RB-21, Lump-Sum Death Payment, Residual Lump-Sum, Annuities Unpaid at Death

Form RB-21 (10-18).pdf

Application for Survivor Death Benefits

RB-21, Lump-Sum Death Payment, Residual Lump-Sum, Annuities Unpaid at Death

OMB: 3220-0031

Document [pdf]
Download: pdf | pdf
CURRENT
For Use With Form AA-21

LUMP-SUM DEATH PAYMENT,
RESIDUAL LUMP-SUM, AND
ANNUITIES UNPAID AT DEATH

Railroad Retirement Board
Visit our Web site at http://www.rrb.gov

FORM RB-21 (10-18)

Paperwork Reduction Act and Privacy Act Notices
This notice is given under the Paperwork Reduction Act of 1995 and the Privacy Act of 1974. The
Privacy Act requires that the Railroad Retirement Board (RRB) tell you the following whenever we ask
you for information.
1)
2)
3)
4)

The law which allows us to ask for the information;
whether that law requires you to give us that information and what, if anything, might happen to
you if you do not give it to us;
the reason why the information is requested; and
the persons, organizations, and agencies to which we may release the information without your
permission.

The RRB’s authority for requesting this information is Section 7(b) of the Railroad Retirement Act of 1974.
Providing us with this information is voluntary on your part. However, if you fail to provide us with the
requested information, we may be unable to pay you the lump-sum death benefit and any other related
benefit. The RRB needs this information in determining whether you are eligible to receive such benefits
and, if so, the amount you are entitled to receive.
Although the information we request is almost never used for any purpose other than the payment of
benefits under the Railroad Retirement Act, the RRB does have the authority to release information to
the indicated individuals, organizations, and/or agencies without your approval.
1)
2)
3)
4)
5)
6)
7)
8)

An attorney, the Office of the President, a Congressional office, a labor union or to the Department
of State’s embassy or consular offices if they allege to be representing you at your request.
Other people who are receiving benefits based on the same railroad retirement account as you are if
the information affects their payments from the RRB.
People or organizations who are working for the RRB.
The U.S. Treasury Department or U.S. Postal Service to issue checks and to investigate lost, forged
or stolen checks.
The Internal Revenue Service or to state and local taxing authorities for figuring your taxes and for
use in audits.
The Government Accountability Office for audits and for collecting overpayments owed to the
RRB or Social Security Administration.
In certain cases for law enforcement purposes and for court proceedings.
Information about the determination and recovery of an overpayment made to you may be released
to any other person from whom any portion of the overpayment is being recovered.

We estimate the application process takes an average 20 to 40 minutes per response to complete, including
the time for reviewing the instructions, getting the needed data, and reviewing the completed application.
Federal agencies may not conduct or sponsor, and respondents are not required to respond to, a collection
of information unless it displays a valid OMB number. If you wish, send comments regarding the accuracy
of our estimate or any other aspect of this process, including suggestions for reducing completion time, to
the Associate Chief Information Officer for Policy and Compliance, Railroad Retirement Board, 844 North
Rush Street, Chicago, Illinois 60611-1275.
Computer Matching and Privacy Protection Act Notice
The Computer Matching and Privacy Protection Act of 1988 requires the Railroad Retirement Board
(RRB) to advise you that information you have provided may be used, without your consent, in automated
matching programs. These matching programs are a computer comparison of RRB records with records
kept by other Federal, state, or local governmental agencies. Information from these matching programs can
be used to establish or verify a person’s eligibility for Federally funded or administered benefit programs
and for repayment of payments or delinquent debts under these programs.

INTRODUCTION
From the information which you have provided to us and the information in our
records, it appears that you may be entitled to the following benefit(s) (only the
checked item(s) apply) :
			Lump-Sum
Death Payment
o
			
			Residual
Lump-Sum
o
			 o

Annuities Unpaid At Death

			Railroad
Tax Refund
o
The sections in the booklet explain:
	

l

The different types of benefits.

