RB-19A Booklet; Child's Disability Benefits

RB-19a (5-99).pdf

Application for Survivor Insurance Annuities

RB-19A Booklet; Child's Disability Benefits

OMB: 3220-0030

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For Use With
Form AA-19a

CHILD'S
DISABILITY
BENEFITS

United States of America
Railroad Retirement Board
Visit our Web site at http://www.rrb.gov

Form RB-19a (05-99)

Table of Contents
Page
Part I . General Information
Chapter 1 . Application Forms ......................................................................................
I
Chapter 2 . Medical Evidence ......................................................................................
1
Chapter 3 . After You Return Your Application .............................................................3
Chapter 4 . Periodic Review of Disability ......................................................................4
4
Chapter 5 . Information and Assistance .......................................................................

Part II . About Your Survivor Disability Annuity
Chapter 6 . Eligibility Requirements for a Disability Annuity .........................................5
Chapter 7 . When Your Disability Annuity Can Begin ...................................................5
Chapter 8 . How Work Can Affect Your Disability Annuity Payments ..........................6
Chapter 9 . Felony Conviction Can Affect Your Annuity ..............................................6
Chapter 10 . When Your Disability Annuity Could End .................................................6

Part Ill. Applying For Medicare Before Age 65
Chapter 11 . Types of Medicare Coverage ............................................................... 9
Chapter 12 . Eligibility Requirements for Medicare .................................................... 10
Chapter 13 . When Your Medicare Could End ..........................................................10
Chapter 14 . Enrollment for Medicare .....................................................................11

Part IV. Events That Can Affect Your Disability Benefits
Chapter 15 . Events You Must Report ........................................................................ 13
13
Chapter 16 . How to Report an Event .........................................................................

Part V . Taxation
Chapter 17 . Taxation of Railroad Retirement Annuities ............................................15

Part VI . Glossary
Chapter 18 . Special Railroad Retirement Board Terms Defined ............................... 17

Part I - General Information

Chapter 1 - Application Forms

To receive the disability benefits described in this booklet, you must file an
application form. This chapter will explain the forms you must file to receive a
disability benefit.
Children of Deceased Employees
To receive monthly survivor disability annuity payments, Form AA-1 9a,
Application for Determination of Child Disability, must be filed with Form AA-19,
Application for Child's Annuity, or Form AA-18, Application for Motherls/Father's
and Child's Annuity.
If you have filed for a disability annuity, you are automatically considered for early
Medicare coverage.
Children of Livinq Employee Annuitants
As the child of a living employee annuitant, you are not eligible to receive annuity
payments in your own right. However, you may be included in the employee's
annuity payments under a special guaranty provision, or you may qualify a
spouse for an annuity. Form AA-1 9a, Application for Determination of Child's
Disability, must be filed to qualify an employee or spouse for these benefits.
If your disability increases the amount of the employee's annuity payments or if
your disability qualifies a spouse for an annuity, you are automatically considered
for early Medicare coverage. Otherwise, you must file Form AA-19a, Application
for Determination of Child's Disability, to receive early Medicare coverage.
Chapter 2 - Medical Evidence

When you apply for any type of disability benefit, it is your responsibility to prove
to the Railroad Retirement Board (RRB) that you are "permanently disabled' (see
Part VI, Item 6, for definition). You must provide or tell us about any evidence
which may show that you are disabled.

Part I

- General lnformation

How to Furnish Medical Evidence
You may furnish medical evidence in three ways:

1. 	 We will give you a report form for your personal physician to complete.
In this way we can get information about your condition from the
medical source who knows you best.
2. 	 We will ask you to sign an authorization to release to the RRB any
hospital, clinic, or employer medical records about your condition.
3. 	 We may ask you to be examined at the RRB's expense if more
evidence is needed to:
obtain more detailed or specialized medical findings about your
condition, or
resolve conflicts or differences in the evidence already in file.
Acceptable Sources of Medical Evidence
The following are acceptable sources of medical evidence:
Licensed physicians
Licensed osteopaths
Licensed or certified psychologists
Licensed optometrists
Persons authorized to send copies or summaries of the medical
records of hospitals, clinics, sanitoriums, medical institutions or health
care facilities.
Other Sources of lnformation
Sometimes, information from other sources can be important to a decision about
your disability, such as:
school records,
public and private social welfare agencies,
observation by non-medical sources (for instance a vocational
consultant),
other practitioners (naturopaths, chiropractors, audiologists, etc.).

