RESOURCES TO APPLY FOR FEDERAL DISABILITY
FORMS TO BE COMPLETED & GIVEN TO YOUR PERSONNEL OFFICE
- Standard Form (SF) 3107: Application For Immediate Retirement
This 4-page form is non-disability specific in that it consists mostly of questions about your federal employment history and your post-retirement benefits preferences.
- SF 3112: Documentation in Support of Disability Retirement Application
This document includes several addendums that are completed by various entities. Since these will be completed separately (for instance, part of it by you, part by your supervisor, part by your physician and part by your HR department), the various parts of this document will be assembled by your HR to create a whole package to be submitted by HR to OPM.
SF 3112A: Applicant’s Statement of Disability
This 2-page form is your personal statement of disability. Not only is it imperative to describe the nature and severity of your disabling medical condition(s) accurately and completely, but it is also vital that SF 3112A is consistent with SF 3112C. In other words, there should be no discrepancies (i.e., facts, dates, etc.) between your statement and your doctor’s statement.
SF 3112B: Supervisor’s Statement
This 2-page form is completed by your supervisor. It contains questions about your attendance, performance, and conduct, which allows OPM to evaluate the degree to which your medical conditions prevent you from being able to perform your essential functions. You may not be able to obtain a copy of SF 3112B until after your disability claim has been submitted to OPM.
SF 3112C: Physician’s Statement
The most important component of your disability claim, by far, is the statement provided by your medical practitioner. Without a strong, detailed testimonial from your doctor, it is highly unlikely that OPM will approve your claim.
As instructed in form SF 3112C, the statement includes all the following: a history of your disabling medical conditions; a list/discussion of past and present medications; a list/discussion of past and present therapies and/or treatments; a list/discussion of hospitalizations; a list/discussion of relevant operative procedures and/or diagnostic tests; a detailed account of your symptoms and physical and/or mental limitations; your prognosis; and your medical restrictions. Most importantly, it should include a detailed discussion of the causal relationship between your disabling medical conditions and your inability to perform one or more essential functions of your federal position of record.
SF 3112D: Agency Certification of Reassignment and Accommodation Efforts
This 2-page form is completed by your agency and describes any efforts the agency has made to accommodate and/or reassign you. You may not be able to obtain a copy of SF 3112D until after your disability claim has been submitted to OPM.
SF 3112E: Disability Retirement Application Checklist
This 1-page form is completed by your agency to provide OPM an overview of the documents contained in your application package. You may not be able to obtain a copy of SF 3112E until after your disability claim has been submitted to OPM.