	

l

The requirements that must be met before each payment can be made.

This booklet also contains information about:
	

l

Applying for benefits.

	

l

What you can expect after you file your application.

In this booklet the word “employee” is used to describe the person who worked for the
railroad. The word “applicant” is used to describe the person who is filing a claim to
receive a payment based on the employee’s work and earnings.
Every application for benefits must also include documentary evidence or proof to support the claim. Part V of this booklet describes the acceptable types of evidence.

CONTENTS
	
	Death Payment	
		
Part l - Lump-Sum
Section 1. Requirements the Employee Must Have Met					
Section 2. What Happens if the Employee Does Not Meet the Requirements	
Section 3. Definition of a Lump-Sum Death Payment	
Section 4. Credit for Employee’s Military Service						
Section 5. People Eligible to Receive a 1937 Act Lump-Sum Death Payment	
Section 6. When the 1937 Act Lump-Sum Death Payment Can Be Paid Directly
to the Funeral Home							
Section 7. People Eligible to Receive a 1981 Amendment Lump-Sum Death Payment	
Section 8. When a Lump-Sum Death Payment is Not Payable				
Part ll - Residual
Lump-Sum
	
Section 9. Definition of a Residual Lump-Sum						
Section 10. People Eligible to Receive the Residual Lump-Sum 				
Section 11. Person Eligible for Monthly Benefits May Receive a Residual
Lump-Sum Instead of Monthly Benefits					

Page
1
1
1
2
2
	2
3
3
3
4
4

Part lll - Annuities
Unpaid At Death
	
Section 12. Definition of an Annuity Unpaid at Death					
Section 13. People Eligible to Receive a Retirement Annuity Unpaid at Death		
Section 14. People Eligible to Receive a Survivor Annuity Unpaid at Death			

4
5
5

Part lV - Railroad
Tax Refund
	
Section 15. Definition of a Railroad Tax Refund						
Section 16. Excess Tax Refund								
Section 17. Separation Allowance Tax Refund						
Section 18. People Eligible to Receive a Railroad Tax Refund				

6
6
6
6

Part V - Furnishing
Proof To Support Your Application
	
Section 19. General Information								
Section 20. Proof of Death									
Section 21. Proof of Marriage								
Section 22. Proof of Payment of Burial Expenses						
Section 23. Proof of Military Service							
Section 24. Proof of Appointment as Legal Representative					
Section 25. Proof of Relationship								

7
7
7
8
8
8
9

Part VI - After
	 You Apply For Your
Section 26. Notice of Railroad Retirement Board’s Decision About Your Application	
Section 27. How Payments Are Made							

9
9

Part VlI - Additional
Forms You May Need
	
Section 28. Form G-273a, Funeral Director’s Statement of Burial Charges			
Section 29. Form G-126, Election to Receive a Residual Payment Instead	
of Future Monthly Insurance Benefits Based on Service Under
the Railroad Retirement Act							
Section 30. Form G-131, Authorization of Payment and Release of all Claims
to a Death Benefit or Accrued Annuity Payment					

10
10
10

Part l
Lump-Sum Death Payment
If the introduction to this booklet indicated that
you may be entitled to a lump-sum death payment,
please read this part of the booklet thoroughly.
It will provide information which will help you
understand what a lump-sum death payment is and
when one can be paid.

Section 1 – Requirements the Employee Must
Have Met
The Railroad Retirement Board (RRB) can pay a
lump-sum death payment only if the employee:
l

l

was employed in the railroad industry for at least
120 months or at least 60 months after 1995; and
had a current connection with the railroad industry;
that is, there was no regular employment outside
of the railroad industry between the time when the
employee left the railroad industry and the time of
retirement (or death if the employee never retired).
l

If the employee was alive on October 1, 1981,
we will consider that there is a current
connection with the railroad industry, if
the employee:
l

l

l

a lump-sum death payment. However, the Social
Security Administration (SSA) may be able to pay
you if you are the widow(er) who was living in the
same household as the employee. This application
will be transferred to that agency.
A lump-sum death payment can be paid by either
the RRB or SSA but not by both, even though the
employee may have received payment from both
agencies.