Part I

- General Information

Failure to Submit Evidence
It is in your best interest to fully cooperate if medical or other evidence is needed
so that the decision on your claim will be based on the best information available.
If you fail to submit medical evidence that is needed and requested, a decision
will be made on the evidence available.
If you fail or refuse to report without good cause for an examination scheduled
and paid for by the RRB, it may be decided that you are not disabled.
Chapter 3 - After You Return Your Application
After the RRB receives your completed application and all the needed evidence,
the RRB will decide if you are entitled to disability benefits.
If you cannot receive disability benefits, the RRB will send you a notice
explaining:
why you cannot receive disability benefits, and
what you can do if you disagree with the reason you cannot receive
them.
If you can receive disability benefits, you will receive a notice which shows the
amount of your monthly payments, if any, and other information about your
benefits.
Sometimes the RRB will not be able to make a decision on your application
without obtaining additional information. If so, an RRB representative will contact
you by telephone or mail. You may be asked to send us the additional forms,
proofs, or statements that are needed. You may also be asked to report for a
medical examination.
Unless you receive a request for additional information, the RRB will notify you of
the decision on your application in five to six months. If you do not hear from us
within that time, contact the nearest RRB office so we can find out what is
causing the delay.

Part I

- General Information

Chapter 4 - Periodic Review of Disability
Your case may be periodically reviewed to determine if your condition is still
severe enough to prevent you from working. This is necessary to see if your
disability annuity or early Medicare coverage should continue.
When your case is reviewed, we may ask you for information and evidence or to
report for a medical examination.

Chapter 5 - Information and Assistance
Any time you need information or assistance, you may contact the nearest field
office of the RRB. In addition to the personal attention you will receive, special
booklets and other printed material are available. To locate the nearest RRB
office visit our Web site at http://www.rrb.gov, or call our toll-free HelpLine at 1800-808-0772.
If you need to personally visit one of our field offices, please call for an
appointment. You will not be refused service if you do not have an appointment,
but our staff can serve you better when an appointment is made. Most offices are
open to the public from 9:00 a.m. to 3:30 p.m., Monday through Friday.

Part II - About Your Survivor Disabilitv Annuitv

-

Chapter 6 Eligibility Requirements for a Disability Annuity
The special requirements you must meet in order to receive a disability annuity
are described in this chapter.
In addition to meeting the general annuity requirements for a surviving child
described in booklet RB-17, Sunlivor Annuities, you must:
be at least age 18, and
be permanently disabled for all regular work before age 22.
NOTE: If you previously received a disability annuity, you must be
"permanently disabled" within 84 months (7 years) of your last entitlement
to an RRB disability annuity (see Part VI, Item 6, for definition).
Sometimes a child may file Form AA-1Sa, Application for Determination of Child's
Disability, between ages 16 and 18 to qualify a widow or widower for full mother's
or father's annuity payments.

Chapter 7 - When Your Disability Annuity Can Begin
You may select the date you wish your disability annuity payments to begin.
The date you may select is either: 

the 
earliest date permitted by law, or 

another date that may be more advantageous to you. 

Generally, the earliest date permitted by law is the latest of the following:
The first day of the month in which the employee died.
The first day of the sixth month before the month your application was
filed. (Applications filed before September 1, 1983, had 12 months
retroactively.)
The first day of the month you are permanently disabled.
The first day of the month you attain age 18.
If the date you select is earlier than the earliest date permitted by law, your
annuity will begin on the earliest date permitted by law.

Part II

- About Your Survivor Disabilitv Annuitv

Chapter 8 - How Work Can Affect Your Disability Annuity Payments

If you perform work after your disability annuity begins, full monthly payments will
continue until it is determined that your disability has ended and you are no
longer entitled to a disability annuity. Your annuity is not payable for any month in
which you work for a railroad employer, and you must return your annuity
payment for that month to the RRB.
Your work and earnings will be evaluated to see if you are able to do "regular
work" (see Part Vl, ltem 8, for definition). Also, any work performed after your
disability annuity begins may raise a question about "medical recovery" (see Part
Vl, ltem 4, for definition) regardless of the amount of your earnings. If this
happens, you will be asked for additional information about your medical
condition and we may request you to be examined.

