Proposed Collection; Comment Request

In accordance with the requirement of Section 3506 (c)(2)(A) of the Paperwork ( printed page 68187) Reduction Act of 1995 which provides opportunity for public comment on new or revised data collections, the Railroad Retirement Board (RRB) will publish periodic summaries of proposed data collections.

Comments are invited on: (a) Whether the proposed information collection is necessary for the proper performance of the functions of the agency, including whether the information has practical utility; (b) the accuracy of the RRB's estimate of the burden of the collection of the information; (c) ways to enhance the quality, utility, and clarity of the information to be collected; and (d) ways to minimize the burden related to the collection of information on respondents, including the use of automated collection techniques or other forms of information technology.

1. Title and purpose of information collection: Application and Claim for Unemployment Benefits and Employment Service; OMB 3220-0022.

Section 2 of the Railroad Unemployment Insurance Act (RUIA) (45 U.S.C. 231), provides unemployment benefits for qualified railroad employees. These benefits are generally payable for each day of unemployment in excess of four during a registration period (normally a period of 14 days).

Section 12 of the RUIA provides that the RRB establish, maintain and operate free employment facilities directed toward the reemployment of railroad employees. The procedures for applying for the unemployment benefits and employment service and for registering and claiming the benefits are prescribed in 20 CFR 325. 20 CFR 321 provides for applying and filing claims for unemployment benefits electronically.

The RRB utilizes the following forms to collect the information necessary to pay unemployment benefits. Form UI-1 (or its internet equivalent, Form UI-1 (internet)), Application for Unemployment Benefits and Employment Service, is completed by a claimant for unemployment benefits once in a benefit year, at the time of first registration. Completion of Form UI-1 or UI-1 (internet) also registers an unemployment claimant for the RRB's employment service.

The RRB also utilizes Form UI-3 (or its internet equivalent Form UI-3 (internet)), Claim for Unemployment Benefits, for use in claiming unemployment benefits for days of unemployment in a particular registration period, normally a period of 14 days.

Completion of Forms UI-1, UI-1(internet), UI-3, and UI-3 (internet) is required to obtain or retain benefits. The number of responses required of each claimant varies, depending on their period of unemployment. The RRB proposes no changes to the Forms UI-1, UI-1(internet), UI-3 and UI-3 (internet).

2. Title and purpose of information collection: Medical Reports; OMB 3220-0038.

Under sections 2(a)(1)(iv) and 2(a)(1)(v) of the Railroad Retirement Act (RRA) (45 U.S.C.231a), annuities are payable to qualified railroad employees whose physical or mental condition makes them unable to (1) work in their regular occupation (occupational disability) or (2) work at all (total disability). The requirements for establishing disability and proof of continuing disability under the RRA are prescribed in 20 CFR 220.

Annuities are also payable to (1) qualified spouses and widow(ers) under sections 2(c)(1)(ii)(C) and 2(d)(1)(ii) of the RRA who have a qualifying child who became disabled before age 22; (2) surviving children on the basis of disability under section 2(d)(1)(iii)(C), if the child's disability began before age 22; and (3) widow(er)s on the basis of disability under section 2(d)(1)(i)(B). To meet the disability standard, the RRA provides that individuals must have a permanent physical or mental condition that makes them unable to engage in any regular employment.

Under section 2(d)(1)(v) of the RRA, annuities are also payable to remarried widow(er)s and surviving divorced spouses on the basis of, among other things, disability or having a qualifying disabled child in care. However, the disability standard in these cases is that found in the Social Security Act. That is, individuals must be unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment. The RRB also determines entitlement to a Period of Disability and entitlement to early Medicare based on disability for qualified claimants in accordance with Section 216 of the Social Security Act.

When making disability determinations, the RRB needs evidence from acceptable medical sources. The RRB currently utilizes Forms G-3EMP, Report of Medical Condition by Employer; G-197, Authorization to Disclose Information to the Railroad Retirement Board; G-250, Medical Assessment; G-250A, Medical Assessment of Residual Functional Capacity; G-260, Report of Seizure Disorder; RL-11B, Disclosure of Hospital Medical Records; RL-11D, Disclosure of Medical Records from a State Agency; RL-11D1, Request for Medical Evidence from Employers, and RL-250, Request for Medical Assessment, to obtain the necessary medical evidence. One response is requested of each respondent. Completion is required for all forms to obtain benefits except Form RL-11D1, which is voluntary. The RRB proposes no changes to Forms G-197 and RL-11D. The RRB proposes changes to the following forms:

Form G-3EMP

• Section 1: Updated start of instructions to add new first sentence “The form should be answered and signed by a railroad contact official or their delegate.”; removed “or use a typewriter.” reference; changed date example to “February 13, 2026” and replace “second page” with “last page” in last sentence.
• Question 4: Added “(typically, this is the occupation held most of the time in the last 5 or 15 years)”.
• Important Notices: Changed last sentence of the Paperwork Reduction Act contact information to “Railroad ( printed page 68188) Retirement Board, ATTN: Bureau of Information Services/Policy and Compliance, 844 N Rush St., Chicago, IL 60611-1275.”