Section 3 – Definition of a Lump-Sum Death
Payment
A lump-sum death payment is meant to help defray
the costs of the employee’s burial expenses. It can
only be paid to a widow(er) who was living with
the employee when he or she died or to the person who paid all or part of the employee’s burial
expenses. The lump-sum death payment cannot
be paid if anyone is eligible for monthly survivor
benefits in the month of the employee’s death.
A lump-sum death payment is not taxable for
Federal income tax purposes.
There are two different types of lump-sum death
payments.
l

stopped working in the railroad industry involuntarily and without cause
on or after October 1, 1975; and
had at least 25 years of service; and
did not decline an offer to return to
work in the same class or craft as his or
her last railroad service.

Section 2 – What Happens if the Employee
Does Not Meet the Requirements

l

A 1937 Act lump-sum death payment is payable if the employee was employed for at
least 120 months in the railroad industry prior
to January 1, 1975. This benefit is based on
the employee’s earnings, and ranges between
$180.00 and $1400.00. Refer to Section 5 for
additional information.
A 1981 Amendment lump-sum death payment is payable if the employee did not have
120 months of service in the railroad industry
before January 1, 1975. This benefit is limited
to $255.00. Refer to Section 7 for additional
information.

If the employee does not meet the requirements
described in Section 1, the RRB cannot pay you

1

Section 4 – Credit for Employee’s Military
Service
If the employee was never in the military service,
go on to the next section.
If the employee served in active duty in the
United States Armed Forces, the RRB may
be able to use that military service to increase
the amount of the lump-sum death payment
or residual lump-sum payment. Proof of military service must be submitted if it has not
already been submitted by the employee. Refer
to Section 23 for information on acceptable
proof of military service.

Section 5 – People Eligible to Receive a 1937
Act Lump-Sum Death Payment
If the employee was survived by a widow(er) who
was living with the employee, the entire lump-sum
death payment is paid to the widow(er).

l

an individual;

l

a partnership;

l

a trust;

l

a corporation;

l

a government unit; and

l

the estate of the employee.

If more than one person pays the burial expenses, the lump-sum death payment will be paid
first to the person who paid the funeral home
expenses. If any of the lump-sum death payment
remains, the remaining portion will be paid in
the following priority:
l

l

If no widow(er) qualifies and all of the
employee’s funeral expenses have not been
paid, the lump-sum death payment is paid to
the funeral home. If the unpaid funeral home
expenses are greater than the lump-sum death
payment, the entire lump-sum death payment
is paid to the funeral home.
If the unpaid funeral expenses are less than
the lump-sum death payment, only the
amount of the lump-sum death payment equal
to the unpaid expenses will be paid to the
funeral home.
If there are no unpaid funeral home expenses,
or if the unpaid expenses were less than the
total lump-sum death payment, the remaining
amount of the lump-sum death payment can be
paid to the person(s) whose money was used to
pay any portion of the burial expenses. A “person”
can include:

2

l

The person who paid the grave opening and
closing expenses.
The person who paid for the burial plot.
The person who paid any remaining burial
expenses.

If more than one person pays the same type of
expense, a share of the lump-sum death payment
will be paid to each person who paid the expenses. The shares will be proportional to the amount
of the expenses paid by each person. Under no
circumstances will any person receive a lumpsum death payment which is greater than the
amount which was paid by that person.

Section 6 – When the 1937 Act Lump-Sum
Death Payment Can Be Paid Directly to the
Funeral Home
There are two situations in which the lump-sum
death payment can be paid to the funeral home:
l

The person who assumes responsibility for the
unpaid funeral home expenses can apply for

the lump-sum death payment and instruct the
RRB to make payment to the funeral home.
l

A representative from the funeral home can
apply for the lump-sum death payment directly. However, the application filed by the
representative on behalf of a funeral home
must be filed at least 90 days after the day
the employee died and no one has assumed
responsibility for the expenses.

