OMB control number
Medical Reports
OMB 3220-0038 · RRB.
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 2027-01-31 and can be found here.
Latest Forms, Documents, and Supporting Material
Document Name |
|---|
Form and Instruction |
Form and Instruction |
Form and Instruction |
 3220-0038 .docx (document unavailable)Supporting Statement A |
Supplementary Document |
 SSA-827 (11-12).pdf (document unavailable) Supplementary Document |
Medical Reports All Historical Document Collections
OMB Details
Medical Reports
Federal Enterprise Architecture: Income Security - General Retirement and Disability
| Form G-250 | Medical Assessment | 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 |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.