Form G-250

• Section 1: Added “This form should only be completed by a medical examiner. This form should not be signed by auxiliary medical staff ( e.g., registered nurse, nurse assistants, medical assistants, etc.).” at the beginning of the instructions.
• Questions 4B, 11B, 15B, 16B, 18B, 18C, 18D, 19B, 20B: Inserted “if any surgeries have been performed or scheduled, and whether maximum medical improvement has been achieved.” to allow an applicant or annuitant to describe or provide additional information.
• Important Notices: Changed last sentence of the Paperwork Reduction Act contact information to “Railroad Retirement Board, ATTN: Bureau of Information Services/Policy and Compliance, 844 N Rush St., Chicago, IL 60611-1275.”

Form G-250A

• Question A4: Added “Crawl”.
• Question A5: Added “and Feelings”.
• Question C:

Added “/Ask Questions” at the end of “Reason/Use Judgement”.

Added “Coordinate Tasks and Set Goals”.

Added “Be Punctual and Maintain Attendance”.

Added “Be Aware of Hazards”.

Added “Engage in Travel”.

Added “Attention”.

• Important Notices: Changed last sentence of the Paperwork Reduction Act contact information to “Railroad Retirement Board, ATTN: Bureau of Information Services/Policy and Compliance, 844 N Rush St., Chicago, IL 60611-1275.”

Form G-260

• Section 1: Added “This form should only be completed by a medical examiner. This form should not be signed by auxiliary medical staff ( e.g. registered nurses, nurse assistants, medical assistants, etc.).” and replaced “Item 26” with “Section 15.” in the Iast paragraph.
• Section 2: Updated beginning of sentence to “Print all answers in ink.” and changed the date example to “February 13, 2026”.
• Question 10a: Inserted “frequency ( e.g. daily, weekly, monthly, or yearly) and”.
• Important Notices: Changed last sentence of the Paperwork Reduction Act contact information to “Railroad Retirement Board, ATTN: Bureau of Information Services/Policy and Compliance, 844 N Rush St., Chicago, IL 60611-1275.”

Form RL-11B

• Page 1: Changed the last sentence of the second paragraph to “If you are unable to provide the records without charge, please contact this office at [fillable] to discuss alternative options before you respond.”
• Paperwork Reduction Act Notice: Changed last sentence of the Paperwork Reduction Act contact information to “Railroad Retirement Board, ATTN: Bureau of Information Services/Policy and Compliance, 844 N Rush St., Chicago, IL 60611-1275.”

Form RL-11D1

• Top of Page 2: Added blank fields to allow the RRB personnel to automate adding the claimant's name and claim number to resolve issue when agency only receive page 2 of the form.
• Page 2: Please return this form and any medical records to section: Removed return address and replaced with fields to allow RRB personnel automate adding the appropriate office return address.
• Paperwork Reduction Act Notice: Changed last sentence of the Paperwork Reduction Act contact information to “Railroad Retirement Board, ATTN: Bureau of Information Services/Policy and Compliance, 844 N Rush St., Chicago, IL 60611-1275.”

Form RL-250

• Page 1: Changed layout of the end of the second sentence to first bullet “Submit a copy of your office records on the claimant's treatment for at least the last 12 months. Also, include copies of all available laboratory, hospital, and consultative reports. Authorization to release medical information is enclosed.” and second bullet “Complete the enclosed Form G-250, Medical Assessment. This is not an authorization to conduct a new examination.”
• Page 1: Inserted “and office records” in the fifth paragraph.
• Page 1: Moved last sentence to the end of second new bullet in paragraph 2.
• Page 2: Deleted first paragraph.
• Page 2: Moved sentence to the end of the first new bullet in paragraph 2.
• Paperwork Reduction Act Notice: Changed last sentence of the Paperwork Reduction Act contact information to “Railroad Retirement Board, ATTN: Bureau of Information Services/Policy and Compliance, 844 N Rush St., Chicago, IL 60611-1275.”

3. Title and purpose of information collection: Placement Service; OMB 3220-0057.

Section 12(i) of the Railroad Unemployment Insurance Act (RUIA) (45 U.S.C. 362), authorizes the RRB to establish, maintain, and operate free employment offices to provide claimants for unemployment benefits with job placement opportunities. Section 704(d) of the Regional Railroad Reorganization Act of 1973, as amended, and as extended by the Consolidated Omnibus Budget Reconciliation Act of 1985, required the ( printed page 68189) RRB to maintain and distribute a list of railroad job vacancies, by class and craft, based on information furnished by rail carriers to the RRB. Although the requirement under the law expired effective August 13, 1987, the RRB has continued to obtain this information in keeping with its employment service responsibilities under Section 12(k) of the RUIA. Application procedures for the job placement program are prescribed in 20 CFR 325. The procedures pertaining to the RRB's obtaining and distributing job vacancy reports furnished by rail carriers are described in 20 CFR 346.1.