In either case, the funeral home must complete
Form G-273a, Funeral Director’s Statement Of
Burial Charges (see Section 28 for information
on Form G-273a).

Section 7 – People Eligible to Receive a 1981
Amendment Lump-Sum Death Payment
A “1981 Amendment” lump-sum death payment
is payable only to the widow(er) who was living in
the same household with the employee at the time
of the employee’s death.

Section 8 – When a Lump-Sum Death
Payment is Not Payable
The “1937 Act” or “1981 Amendment” lump-sum
death payment cannot be paid if there is any survivor of the employee who is eligible for a railroad
retirement annuity in the month the employee died.
In addition, a lump-sum death payment can
only be paid if an application is filed by the
second anniversary of the employee’s death. If
no application for the lump-sum death payment
or a monthly benefit is received by that date,
the lump-sum death payment cannot be paid.

Part ll
Residual Lump-Sum

please read this part of the booklet thoroughly. It
will provide information which you will need to
understand the residual lump-sum.

Section 9 – Definition of a Residual Lump-Sum
The residual lump-sum is the means by which railroad employees and their survivors are guaranteed to receive at least as much in benefits as the
employee paid in railroad retirement taxes for the
years 1937 through 1974. A residual lump-sum is
not taxable for Federal income tax purposes.
The amount of the residual lump-sum equals the
amount of the railroad retirement taxes paid by
the employee prior to 1975 plus an allowance for
interest.
The gross residual amount is reduced by:
l

l

the amount of all retirement benefits which
the employee received based on his or her railroad work; and
the total amount of any survivor benefits
based on the employee’s account which were
paid by either the RRB or the Social Security
Administration.

In most cases, there is no residual lump-sum payable because the total amount of benefits paid is
more than the gross residual amount.
In addition, even if a residual lump-sum exists, it
cannot be paid if any railroad retirement or social
security benefits are currently being paid based on
the employee’s account, or if benefits can be paid
in the future. There is one exception. A widow(er)
or parent who is not currently entitled can elect to
receive the residual lump-sum instead of future
payments. See Section 11 for more details.

If the introduction to this booklet indicated that
you may be entitled to a residual lump-sum,

3

Section 10 – People Eligible to Receive the
Residual Lump-Sum
A residual lump-sum is paid according to the
following priorities:
1

A beneficiary designated by the employee on
a form or statement on file with the RRB. If
there is no designated beneficiary, the residual
lump-sum can be paid to:

2

the employee’s widow(er) if the employee
and widow(er) were living together when the
employee died. If there is no widow(er) who
meets this qualification, the residual lumpsum can be paid to:

3

the children of the employee. If no children
survive the employee, the residual lump-sum
can be paid to:

4

the parents of the employee. If no parents survive the employee, the residual lump-sum can
be paid to:

5

6

the brothers and sisters of the employee.
Finally, if there are no brothers and sisters who
survive the employee, the residual lump-sum
can be paid to:
the employee’s estate.

If there is more than one person in the category of
people to whom the residual lump-sum is being
paid, the residual lump-sum will be split equally
among all qualified people in that category.

Section 11 – Person Eligible for Monthly
Benefits May Receive a Residual Lump-Sum
Instead of Monthly Benefits
If there are no survivor benefits currently being
paid by either the RRB or the Social Security
Administration and the only benefits which will

4

become payable in the future are benefits for a
widow(er) or parent, the widow(er) or parent, if
under age 60, can waive the right to ever receive
monthly benefits based on the employee’s railroad work in order to allow the residual lumpsum to be paid. Any eligible widow(er) or parent
must complete a Form G-126, Election to Receive
a Residual Payment Instead of Future Monthly
Insurance Benefits Based on Service Under the
Railroad Retirement Act, to waive the benefits
before the benefits become payable. See Section
29 for more information on Form G-126.

