Medical Reports
OMB 3220-0038
OMB 3220-0038
The Railroad Retirement Act provides disability annuities for qualified railroad employees whose physical or mental condition renders them incapable of working in their regular occupation (occupational disability) or any occupation (total disability). The medical reports obtain information needed for determining the nature and severity of the impairment.
The latest form for Medical Reports expires 2023-12-31 and can be found here.
Latest Forms, Documents, and Supporting Material
Document Name |
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Form and Instruction |
Form and Instruction |
Form and Instruction |
Supporting Statement A |
Supplementary Document |
Supplementary Document |
Form G-3EMP Medical Reports
3220-0038 .docx
SSA-4734-F4-SUP (08-85).pdf
Medical Reports All Historical Document Collections
OMB Details
Medical Reports
Federal Enterprise Architecture: Income Security - General Retirement and Disability
| Form RL-11B (Proposed) | Disclosure of Hospital Medical Records | Paper Only | Form and instruction |
| Form G-3EMP (Proposed) | Report of Medical Condition by Employer | Paper Only | Form and instruction |
| Form G-250A (Proposed) | Medical Assessment of Residual Functional Capacity | Paper Only | Form and instruction |
| Form G-260 (Proposed) | Report of Seizure Deisorder | Paper Only | Form and instruction |
| Form RL-250 | Request for Medical Assessment | Paper Only | Form and instruction |
| Form RL-11B | Disclosure of Hospital Medical Records | Paper Only | Form and instruction |
| Form G-260 | Report of Seizure Disorder | Paper Only | Form and instruction |
| Form G-250A | Medical Assessment of Residual Functional Capacity | Paper Only | Form and instruction |
| Form G-3EMP | Report of Medical Condition by Employer | Paper Only | Form and instruction |
| Form G-250 | Medical Assessment | Paper Only | Form and instruction |
| Form G-250 (Proposed) | Medical Assessment | Paper Only | Form and instruction |
| Form RL-250 (Proposed) | Request for Medical Assessment | Paper Only | Form and instruction |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.
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