RI 20-123, Request for Case Review for Enhanced Disability Annuity Benefit

OMB 3206-0254

Form RI 20-123, Request for Case Review for Enhanced Disability Annuity Benefit is used by retirees separated for disability and the survivors of retirees separated for disability to request that Retirement Operations review the computations of disability annuities to include the formulae provided in law for individuals who performed service as law enforcement officers, firefighters, nuclear materials carriers, air traffic controllers, Congressional employees, and Capitol and Supreme Court police. There were editorial changes to the Public Burden Statement. A Privacy Act Statement has been added due to a systematic review.

The latest form for RI 20-123, Request for Case Review for Enhanced Disability Annuity Benefit expires 2022-12-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form RI 20-123 RI 20-123, Request for Case Review for Enhanced Disability Annuity Benefit Form and Instruction
RI 20-123_ Supporting Statement 2022_Final.docx Supporting Statement A
E8-5659.pdf Supplementary Document
RI 20-123_30DAYFRN_Published_2022_08_24.pdf Supplementary Document
RI20-123_60DAYFRN_Published_2022_03_18.pdf Supplementary Document
RI 20-123, Request for Case Review for Enhanced Disability Annuity Benefit Form and Instruction

All Historical Document Collections

202211-3206-004 Approved with change	Extension without change of a currently approved collection	2022-11-18
201910-3206-001 Approved with change	Revision of a currently approved collection	2019-10-21
201703-3206-004 Approved without change	Extension without change of a currently approved collection	2017-03-30
201401-3206-004 Approved without change	Extension without change of a currently approved collection	2014-02-18
201010-3206-005 Approved without change	New collection (Request for a new OMB Control Number)	2010-11-02