Part lll
Annuities Unpaid At Death
If the introduction to this booklet indicated that
you may be entitled to an annuity unpaid at death,
please read this part of the booklet thoroughly. It
will provide information which you will need to
understand annuities unpaid at death.

Section 12 – Definition of an Annuity Unpaid
at Death
An annuity unpaid at death is any annuity payments which were due a railroad retirement annuitant and, for any reason, were not paid before the
annuitant died. This includes any check which
was returned to the RRB because the annuitant
died before cashing it. An annuity unpaid at death
is taxable for Federal income tax purposes. For
further information concerning the taxability of
an annuity unpaid at death, refer to the booklet TB-85, Information About the Taxation of
Railroad Annuities.
There are two types of unpaid annuities.
l

l

A retirement annuity unpaid at the death of the
retirement annuitant; and
a survivor annuity unpaid at the death of a
survivor annuitant.

The application for either type of unpaid annuity must be filed by the second anniversary of
the annuitant’s death to whom the annuity was
originally payable.

Section 13 – People Eligible to Receive a
Retirement Annuity Unpaid at Death
An unpaid retirement annuity is paid according to
the following priorities:
1

2

A widow(er) if he or she was living with the
annuitant at the time of death. If there is no
qualified widow(er), the unpaid annuities can
be paid to:
the person(s) who paid the employee’s burial
expenses. If more than one person paid the
burial expenses, each person will receive a
share of the unpaid annuities in proportion to
the burial expenses which each person paid.
However, no person will receive more than
the actual amount of burial expenses that the
person paid.
Annuities unpaid at the employee’s death
cannot be paid to a funeral home. Therefore,
unless there is a widow(er) entitled to receive
the unpaid annuities, all burial expenses must
be paid before the unpaid annuities can be paid.
If all the burial expenses have been paid, or if
the amount of the unpaid annuities is greater
than the amount of the unpaid burial expenses, the unpaid annuities (or whatever portion
remains) can be paid to:

3

the employee’s children. If no children survive the employee, the unpaid annuities can
be paid to:

4

the employee’s grandchildren. If no grandchildren survive the employee, the unpaid
annuities can be paid to:

5

the employee’s parents. If no parents survive
the employee, the unpaid annuities can be
paid to:

6

the brothers and sisters of the employee.

If there is more than one person in the category of
people to whom the unpaid annuities are paid, the
unpaid annuities will be split equally among all
the qualified people in that category.

Section 14 – People Eligible to Receive a
Survivor Annuity Unpaid at Death
An unpaid survivor annuity is paid only to the
relatives of the employee according to the following
priorities:
1

The widow(er) of the employee who was living
with the employee at the time of death. If there
is no qualified widow(er), the unpaid survivor
annuity can be paid to:

2

the employee’s children. A stepchild cannot
qualify for payment. If no children survive the
employee, the unpaid annuity can be paid to:

3

the employee’s grandchildren. If no grandchildren survive the employee, the unpaid
annuity can be paid to:

4

the employee’s parents. If no parents survive the employee, the unpaid annuity can
be paid to:

5

the brothers and sisters of the employee.

If there is more than one person in the category of
people to whom the unpaid survivor annuities are
being paid, the unpaid survivor annuities will be
split equally among all the qualified people in that
category.

5

Part lV
Railroad Tax Refund
If the introduction to this booklet indicated that
you may be entitled to a railroad tax refund,
please read this part of the booklet thoroughly.
It will help you understand what a railroad tax
refund is and when one can be paid.

Section 15 – Definition of a Railroad Tax
Refund
If the railroad taxes the RRB receives are greater than the amount which will affect the annuity amount, the employee can receive a refund
of the additional railroad taxes. Generally, the
additional railroad taxes will be paid when the
employee begins receiving a railroad retirement
benefit. If the employee dies before receiving a
refund, the additional railroad taxes are payable
to the employee’s survivors. An application for
a railroad tax refund must be filed by the second
anniversary of the employee’s death. The two
types of railroad tax refunds, excess and separation allowance, are described in the following
sections.