-

Chapter 9 Felony Conviction Can Affect Your Annuity

The amount of your annuity may be affected if you are:
convicted of a felony which was committed after October 19, 1980, or
imprisoned or confined for conviction of a felony.
See Part VI, Items 1 and 2, for definitions of "Confinement" and "Felony."
Chapter 10 -When Your Disability Annuity Could End

Entitlement to a disability annuity payment ends effective with the earliest of the
last day of the:
month before the month in which your death occurs,
second month after the month in which your disability ends,
month before you marry.

Part II - About Your Survivor Disabilitv Annuitv

Disability ends if you:

"medically recover" (see Part VI, ltem 4, for definition) so that you are
able to work, or
return to work and hold a job whether or not there has been any
substantial improvement in your condition. (See Part VI, ltem 10, Trial
Work Period.)

Part Ill - Applying for Medicare Before Age 65

Chapter 11 - Types of Medicare Coverage
Medicare is a two-part Federal health insurance program for people age 65 or
older and certain disabled people. One part is Hospital insurance (also called
Part A). The other part is Medical insurance (also called Part B).
Hospital insurance can help pay for:
medically necessary inpatient hospital care,
inpatient care in a skilled nursing facility, and
care in your home by a home health agency.
Medical insurance can help pay for:
medically necessary doctors' services,
outpatient hospital services,
outpatient physical therapy and speech pathology services, and
a number of other medical services and supplies that are not covered by
the Hospital insurance part of Medicare.
If you are permanently disabled for any regular work before age 22, Medicare
coverage may begin on the first day of the 25thcalendar month you meet all of the
eligibility requirements described in Chapter 12.
If you suffer from chronic renal disease, Medicare coverage may begin after a
three-month waiting period. Contact the Social Security Administration for this
coverage.

Part Ill - Applying for Medicare Before Age 65
Chapter 12 - Eligibility Requirements for Medicare

To be eligible for Medicare coverage before age 65, you must be:
at least age 18, or
'permanently disabled" for all "substantial gainful work" (see Part VI,
Items 6 and 9, for definitions)" before age 22.
NOTE: If you were previously entitled to Medicare, you must be
permanently disabled before the end of the 84thmonth (7 years) of your
last entitlement to an RRB disability annuity.
In addition, you must meet one of the following requirements:
Receive disabled child annuity payments.
Be eligible to be included in the employee's annuity payments.
A spouse's annuity is payable because you are disabled and in the
spouse's care.
Chapter 13 - When Your Medicare Could End

Medical Recovew
If it is determined that your condition has improved and that you are medically
able to work, your Medicare coverage will end. This is true whether or not you
have actually worked. When this happens, your Medicare coverage ends with
the latest of the last day of the:
second month after the month in which your "medical recovery" (see
Part VI, Item 4, for definition) occurs, 

month after the month in which you were notified in writing that your 

disability ended, 

month in which your death occurs. 

Work
If you are working, or have worked since your coverage began, your Medicare
coverage may end. This is true even though your medical condition may not
have improved. Unless medical recovery occurs first, your Medicare coverage
ends with the earlier of the last day of the:

Part Ill - Applying for Medicare Before Age 65

24thmonth after you have completed a "trial work period" (see Part VI,
ltem 10, for definition) and it is determined you performed "substantial
gainful work" (see Part VI, ltem 9, for definition),
month in which your death occurs.
Chapter 14 - Enrollment for Medicare

As soon as you are determined to be eligible for Medicare, and have met the
eligibility requirements, you will automatically be enrolled for Hospital insurance
coverage (Part A). You pay nothing for this coverage. You will also be
automatically enrolled for Medical insurance coverage (Part B). You will have to
pay a monthly premium for Part B. If you receive a benefit payment, the premium
will usually be deducted from your monthly payment. If you choose not to receive
Part B coverage, you must notify the Railroad Retirement Board.

