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This package contains the following forms Then download your completed document in pdf, share, or save it to your cloud storage. Standard form 3112a, applicant's statement of disability, standard form 3112b, supervisor's statement, standard form 3112c, physician's statement, standard form 3112d, agency certification of reassignment and accommodation efforts, and standard form 3112e, disability retirement application checklist.
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This section serves to determine if a reasonable accommodation will enable you to fully perform your job duties or if a vacant position is available in your agency at the same pay/grade level, in the same commuting area, for which you are qualified for reassignment. Use the form sf 3112 template to create a document without hassle and in minutes This package contains the forms applicants for disability retirement from civilian federal service need to complete
You should have received with this package a pamphlet entitled
Put a copy of your position description with the forms you give your doctor(s) See that the information you submit contains diagnosis, prognosis, and a treatment plan dated no more than 60 days before the date your application is filed. Open form sf 3112 in the pdf editor Fill in your personal information in the designated fields
Complete sections detailing your medical condition and work history Attach any necessary medical documentation by referencing the instructions Review your entries for accuracy. Follow the steps to successfully complete your sf 3112 application.
Browse the listing below to download your choice of form (s)
On june 26, 2013, the supreme court ruled that section 3 of the defense of marriage act (doma) is unconstitutional.