Section 16 – Excess Tax Refund
If the employee had railroad employment and
employment covered by the Social Security Act
in the same year, both railroad retirement and
social security taxes may have been deducted
from the employee’s earnings. Excess taxes that
were deducted from the employee’s earnings in
the years between 1950 and 1974 can be refunded
by the RRB. Excess taxes that were deducted for
years after 1974 must be refunded by the Internal
Revenue Service.

Section 17 – Separation Allowance Tax
Refund
If the employee received a separation allowance
or severance payment after 1984, it is possible the

6

payment will not produce additional service credits. If additional service is not credited, the Tier 2
payroll taxes that were withheld from the payment
may be refunded.

Section 18 – People Eligible to Receive a
Railroad Tax Refund
The railroad tax refund is paid to an employee’s
survivors according to the following priorities:
1

The widow(er) of the employee who was living
with the employee at the time of the employee’s death. If there is no qualified widow(er),
the unpaid railroad tax refund can be paid to:

2

the employee’s children. If no children survive the employee, the unpaid railroad tax
refund can be paid to:

3

the employee’s grandchildren. If no grandchildren survive the employee, the unpaid railroad tax refund can be paid to:

4

the employee’s parents. If no parents survive
the employee, the unpaid railroad tax refund
can be paid to:

5

the employee’s brothers and sisters. If no
brothers and sisters survive the employee, the
unpaid railroad tax refund can be paid to:

6

the employee’s estate.

If there is more than one person in the category
of people to whom the unpaid railroad tax refund
is being paid, the unpaid railroad tax refund will
be split equally among all the qualified people in
that category.

Part V
Furnishing Proof To Support Your
Application
Every application for railroad retirement benefits
must be accompanied by documentary evidence
that supports the claim for benefits. The sections
in this part discuss the types of acceptable evidence. If you are unable to secure the necessary
information, please contact the nearest field office
of the Railroad Retirement Board (RRB). The
people there will be glad to assist you.

Section 19 – General Information
Evidence submitted in support of an applicant’s
claim should be:
l

l

l

an original document; or

NOTE: This is not an acceptable proof of

death if the applicant is a funeral
director or a representative of a
funeral home.

l

l

If the death occurred outside the United States,
the proof of death can include:
l

a photocopy or transcript of either of the above.
l

Section 20 – Proof of Death
Proof of death is required with all claims for benefits.
If the death occurred inside the United States, the
best proof of death includes:
l

l

A certified copy of the death certificate. This
can be secured from the Bureau of Vital
Statistics or Department of Health for the city,
county, or state in which the death occurred.
A signed statement of death by the funeral director on RRB Form G-273a or SSA’s
Forms SSA-721 or SSA-2872.

The verdict of the coroner’s jury of the state
or community where death occurred.

A certified photocopy of any of the documents
described above is acceptable. If you are unable
to obtain any of these documents, contact the
nearest field office of the RRB. The people there
will be glad to assist you.

a copy of a public record certified by the
custodian of the record; or

Facsimiled copies or documents which have been
altered in any way do not qualify as original or
certified copies. Therefore, they cannot be used as
evidence.

A copy of the coroner’s report of death.

l

A report of death by a United States consul, or
other agent of the State Department, bearing
the signature and official seal. You can secure
this report from the United States consulate or
embassy.
A certified copy of the public record of death.
A signed statement of death by a funeral
director.

Section 21 – Proof of Marriage
The best proof of a ceremonial marriage is the
original marriage certificate. If you cannot locate
your original certificate, the following proofs are
acceptable:
l

A copy of a public record of the marriage
certified by the custodian of the record.
This record can be secured by contacting
the Clerk of the Court in the city or county
where the marriage license was obtained, or
the Bureau of Vital Statistics of the state in
which you were married.

