Sf 3112-2

SF3112-2.pdf

SF 3112, CSRS/FERS Documentation in Support of Disability Retirement Application

SF 3112-2

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Table of Contents
Page

When to Consider Applying for Disability Retirement . . . . . . . . . 1
Applying for Disability Retirement . . . . . . . . . . . . . . . . . 1
If You Have Been Separated from Federal Service for
More Than 31 Days . . . . . . . . . . . . . . . . . . . . . . 2
Eligibility Requirements for Disability Retirement . . . . . . . . . . . 2
Required Documentation . . . . . . . . . . . . . . . . . . . . . 4
How Disability Retirement Applications Are Processed . . . . . . . . . 5
Disability Annuity Computation . . . . . . . . . . . . . . . . . . 6
Duration of Disability Annuity Benefits . . . . . . . . . . . . . . . 8
Medical Recovery . . . . . . . . . . . . . . . . . . . . . . 8
Restoration of Earning Capacity. . . . . . . . . . . . . . . . . 9
Reemployment in the Federal Service After You Retire . . . . . . . 9
Receipt of Benefits from OWCP, U.S. Department of Labor. . . . . . . 10

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When to Consider Applying for Disability Retirement
You should consider applying for disability retirement only after you have
provided your employing agency with complete documentation of your medical
condition and your agency has exhausted all reasonable attempts to retain you in
a productive capacity, through accommodation, reassignment, etc. (“Accommodation” means an adjustment made to a job and/or work environment that enables
a qualified disabled person to perform the duties of that position.)

Applying for Disability Retirement
If you are applying for disability retirement, you must complete SF 3107, Application for Immediate Retirement, and SF 3112, Documentation In Support of
Disability Retirement. Your employing agency will help you complete these
forms and will forward the completed forms to the Office of Personnel Management (OPM). However, it is your responsibility to obtain all of the information
necessary for OPM to make a decision on your claim. This includes providing all
of the required forms and documentation.
If you are under age 62, Federal retirement law requires your disability benefits
under the Federal Employees Retirement System (FERS) to be reduced by 100
percent of your social security benefit for any month in which you are entitled to
social security disability benefits during the first 12 months of eligibility. After
the first year, your disability annuity is equal to 40 percent of your high-3 average salary minus 60 percent of your social security benefit for any month in
which you are entitled to social security disability benefits. Therefore, it is also
your responsibility to document that you have applied for social security disability benefits AFTER YOU SEPARATE FROM YOUR AGENCY. Your application
cannot be completely processed without this information. If you are awarded
social security disability benefits at any time after you have applied for or begin
receiving disability benefits, you must still notify OPM of the effective date and
the amount of the social security benefits.
Important: FERS disability benefits usually begin before the claim for social
security benefits is fully processed. Because the FERS disability benefit must be
reduced by 100 percent of any social security benefit payable for 12 months,
social security checks should not be negotiated until the FERS benefit has been
reduced. The social security checks will be needed to pay OPM for the reduction
which should have been made in the FERS annuity.
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If You Have Been Separated from Federal Service for More
Than 31 Days
Your application for disability retirement must be received by either the Office of
Personnel Management (OPM) or your former employing agency within one year
after the date of your separation. If you have been separated from Federal service
for more than 31 days, you should submit your application directly to OPM. The
address is
U.S. Office of Personnel Management
Federal Employees Retirement System
Retirement Operations Center
Boyers, PA 16017-0001.

Ask your former supervisor and employing agency to complete SF 3ll2B,
SF 31l2D, and SF 3112E and give them to you so that you can send them directly
to OPM. If you think you will not have the completed package in time to meet
the one-year deadline, send OPM the completed SF 3107 and SF 3ll2A, along
with the name, address and telephone number of the person(s) you have asked to
complete the remaining forms. Do not delay submitting your application.
The one-year time limit for applying for disability retirement is established
by law. Waiver of that time limit is permitted only if you were mentally
incompetent to file within the established time frame. Failure to follow
instructions or unfamiliarity with applicable law’ and regulation is not a basis
for waiving the time limit.

