Policy and Systems

Sick Pay and Supplemental Sickness Benefits

Sickness benefits are not payable for any day for which you receive sick pay from your employer. But benefits may be paid if you receive supplemental sickness benefits from your employer or an insurance company. Sick pay is a continuation of part or all of your wages while you are unable to work. Sick pay is generally subject to all regular payroll deductions. You must report sick pay on your claim form; failure to do so may result in an overpayment of RRB sickness benefits that you will have to refund.

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Medical Statements

To receive sickness benefits, you must have your doctor complete Form SI-1b, Statement of Sickness in support of your claim. In addition, you may be asked to have your doctor provide the RRB with additional (supplemental) medical information in order to continue to receive your sickness benefit payments. How often supplemental medical information is required depends on several factors, including when you are expected to return to work.

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Eligibility Requirements

To receive sickness benefits you must:

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Tier I Tax Deductions

Except for benefits paid for on-the-job injuries, sickness benefits are subject to Tier I railroad retirement taxes if paid within 6 months after the month in which you last worked. Tier I tax deductions reduce the amount of benefits payable for a claim.

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Number of Days of Sickness

After you have satisfied the benefit year waiting period requirement, benefits are generally paid for days of sickness over 4 in 14-day claim periods.

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Daily Benefit Rate

Your daily benefit rate is 60 percent of the daily rate of pay for your last job in the base year, but not less than $12.70 a day or more than 5 percent of the monthly compensation base.

For example, the monthly compensation base for 2011 is $1,330.00, which results in a maximum daily benefit rate of $66.00 for periods beginning after June 30, 2012. The maximum benefit rate is subject to increases under indexing rules reflecting the growth in average national wages. Contact your local RRB field office if you need information about the maximum benefits rates for other periods.

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Accelerated Benefits

Under certain special provisions, if you have 10 or more years of service, you can receive benefits before the regular beginning date of a benefit year. To qualify, you must be qualified for the next benefit year, but not the current year. You must also have 14 or more consecutive days of sickness and not have voluntarily retired. Accelerated sickness benefits are not payable once you attain age 65.

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Extended Benefits

If you have 10 or more years of service and exhaust your normal sickness benefits, you may be eligible to receive extended benefits for up to 65 days (7 consecutive 14-day claim periods having 10 days payable in each). Also, if you are not qualified for benefits in the current benefit year, but received normal benefits in the previous year, you may still be eligible for extended benefits.

To qualify for extended benefits, you must not have voluntarily retired. Extended sickness benefits are not payable once you attain age 65.

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Normal Benefits

You can receive normal benefits for as many as 130 days (26 weeks) in a benefit year, but your benefits cannot be more than your base year wages counting not more than a prescribed amount for any month. Benefit rights are exhausted when a benefit year ends (normally June 30) or earlier if benefit payments equal base year creditable earnings.

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Waiting Period

To satisfy a one-week waiting period requirement, no benefits are payable for your first 7 days of sickness in your first claim in a period of continuing sickness, unless you have already served a waiting period in the benefit year. Benefits are payable for each remaining day of sickness in your first claim. For example, if you claim all 14 days in your first claim, you will be paid benefits for 7 days. If you are eligible and your claims are continuous from one benefit year to another, you generally will serve only one waiting period in your period of continuing sickness.

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