Part IV

- Events That Can Affect Your Disabilitv Benefits

Chapter 15 - Events You Must Report

This chapter describes the different events that will affect your disability benefits.
You should be aware of these different events and notify us immediately if any of
them applies to you.
The events you should report can affect:
the amount of your monthly payment, or 

whether you can continue to be paid at all, or 

whether your early Medicare coverage can continue. 

Keep this booklet handy and refer to this part occasionally to see if you need to
report any event to the Railroad Retirement Board (RRB).
The following events must be promptly reported to the RRB:
If you perform any work, including self-employment, regardless how
much you earn.
If your condition improves, or your doctor tells you that you are able to
work. 

If you are convicted of a felony. 

These events must be reported in addition to any other events you must report
described in booklets RB-17, Survivor Annuities, or RB-30, Spouse Annuity.

-

Chapter 16 How to Report an Event

If at any time after you have completed your application you find that one of the
conditions explained in Chapter 15 applies to you, immediately notify the RRB in
writing. The notice should be sent to the RRB field office at the address shown
on the receipt for your application. However, if you wish, you may also call or visit
that office.
When you report an event, be sure to include the following:
your railroad retirement claim number, which is shown at the top of your
application receipt, and
your name (or the child's name if you are reporting an event for a child),
and

Part IV - Events That Can Affect Your Disability Benefits

the railroad employee's name, and
a clear explanation of what event you are reporting, and
the exact date (month, day, year) that the event occurred.
If you are reporting work, it is important that you also furnish:
the kind of work you are doing,
the name and address of your employer,
how much you expect to earn each month,
the period of time you expect to work, and
how many hours per week you work.

Part V

- Taxation

-

Chapter 17 Taxation of Railroad Retirement Annuities
Railroad retirement, survivor, and disability annuities are subject to United States
(U.S.) Federal income tax. Detailed information concerning the taxation of
annuities is available in Booklet TB-85, Information About the Taxation of
Railroad Retirement Annuities. You can get a copy of Booklet TB-85 from any
RRB office.
Under Section 14 of the Railroad Retirement Act, railroad retirement, survivor,
and disability annuities are not taxable for state income tax purposes.
If you want to have taxes withheld from your annuity or want further information
regarding tax withholding, you should get Booklet TB-25, Tax Withholding and
Railroad Retirement Payments. If you are a U.S. citizen residing outside of the
U.S. or a nonresident alien, you should complete Form RRB-1001, Nonresident
Questionnaire, to claim a tax treaty exemption that may result in reducing tax
withholding or no tax withholding.
For assistance with your tax inquiries, or to request RRB forms and publications,
contact:
your nearest RRB field office (if you reside inside the U.S.) or
a U.S. consulate/embassy (if you reside outside the U.S.).
If you have questions about how to figure your taxable payments or what
amounts to show on your income tax return, contact your own tax preparer or the
Internal Revenue Service.

Part VI - Glossary

-

Chapter 18 Special Railroad Retirement Board Terms Defined
The following are definitions of certain terms used throughout the booklet.
1. 	 Confinement - To be imprisoned or under a sentence of confinement means
confinement to a jail, prison, or other penal institution or correctional facility.
This includes any facility which is under the control and jurisdiction of a penal
system, or any facility in which a person may be confined. This also includes
hospitals, institutions, and half-way houses which are used as a place of
confinement. A person under a sentence of confinement to any of these
facilities is considered confined even though he or she may go outside the
facility to work, attend school, or for some other reason.
Note: 	 A prisoner who is released on parole or because the sentence has
ended or has been suspended or overturned, is no longer
considered to be confined or imprisoned.
2. 	 Felony - A crime is a felony if it is considered to be a felony under applicable
law. Most states define certain crimes as felonies. However, some states
and foreign countries do not classify crimes as felonies. If a crime has not
been classified as a felony, it is still considered to be a felony if it is a crime
punishable by death or imprisonment for more than one year.
3. 	 Imprisonment - See Confinement.
4. 	 Medical Recovery - A person has medically recovered from disability if,
based on medical evidence or demonstration by the individual, it is
determined that the individual is able to return to regular or substantial
gainful work. Also see Regular Work and Substantial Gainful Work.

5. 	 Permanent Medical Condition - A permanent medical condition is a
medically determinable mental or physical condition or impairment which has
lasted, or is expected to last, for a continuous period of at least 12 months,
or is expected to result in death.
6. 	 Permanently Disabled - To be permanently disabled, you must have a
permanent medical condition that prevents you from working. Also see
Permanent Medical Condition.