Eligibility Requirements for Disability Retirement
You must meet all of the following conditions to be eligible for disability
retirement:
1. You must have completed at least 18 months of Federal civilian service
which is creditable under the Federal Employees Retirement System (FERS);
2. You must, while employed in a position subject to the retirement system,
have become disabled, because of disease or injury, for useful and efficient
service in your current position. (Useful and efficient service means fully

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successful performance of the critical or essential elements of the position
or the ability to perform at that level — and satisfactory conduct and attendance.)
3. The disability must be expected to last at least one year.
4. Your agency must certify that it is unable to accommodate your disabling
medical condition in your present position and that it has considered you for
any vacant position in the same agency at the same grade or pay level, within
the same commuting area, for which you are qualified for reassignment.
(An employee of the Postal Service is considered not qualified for reassignment if the reassignment is to a position in a different craft or is inconsistent
with the terms of a collective bargaining agreement covering the employee.)
5. You, or your guardian or other interested person, must apply before your
separation from service or within one year thereafter. The application must
be received by either the Office of Personnel Management (OPM) or your
former employing agency within one year of the date of your separation:
This time limit can be waived only if you were mentally incompetent on
the date of separation or within one year of this date.
6. You must apply for social security disability benefits. Application for
disability retirement under the Federal Employees Retirement System
(FERS) requires an application for social security disability benefits. If the
application for social security disability benefits is withdrawn for any reason,
OPM will dismiss the FERS disability retirement application upon notification by the Social Security Administration.
If you are a Military Reserve Technician being separated from your position
because of a disability that disqualifies you from membership in the Military
Reserve or from holding the military grade required for your employment,
special provisions may apply to you. Contact your employing agency for the
necessary information.

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Required Documentation
To decide if your disability claim is allowable, OPM considers the documentary
evidence you, your agency, and your physician provide. Your claim can be
allowed only if the evidence establishes that you meet all of the following criteria:
1. A deficiency in service with respect to performance, conduct or attendance,
or, in the absence of any actual service deficiency, a showing that your
medical condition is incompatible with other useful service or retention in
the position.
2. A medical condition, which is defined as a health impairment resulting from
a disease or injury, including a psychiatric disease.
3. A relationship between the service deficiency and the medical condition such
that the medical condition has caused the service deficiency.
4. The disability must be expected to last at least one year.
5. You became disabled while serving under the Federal Employees Retirement
System (FERS).
6. The inability of your employing agency to make reasonable accommodation
to your medical condition.
7. The absence of another available position, within the employing agency and
commuting area, at the same grade or pay level and tenure, for which you are
qualified for reassignment.
The Office of Personnel Management (OPM) will not pay for any medical
examination or procedure needed to provide the necessary documentation.

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How Disability Retirement Applications Are Processed
If you are still employed, your employing agency will assemble the form
Documentation in Support of Disability Retirement (SF 3112), including
Schedules A, B, C, D and E, together with your Application for Immediate
Retirement (SF 3107) and associated forms, your preliminary Individual
Retirement Record (SF 3100), and all available disability documentation and
send them to OPM. The disability documentation will include that which you
obtain for the purpose of applying for disability retirement and all documentation
on file with your agency concerning your medical condition and its relationship
to service deficiencies, attempts or requests to reassign or accommodate because
of your medical condition, etc. The time required for assembly and submission
of the application and documentation varies from agency to agency. If you are
separated from the Federal service, you (or your guardian or other interested
party) are responsible for seeing that your application is filed within the time
limit see If You Have Been Separated from Federal Service for More than 31
Days — on page 2.
Shortly after receiving your application, the Office of Personnel Management
(OPM) will send you an acknowledgment letter with information and a claim
number (beginning with the letters “CSA”). Receipt of an acknowledgment and a
CSA claim number means that your application has been received and will be
reviewed to determine your eligibility for disability retirement. Any inquiries
before you receive this acknowledgment and claim number should be addressed
to your employing agency. Any inquiries to OPM should include your claim
number.
OPM will examine your application and supporting documentation to determine
whether a finding of disability is warranted. You or your employing agency may
be contacted if additional information is needed. Both you and your agency will
be notified of the allowance or disallowance of your application. If your claim is
disallowed, we will provide information about your right to request further consideration of your claim.
You or your agency should notify OPM of any change in your status, such as a
change in your current job or assignment. If, while OPM is processing your,
claim, you decide to withdraw your application, you must notify us in writing
of the withdrawal request. Such a request can be accepted if it is received by
OPM before your application is approved or before you have been separated
from your agency, whichever is later. Also, if you file a non-disability retirement
application with OPM at any time before separation from your agency, OPM will
consider this action to be a withdrawal of the disability application.
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If your application is approved, your employing agency will be requested to
separate you from its rolls and send OPM your final retirement records. The
actual date of separation is determined by your agency.
Interim payments can be authorized only after the disability application has been
allowed and your agency has notified OPM of the date your pay stopped and
OPM has a copy of your receipt for application for social security disability
benefits or social security’s decision letter. Interim payments are intended to
help you fmancially until OPM can compute the actual amount of your annuity.
OPM can complete processing of your case only after your final retirement
records and all other supporting documentation have been received from your
agency.

