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OMB Control No: 3220-0038	ICR Reference No: 198012-3220-001
Status: Historical Inactive	Previous ICR Reference No: 198011-3220-009
Agency/Subagency: RRB	Agency Tracking No:
Title: MEDICAL REPORTS
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Disapproved	Conclusion Date: 02/05/1981
	Date Received in OIRA: 12/31/1980
Terms of Clearance: IN DECEMBER 1979 THE G-3EMP, 250, 253A AND 257 WERE APPROVED FOR SIX MONTHS ONLY, UNTIL JUNE 1980, "TO ALLOW RRB TIME TO REVISE ALL OF ITS FORMS REQUESTING MEDICAL DATA, INCLUDING G-3EMP. G-250, G-253A AND G-257, TO BE SIMILAR TO THOSE IN USE BY SSA. SSA'S FORMS BASICALLY REQUEST ONLY MEDICAL DATA RELEVANT TO THE DETERMINATION OF DISABILITY VERSUS A MORE COMPLETE PHYSICAL REPORT." FINALLY, ON DECEMBER 31, 198 RRB REQUESTED APPROVAL TO CONTINUE TO USE THE G-3EMP AND 250, WITH SOM REVISION, AND TO USE A RL-11B FORM. THIS REQUEST IS DISAPPROVED. RRB SHOULD QUICKLY SUBMIT A REVISED PACKAGE, ESPECIALLY A REVISED G-250, WITH UNNECESSARY QUESTIONS, SUCH AS THE QUESTIONS ON AGE, HEIGHT, WEIGHT, SEX, TEMPERATURE, VISION, HEARING, URINANALYSIS RESULTS, AND BLOOD TEST RESULTS, ON THE G-250, DELETED.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		12/31/1980
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

Abstract: SECTION 2 OF THE RAILROAD RETIREMENT ACT PROVIDES FOR THE PAYMENT OF DISABILITY ANNUITIES TO QUALIFIED RAILROAD EMPLOYEES WHO ARE UNABLE TO WORK IN THEIR REGULAR OCCUPATION (OCCUPATIONAL DISABILITY) OR ANY OCCUPATION (TOTAL DISABILITY). THE MEDICAL REPORTS ARE NEEDED TO DETERMINE THE EMPLOYEE'S ENTITLEMENT TO A DISABILITY ANNUITY.

Authorizing Statute(s): None

Citations for New Statutory Requirements: None

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

Federal Register Notices & Comments
Did the Agency receive public comments on this ICR? No

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
MEDICAL REPORTS	G-3RMP,, G-250,, G-253A,, G-257, G-3EMP, G-250, G-253A, G-257

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

View ICR - OIRA Conclusion