI-1b signed by doctor or 

hospital official.

7/28 Forms SI-1a/b are received in an 

office of the RRB.

Example 10

7/08 Forms SI-1a/b furnished to 

employee by a field office. Field 

office enters date furnished on 

forms.

Filed with respect to July 1. Action 

of obtaining forms shows effort to 

file.
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7/16 Completed forms SI-1a/b 

received in an office of the RRB.

Appendix B - Filing Statements Of Sickness In Advance

THE FOLLOWING RESPONSE PROVIDES THE RATIONALE FOR WHY A 

STATEMENT OF SICKNESS IS NOT ACCEPTABLE IF IT IS FILED IN 

ADVANCE OF THE EMPLOYEE BECOMING UNABLE TO WORK.

A question was recently asked whether applications for sickness benefits and 

statements of sickness signed before the employee becomes unable to work are 

acceptable. A statement of sickness signed before the employee is unable to

work is not acceptable. Nor is it acceptable if the last examination or treatment 

date precedes by more than one day the date the employee became unable to 

work. This is true even if the doctor's signature date is after the first reported day 

of inability to work. An application that is signed early, however, may be 

accepted if accompanied or followed by an acceptable statement of sickness.

Section 1(k) of the RUIA defines a day of sickness, in part, as a day on which an 

employee is unable to work due to infirmity and for which the employee has filed 

a statement of sickness. Section 12(I) provides that a statement of sickness must 

contain substantial evidence of the days of sickness of the employee. Under AIM 

728 and 1024, medical evidence is acceptable only if the doctor examined or 

treated the employee during the period of illness or injury. These sections of the 

law and policy require the same documentation of the employee's actual (rather 

than potential) inability to work. A doctor cannot, however, certify that a condition 

is disabling if the employee is working. A doctor's estimate that inability will begin 

when elective surgery is performed some days in the future is speculative. The 

inability may or may not occur. The surgery could be postponed, canceled, or 

bring results other than the doctor expects. Therefore, examiners may accept 

only a statement of sickness showing that the doctor examined or treated the 

employee during the period when the employee was unable to work due to the 

infirmity.

Since these cases are rare, examiners may release claims after verifying by 

telephone with doctors' offices that surgery took place as scheduled or that nonsurgical treatment occurred during a period of inability to work. The verification is 

to be documented on the original statement of sickness.