The RRB currently utilizes four forms to obtain information needed to carry out its job placement responsibilities. Forms ES-21, Referral to State Employment Service, and ES-21c, Report of State Employment Service Office, are used by the RRB to provide placement assistance for unemployed railroad employees through arrangements with State Employment Service offices. Form UI-35, Field Office Record of Claimant Interview, is used primarily by the RRB to conduct in-person interviews of claimants for unemployment benefits. Completion of these forms is required to obtain or maintain a benefit. In addition, the RRB also collects Railroad Job Vacancies information received voluntarily from railroad employers. The RRB proposes the following changes to Forms ES-21, ES-21C and Form UI-35:

Form ES-21

• The RRB proposes to remove Form ES-21 from the information collection due to Field Service no longer disseminating and tracking Form ES-21 sent to claimants for job placement assistance as claimants are increasingly using other digital federal, state, and private job placement assistance platforms.

Form ES-21c

• The RRB proposes to remove Form ES-21c from the information collection due to Field Service no longer disseminating and tracking Form ES-21c sent to claimants for job placement assistance as claimants are increasingly using other digital federal, state, and private job placement assistance platforms.

Form UI-35

• Form Title: Changed to “Record of Claimant Interview”.
• Question 3: Added “Email Address.
• Question 6a: Bolded instructions.
• Question 6b(3): Added “Email Address” and added “Mailing” to Address field.
• Question 8a: Changed to “ Employer-provided job protection or wage guarantee payments?”
• Question 14: Changed to “Enter the following information about the kinds of work that you are qualified for and willing to accept (railroad and nonrailroad):”
• Question 14c: Changed to “Maximum miles willing to commute:”.
• Page 7, Rights and requirements section: Removed “Central register”.

4. Title and purpose of information collection: Report of Medicaid State Office on Beneficiary's Buy-In Status; OMB 3220-0185.

Under Section 7(d) of the Railroad Retirement Act (45 U.S.C. 231), the RRB administers the Medicare program for persons covered by the railroad retirement system. Under Section 1843 of the Social Security Act, states may enter into “buy-in agreements” with the Secretary of Health and Human Services for the purpose of enrolling certain groups of low-income individuals under the Medicare medical insurance (Part B) program and paying the premiums for their insurance coverage. Generally, these individuals are categorically needy under Medicaid and meet the eligibility requirements for Medicare Part B. States can also include in their buy-in agreements, individuals who are eligible for medical assistance only. The RRB utilizes Form RL-380-F, Report of Medicaid State Office on Beneficiary's Buy-In Status, to obtain information needed to determine if certain railroad beneficiaries are entitled to receive Supplementary Medical Insurance program coverage under a state buy-in agreement in the states in which they reside. Completion of Form RL-380-F is voluntary. One response is received from each respondent. The RRB proposes the following changes to Form RL-380-F:

• Removed “Medicaid Number” section to comply withPublic Law 114-10, Medicare Access, and CHIP Reauthorization Act of 2015 (MACRA).
• Paperwork Reduction Act Notice: Changed last sentence of the Paperwork Reduction Act contact information to “Railroad Retirement Board, ATTN: Bureau of Information Services/Policy and Compliance, 844 N Rush St., Chicago, IL 60611-1275.”

5. Title and purpose of information collection: Report of Stock Options and Other Payments; OMB 3220-0203.

The Railroad Retirement Board (RRB) is directed by 45 U.S.C. 231f(c)(2) to establish a financial interchange (FI) between the railroad retirement and social security systems to place the Social Security Old-Age and Survivors Insurance (OASI) and Disability Insurance (DI) Trust Funds and the Centers for Medicare and Medicaid Services (CMS) Hospital Insurance (HI) Trust Fund in the same condition they would have been had railroad employment been covered by the Social Security Act and Federal Insurance Contributions Act (FICA). Each year, the RRB estimates the benefits and expenses that would have been paid by these trust funds, as well as the payroll taxes and income taxes that would have been received by them. To make these estimates, the RRB requires information on all earnings data that are not taxable under the Railroad Retirement Tax Act (RRTA) but would be taxable under FICA.

The payroll information collected from the BA-15 is essential for the calculation of payroll taxes and benefits used by the FI. Failure to collect NQSOs and ratification payment information will result in understating the payroll taxes that should have been collected and the benefit amounts that would have been payable under the Social Security Act for FI purposes. Accurate compensation file tabulations are also an integral part of the data needed to estimate future tax revenues and corresponding FI amounts. Without information on NQSOs and ratification payments, the amount of funds to be transferred between the RRB, SSA and CMS cannot be determined.

Form BA-15, Report of Stock Options and Other Payments, to request employer information and report identifying information as well as each employee's social security number, name, and compensation information, which will be reported annually in a quarterly breakdown. The RRB receives Form BA-15 by secure Email, File Transfer Protocol (FTP), or via CD-ROM. The RRB proposes no changes to Form BA-15.

Additional Information or Comments: To request more information or to obtain a copy of the information collection justification, forms, and/or supporting material or comments regarding the information collection should be addressed to Brian Foster, Railroad Retirement Board, 844 North Rush Street, Chicago, Illinois 60611-1275 or emailed to Brian.Foster@rrb.gov. Written comments should be received within 60 days of this notice.