After we receive your application, we will mail your first claim to
you. Claims for subsequent 14-day periods will be mailed to you for as
long as you remain unemployed and eligible for benefits. You must
complete and return each claim promptly by mail, or file online at
www.rrb.gov or you may lose benefits. The time for filing a claim,
including time for mailing, is limited to 15 days from the last day of
the claim period or 15 days from the date the claim form was mailed to
you, whichever is later.
If you return to work and do not have at least 5 claimed days during a claim
period, do not return the claim form. This will stop the release of additional
claims to you.
If you stop claiming benefits during a benefit year, but become unemployed
again and need a new claim form, contact your local Railroad Retirement Board
office to obtain a new claim. You must request
your new claim within 30 days of the first day for which you wish to claim
benefits or you may lose benefits.
Read the following instructions carefully
before completing your claim form. Failure to complete your claim
correctly could delay the payment the of your benefits.
Item 1a
This item shows the 14-day period of your claim. Below each day of the
claim period, you must enter the correct letter code showing whether
you want to claim benefits for the day, or whether you worked, received
vacation pay, holiday pay, or other earnings, or cannot claim benefits
for some other reason.
Remember that you cannot claim benefits for any day on which you worked
or otherwise earned wages, holiday pay, vacation pay, or other pay.
This includes pay from full-time and part-time work in either railroad
or non railroad employment, and from self-employment. In addition, you
cannot claim benefits for any day on which you were not available for
work. This means that you must not have been sick or injured on any day
for which you claim benefits, and you must have been willing and ready
to work on the day.
Use the following letter codes to show whether you are claiming
benefits for the days in the claim period:
- X -
Enter an "X" if you did not work on the day, will not receive any
type of pay for the day, were not sick or unable to work because of
injury or mental infirmity on the day, and were willing and ready to
work. Any day you mark with an "X" is considered to be a day of
unemployment for which you are claiming benefits.
Use an "X" to show your normal
rest days, unless you worked or
otherwise received pay from either a railroad or non-railroad employer
for the day, or unless you were sick or otherwise unable or not
available for work on the day.
- E
- Enter an "E" if you were employed either full-time or part-time on
the day. Include work for either a railroad or non-railroad employer,
and any self-employment. Also show an "E" for days you were on active
duty with the National Guard or a Reserve unit.
- P -
Enter a "P" for any day that you were not employed, but will
receive payment from a railroad or non railroad employer. This includes
such payments as vacation pay, holiday pay, daily wage guarantee
payments, and pay for time lost.
If you receive guarantee pay or pay for time lost for days for which
you previously claimed unemployment benefits, the benefits paid to you
must be refunded to the RRB. You should notify us if you are eligible
for guarantee pay or claiming pay for time lost so we can arrange for
your employer to deduct the proper amount for refund to the RRB. Verify
the accuracy of the amount of benefits withheld from your pay by
checking your own record of RRB payments or by contacting the RRB.
Notify us promptly if you believe the correct amount was not withheld.
Do not show a "P" for payments under a supplemental unemployment
insurance plan paid or financed by your employer. Such payments are
normally paid in addition to your unemployment benefits from the RRB. However,
if railroad retirement taxes are deducted from payments by your employer, the
payments are not "supplemental" payments and must be reported on your claim
form.
- O -
Enter an "O" for days on which you did not work
and did not receive any type of payment, but which you cannot claim because
you were not able and available for work on the day.
Show an "O" for days that you:
- were unable to work due to sickness or injury;
- marked off, missed a call to work, or did not report to work because of
personal business or family obligations;
- did not work due to laying over or standing by between regularly
assigned trips;
- failed to exercise seniority to obtain a suitable job for which you are
qualified;
- did not work because the day is an extra rest day after you worked four
10-hour days;
- did not perform work which was available to you.
Click here for an
example of how the boxes are to be completed.
Item 1b
Enter the dollar amount of your total gross earnings from
all full-time and part-time work performed in the claim period. Include earnings
from railroad, nonrailroad, and self-employment. Include pay for personal and
vacation days and any other paid leave for days in the claim period. Also
include any pay you would have earned except for your failure to mark up in time
or report for duty, or because you missed a turn in pool service or were
otherwise not available for work. Do not include payments you receive during the
claim period that were earned on days outside the claim period. All earnings for
a work shift are attributable to the day the shift begins. Do not include
payments received under a supplemental unemployment benefit plan. See Examples
A and B on pages 3 and 4.
Item 2
Enter the complete company name of your last railroad employer
in Item 2a, and your last railroad occupation in Item
2b. Enter an
"X" in the appropriate box in Item 2c to show the
reason why you are not now working for your last railroad employer.
Item 3
This item is pre-filled with the name and address of your local Railroad
Retirement Board office. Mail your completed claim to that
office.
Item 4
This item is pre-filled with your name and address. If necessary, show
corrections to your name and address in the box.
Item 5
If you have worked for a nonrailroad employer since your last day of railroad
work, answer Item
5a "Yes." Enter the
nonrailroad employer's name and address in Item 5b
and the
date last worked before this claim for the nonrailroad employer, in Item 5c.
If you have stopped working for that nonrailroad employer, enter the reason why
in Item
5d.
If you have not stopped working for that non railroad employer, enter
"Still Working" in Item 5d.
Item 6
If you worked in train and engine service or passenger service, answer Item
6a "Yes." Enter the number
of miles or hours you worked during the 14-day claim period in Item
6b. Include miles or hours earned for
regular pay, premium pay, overtime, and deadheading. Enter the days that you
did not work because of a layover or stand-by rule, mileage restriction, or
because you missed a turn in pool service in Item
6c.
Item 7
You must enter an "X" in either "Yes" or "No" for all of the
questions in Item 7. If you complete a box that has an asterisk (*) in front of it,
be sure to explain your answer. Unless otherwise
indicated, the questions should be answered for days included in the claim
period.
Item 8
By signing and dating this item you certify that the information contained on
your claim form is true and complete. Do not
complete and sign the claim form before the last day of the claim period.
If your claim is mailed before the last day of the claim period, benefits due
you may be delayed or denied.
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