Several unrelated conditions that are not considered severely disabling in
themselves can be combined and considered together to see if in this way
they prevent work.

Part VI

- Glossarv

You are considered unable to work if your condition prevents you from
performing basic work activities. These activities are those physical andlor
mental abilities and aptitudes required to do most jobs, such as:
walking, standing, sitting, lifting, pulling, pushing, reaching, carrying, or
handling;
seeing, hearing and speaking;
understanding, carrying out, and remembering simple instructions;
using judgment;
responding appropriately to supervision, co-workers, and usual work
situations;
dealing with changes in the work setting.
You will not be considered permanently disabled if you fail to follow
treatment prescribed by your doctor that may restore your ability to work.
However, you will not be penalized if the reason you did not follow
prescribed treatment is acceptable to the RRB.

7 . 	 Regular Work - Regular work is the performance of the full range of material
and substantial duties of any regular and gainful employment with any
employer. Substantial duties are those which involve significant mental or
physical activity even if they are only done part time. Gainful employment is
work that is done for pay or profit, or is the kind that is usually done for pay
or profit even if no profit is realized. Also see Substantial Gainful Work.
8. 	 Substantial Gainful Work - This is any work generally done for pay or profit
that involves performing significant physical or mental duties. Work may be
considered substantial even if it is done part time. In evaluating work,
consideration is given to job duties, skill, and experience required to do the
job in addition to pay. Although current work may pay less or may be
different from previous work, a person may not necessarily be considered
disabled. Also see Regular Work.

Part VI

- Glossary

9. 	 Trial Work Period - If you work after your disability benefits begin, you may
receive a trial work period during which you may test without penalty your
ability to work. A trial work period may last nine months (not necessarily
consecutive). In some cases, the trial period can be extended. After the trial
work period we will decide whether you are still disabled.

You cannot qualify for a trial work period if you have medically recovered.
Also see Medical Recovery.
All of the rules for determining if you qualify for a trial work period are not
covered in this booklet due to their complexity. If you have any questions
about them, contact the nearest field office of the RRB.

NONDISCRIMINATION ON THE BASIS OF DISABILITY

Under Section 504 of the Rehabilitation Act of 1973 and Railroad Retirement
Board (RRB) regulations, no qualified person may be discriminated against on
the basis of disability. RRB programs and activities must be accessible to all
qualified applicants and beneficiaries, including those who are vision or hearingimpaired. Disabled persons needing assistance (including auxiliary aids or
program information in accessible formats) should contact the nearest RRB
office. Complaints of alleged discrimination by the RRB on the basis of disability
must be filed within 90 days in writing with the Director of Administration, Railroad
Retirement Board, 844 North Rush Street, Chicago, Illinois 60611-2092.
Questions about individual rights under this regulation may be directed to the
RRB's Director of Equal Opportunity at the same address shown above.

FRAUD AND ABUSE HOT LINE

Call the toll-free Fraud and Abuse Hot Line if you have reason to believe that
someone is receiving railroad retirement or unemployment-sickness benefits to
which (s)he is not entitled; that persons responsible for the financial affairs of
minors or incompetent beneficiaries are misappropriating benefits; or that a
doctor, hospital, or other provider of health care services is performing unnecessary or inappropriate services or is billing Medicare for services not received.
You may also use the Hot Line to report any suspected misconduct by a Railroad
Retirement Board (RRB) employee. The Hot Line has been installed by the
RRB's lnspector General to receive any evidence of fraud or abuse of the RRB's
benefit programs.
Call (toll-free) 1-800-772-4258. Or you may send your complaints in writing to the
RRB, OIG, Hot Line Officer, 844 North Rush Street, Chicago, Illinois 6061 1-2092.
Please do not call the lnspector General's Hot Line with questions about eligibility
requirements, delayed claims, or similar problems. Such matters should be
directed to the nearest RRB field office.


File Typeapplication/pdf
File TitleRRB Form RB-19a
SubjectU.S. Railroad Retirement Board Information Collection Exhibit
AuthorCharles Mierzwa
File Modified2007-04-27
File Created2007-04-27

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