To receive sickness benefits, you must complete an application and claim form(s). You may also be asked to complete other forms. Some of these forms are listed below along with estimates of how long we think it takes to complete them. The estimates include time for reviewing the instructions, getting the needed data, and reviewing the completed form. 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 estimates or any other aspect of the forms, including suggestions for reducing completion time, to the Chief of Information Resources Management, Railroad Retirement Board, 844 N. Rush Street, Chicago Illinois 60611-1275. Be sure to include the form title and control number (in parentheses) with your comments.
| Form No. |
Title |
Estimated Completion Time (Min) |
| SI-1a |
Application for Sickness Benefits (3220-0039) |
10 |
| SI-1b |
Statement of Sickness (3220-0039) |
8 |
| SI-3 |
Claim for Sickness Benefits (3220-0039) |
5 |
| SI-3 |
Internet Claim for Sickness Benefits (3220-0039) |
5 |
| SI-10 |
Statement of Authority to Act for Employee (3220-0034) |
6 |
| ID-7h |
Notice of Non-Entitlement to Sickness Benefits and Information on Unemployment Benefits (3220-0039) |
5 |