7

l

A copy of a religious record of the marriage certified by the custodian of the record.
This record can be secured by contacting the
church where the marriage took place or the
clergy who performed the service.

Creditable military service can be counted as if it
were railroad service if the following conditions
are met:
l

NOTE: A marriage license is NOT an accept-

able proof of marriage. If no marriage
ceremony took place, contact your local
field office.

Section 22 – Proof of Payment of Burial
Expenses
To prove the payment of all or any part of the
burial expenses, you must either submit RRB
Form G-273a or an itemized, receipted statement
or bill from the funeral director and other persons furnishing goods and services. The receipt
must identify the deceased person, be signed by the
funeral director or other person to whom payment
was made, and give all of the following information:
l

l

Total amount of all burial expenses.
Name of each person who paid the burial
expenses.

l

Amount and date of each payment.

l

Amount of unpaid burial expenses.

If more than one funeral home is involved, proof
of payment of burial expenses must be furnished
by each one.

l

The employee performed creditable railroad
service in the same or preceding year in which
the military service began.
The military service was involuntary.

Voluntary service is only creditable when such
service was entered during a war period. Special
rules may apply if the military service was from
June 15, 1948, through December 15, 1950.
Contact your local field office if this situation
applies.
If the military service cannot be counted as railroad service, it still might be countable as wage
credits. The RRB will determine the most advantageous way to count it.

Section 24 – Proof of Appointment as Legal
Representative
Evidence of appointment as legal representative
is required of anyone filing an application for
benefits on behalf of the employee’s estate. A
legal representative can be the guardian, trustee,
committee or conservator of an individual, or the
administrator or executor of an estate.
Proof of Court Appointment includes:
l

a certified copy of letters of appointment; or

Form G-273a must be submitted.

l

a “short” certificate; or

Section 23 – Proof of Military Service

l

a certified copy of the order of appointment; or

Proof of military service may be a certificate
of discharge or any official military record that
shows the dates of service. If you cannot locate
the military service record, contact your local
field office for help.

l

NOTE: If there are unpaid burial expenses, RRB

8

any official document issued by the clerk or
other proper official of the appointing court.

The document submitted must bear the court seal
or the signature of the court clerk. If the court

Part VI
After You Apply For Your Benefits

papers of appointment were made more than one
year before the application is filed, the certification
must show that they are still in full force and effect.

Section 25 – Proof of Relationship
Proof of relationship must be given by each person applying for benefits as the child, parent,
brother, sister, or grandchild of the former railroad employee. The best proof of relationship
is a certified copy of the civil or religious birth
record of the person filing for benefits showing
the parents’ names.
When the relationship involves a legally adopted child or the parent of a legally adopted child,
the best proof is a certified copy of the decree or
order of adoption.
It may be necessary to submit more than one
document to prove the relationship to the
employee. The following situations are examples
of when this may occur.
l

l

l

l

A stepchild must show he or she is the child of
the person married to the employee.
A grandchild must show who his or her
parents are and prove that his or her parent is
related to the employee.
A brother or sister of the employee must furnish his or her birth record and the employee’s
showing that they both have the same parents.
A stepparent must show that the person he or
she is married to is the employee’s parent.

Section 26 – Notice of Railroad Retirement
Board’s Decision About Your Application
Using the information on your application and
proofs, the RRB will decide if you can be paid.
If you cannot be paid, the RRB will send you a
letter which explains:
l

l

why you cannot be paid; and
what you can do if you disagree with the reason
you cannot be paid.

If you can be paid, you will receive:
l

l

a letter which shows the amount of your
payment and other information about your
entitlement; and
a payment.

Sometimes the RRB will not be able to make a
decision on your application without some additional information. If so, you will be contacted by
a representative of the RRB. You will be asked to
send us the additional forms, proofs, or statements
that are needed.
Unless you receive a request for additional
information, the RRB will notify you of the
decision on your application in about 65 days.
If you do not hear from us by the end of the 65
days, please contact us so we can determine
what is causing the delay.