Disability Annuity Computation
Disability benefits under the Federal Employees Retirement System (FERS) are
computed in different ways depending on the retiree’s age and amount of service
at retirement. In addition, FERS disability retirement benefits are recomputed
after the first twelve months and again at age 62, if the annuitant is under age 62
at the time of disability retirement.
1. If at disability retirement you are already 62 years old, or you meet the age
and service requirements for immediate voluntary retirement, you will
receive your “earned” annuity based on the general FERS annuity computation:
1% of your “high-3” average salary
Multiplied by
your years and months of service

However, if you are at least 62 years old at retirement and have completed at
least 20 years of service, your annuity will be computed as follows:
1.1% of your “high-3” average salary
Multiplied by
your years and months of service

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2. If at disability retirement you are under age 62 and not eligible for voluntary
retirement, you will receive the following benefit:
a. For the first 12 months —
60% of your “high-3” average salary minus 100% of your social security
benefit for any month in which you are entitled to social security disability benefits.
b. After the first 12 months —
40% of your “high-3” average salary minus 60% of your social security
benefit for any month in which you are entitled to social security disability benefits.
However, you are entitled to your earned annuity (1% of your “high-3”
average salary multiplied by your years and months of service), if it is
larger than your disability annuity computed under steps 2a. or 2b.
above.
c. When you reach age 62 —
Your annuity will be recomputed using an amount that essentially
represents the annuity you would have received if you had continued
working until the day before your sixty-second birthday and then retired
under the Federal Employees Retirement System (FERS) non-disability
provisions. The total service used in the computation will be increased
by the amount of time you have received a disability annuity. The
average salary will be increased by all FERS cost-of-living increases
which occurred during the time you received a disability annuity (even
if the adjustment did not affect your annuity). The FERS basic annuity
formula (1% of your “high-3” average salary multiplied by your total
years and months of service) is then applied, using the adjusted time
base and average salary. If your actual service plus the credit for time as
a disability retiree equals 20 or more years, the formula would be 1.1%
of your “high-3” average salary multiplied by the total of your years and
months of service, using the adjusted time base and average salary.
Your “high-3” average salary is figured by averaging your highest basic pay over
any three years of consecutive service. These three years are usually your final
three years of service, but can be an earlier period. Your basic pay is the basic
salary you earn for your position. It includes increases to your salary for which

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retirement deductions are withheld, such as for shift rates, night shift differential,
locality pay, etc. It does not include payments for overtime, bonuses, etc.
(If your total service was less than three years, your average salary is figured
by averaging your basic pay during all of your periods of creditable Federal
service.)
Your basic annual annuity will be reduced to provide survivor annuity benefits if
you are married (unless you and your spouse jointly waive the survivor benefit)
or if you are required by a qualifying court order to provide benefits for a former
spouse.

Duration of Disability Annuity Benefits
Disability annuity benefits begin accruing on the first: day after your pay as an
employee stops and disability and service requirements have been met. They are
paid on the first business day of the month for the previous month. Annuity is
not payable for any period of time for which compensation (other than a
scheduled award) is paid by the Office of Workers’ Compensation Programs
(OWCP), U.S. Department of Labor. Applicants found eligible for continuing
benefits from OWCP and a disability retirement annuity from the Office of
Personnel Management (OPM) must elect payments from one or the other.
The law prohibits simultaneous receipt of continuing payments from the Office
of Workers’ Compensation Programs (OWCP) and a disability retirement
annuity from OPM.
Under current law and regulations, a disability annuity continues until you are
found recovered, restored to earning capacity, reemployed in the Federal service,
or die. Each of these situations is explained below.
Medical Recovery —
If you are a disability retiree under age 60, OPM may require periodic
reevaluations of your medical condition to determine if you have recovered
from your disability. (Any disability retiree under age 60 may have his or
her eligibility for continued annuity payments reviewed at any time it is
considered necessary by OPM.) You pay the cost of providing any medical
information OPM needs to review your medical condition. If OPM finds you
recovered, your disability annuity payments will stop one year from the date
of the medical examination showing your recovery or on the date you are
reemployed in the Federal service, whichever occurs first. After you turn
age 60, OPM will review your medical condition only at your request.