Section 27 – How Payments Are Made
In most cases, RRB payments are deposited
directly into the applicant’s checking or savings
account at their financial institution. Therefore,
when applying for a benefit, bring the following

9

information: your check book or a voided check;
your bank statement; or the name, location, and
telephone number of your financial institution.
This will allow the field office contact representative to properly route your payment.

Part VlI
Additional Forms You May Need
There are three forms which are sometimes needed
in addition to the application. If, after reading the
following sections, you think you need one of these
forms and you did not receive the form with this
booklet, please contact the nearest field office of
the RRB.

Section 28 – Form G-273a, Funeral
Director’s Statement of Burial Charges
If you are applying for the lump-sum death payment as the representative of a funeral home, or
if there are unpaid funeral home expenses and
you are applying to authorize the RRB to pay the
funeral home, you must submit a Form G-273a.
The Form G-273a must be completed and signed
by the funeral home director. If more than one
funeral home was involved in the employee’s
burial, and each funeral home is keeping a separate bill, a Form G-273a must be secured from
each funeral home.
The Form G-273a can be used in any lumpsum death payment or unpaid employee annuity
case instead of other proof of payment of burial
expenses. However, it is required when there are
unpaid funeral home expenses.

10

Section 29 – Form G-126, Election to Receive
a Residual Payment Instead of Future Monthly
Insurance Benefits Based on Service Under the
Railroad Retirement Act
If you are the employee’s widow(er) or parent and
you are not currently qualified to receive a monthly survivor annuity but will become qualified in
the future, and you are applying for the residual lump-sum, you must complete Form G-126.
By completing Form G-126, you are telling
the RRB that you will give up all rights to
future payment (that is, you will never receive
a monthly survivor annuity based on the
employee’s railroad work) in order to receive
the residual lump-sum now.

Section 30 – Form G-131, Authorization of
Payment and Release of all Claims to a Death
Benefit or Accrued Annuity Payment
If you are eligible to receive a lump-sum death benefit
or an annuity unpaid at death and your share does not
exceed $500, you may complete Form G-131 instead
of filing an application. Before filing this form, you
will be notified of the approximate amount of your
benefit.
By completing this form, you are authorizing your
share of the benefit to another eligible person and
waiving your benefit. You are not required to waive
your benefit or rights to which you may be entitled. If
you desire not to waive your benefit, you should file
an application with the Railroad Retirement Board.
Like an application, Form G-131 must be filed no
later than the second anniversary of the employee’s
or annuitant’s death.

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 hearing-impaired.
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 to the Director of Administration, Railroad Retirement
Board, 844 North Rush Street, Chicago, Illinois 60611-1275. Questions about
individual rights under this regulation may be directed to the RRB’s Director of
Equal Opportunity at the same address.

Fraud, Waste, and Abuse Hotline
The RRB’s Office of Inspector General established its Hotline as a public service. The Hotline
provides individuals with a means to report or discuss any suspected misconduct relating to the
RRB, its programs or employees.
If you believe a doctor, hospital, or other health care provider is billing Medicare for services not
provided or for unnecessary medical procedures or supplies; someone is illegally receiving RRB
benefits; or you wish to report or discuss any other suspected misconduct relating to the RRB, its
programs or employees, please contact the Office of Inspector General at:
Toll-Free Hotline: 1-800-772-4258
U.S. Mail: RRB-OIG Hotline Officer
844 North Rush Street
Chicago, Illinois 60611-1275
Fax: 1-312-751-4342
Email: [email protected]
Please review the RRB’s email notice and Internet privacy policy at www.rrb.gov
before submitting information online.
Note: Please do not contact the Office of Inspector General’s Hotline with questions
regarding benefit eligibility requirements, delayed payments or similar problems.
These types of matters should be directed to an RRB office.
Printed on recycled paper


File Typeapplication/pdf
File Modified0000-00-00
File Created0000-00-00

© 2024 OMB.report | Privacy Policy