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Restoration of Earning Capacity —
If you are a disability retiree under age 60, there is a limit on the amount you
can earn from wages and self-employment and still be entitled to your annuity. Each year, OPM will send you a questionnaire in order to determine your
earnings for the previous calendar year. If your earnings in any calendar year
equal or exceed 80 percent of the current salary rate of the position from
which you retired, your earning capacity will be considered restored. Even if
there is no change in your medical condition, your disability annuity payments will stop six months from the end of the calendar year in which your
earning capacity is restored or on the date you are reemployed in the Federal
service, whichever occurs first. After you turn age 60, there is no restriction
on the amount of wages or earnings from self-employment you may receive.
If you have been found restored to earning capacity, your earnings for any
calendar year fall below 80 percent of the current salary rate of the position
from which you retired, and you are under age 62, you may request OPM to
reinstate your disability retirement annuity. If you request reinstatement of
your annuity, you must provide documentation showing that your income is
below the 80 percent level and that the disease or condition on which your
disability retirement was approved still exists. If OPM reinstates your annuity, it will begin as of January 1 of the year following the year your earnings
were less than 80 percent of the current salary rate of the position from which
you retired.
Reemployment in the Federal Service After You Retire —
If you retire on disability, you may be reemployed in any position for which
you are qualified. The Office of Personnel Management (OPM) does not
need to make a recovery determination prior to your reemployment.
The law does not require that your former employing agency or any other
Federal agency automatically offer you a position if OPM finds that you
are medically recovered or restored to earning capacity. However, if either
of these occurs, you may be eligible for selection priority for competitive
service jobs in Federal agencies under OPM’s Interagency Career Transition
Assistance Plan (ICTAP). The notice to inform you that you are no longer
eligible for a disabi1ity annuity will give you information about ICTAP.

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Receipt of Benefits from OWCP, U.S. Department of Labor
The approval of a claim for benefits by the Office of Workers’ Compensation
Programs (OWCP), U.S. Department of Labor for a work-related injury or
illness, does not automatically entitle an employee to a Federal Employees
Retirement System (FERS) disability retirement. A claim for FERS disability
retirement must also be filed with the Office of Personnel Management. If you
are approved for disability retirement and elect to provide survivor benefit
protection, you will protect the rights of your eligible survivors to receive
annuity benefits after your death. In addition, this will protect your own
annuity rights in the event you lose entitlement to benefits from OWCP. Your
application for disability retirement must be received by the Office of Personnel
Management (OPM) within one year from the date of your separation by your
agency.
In general, you may not receive annuity payments from OPM and payments
from the Office of Workers’ Compensation Programs (OWCP) for the same
period of time. (See information below on when you may receive both payments.) This is because the law prohibits the dual compensation that would
exist if you receive both a Federal Employees Retirement System (FERS)
annuity and OWCP payments for total or partial disability under the Federal
Employees’ Compensation Act. However, if you are eligible for a FERS
annuity and OWCP payments for total or partial disability, you may elect
which of the two benefits you want to receive. Any overpayment of OWCP
benefits or annuity you receive is subject to collection by the Office of
Personnel Management or the Office of Workers’ Compensation Programs.
If you do not apply for retirement or your annuity payments are suspended while
you are in receipt of OWCP payments, you may be eligible to receive a refund
of your retirement contributions if any remain to your credit in the Retirement
Fund. However, if you receive a refund, your right to an annuity and the rights
of your survivors to FERS benefits are forfeited. If you receive the refund, you
would not be eligible to receive FERS annuity benefits if your OWCP benefit
is terminated or reduced. In addition, if your OWCP benefit is terminated, your
Federal Employees’ Group Life Insurance and health insurance coverage, if any,
would also end. You would not have the right to convert your Federal
Employees’ Group Life Insurance coverage to an individual policy.

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You may receive concurrent payment of FERS annuity and OWCP benefits for
the same period of time only if:
1. You are receiving a scheduled award from OWCP. A scheduled award is
usually paid when there is a disability resulting from the loss, or loss of use,
of a function or member of the body (such as a hearing loss or the loss of an
arm).
2. You are receiving OWCP benefits due to the death of another person and you
are eligible for annuity on the basis of your own Federal service, or
3. Your OWCP payments are suspended because you are receiving a financial
settlement from the party directly responsible for the injury (a third party
settlement). In this instance, your annuity may be paid during the period that
your OWCP benefits are suspended.
If, after you retire, you are receiving Federal Employees Retirement System
(FERS) annuity payments and a scheduled award, you must immediately notify
the Office of Personnel Management (OPM) if your scheduled award is changed
to a non-scheduled Office of Workers’ Compensation Programs (OWCP) benefit.
Otherwise, you will incur an indebtedness to the U.S. Government which will be
subject to collection from your benefits.

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United States
Office
of
Personnel Management
1900 E Street, NW
Washington, DC 20415
www.opm.gov/Forms

SF 3112-2
Previous edition is usable


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File TitleH:\CorelVentura\sf3112-2.vp
Authorcsbenson
File Modified2007-03-05
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