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After
your application for unemployment benefits has been received
and processed, your first unemployment claim will be mailed
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
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 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 nonrailroad 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 nonrailroad 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
Write in this item 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 benefits plan. See Examples
A and B in
Eligibility Requirements.
Item 2
You must enter the complete company name of your last
railroad employer in Item 2a,
and your last railroad occupation in Item 2b.
In addition, complete Item 2c
by entering an "X"
in the appropriate box to show the reason why you are not
now working for your last railroad employer.
Item 3
This item is prefilled with the name and address of
your local Railroad Retirement Board office. Your completed
claim is to be mailed to that office.
Item 4
This item is prefilled with your name and address. If
necessary, show corrections to your name and address in
the box.
Item 5
If you answer "Yes"
that you have worked for a nonrailroad employer since your
last day of railroad work, enter that nonrailroad employer's
name and address in Item 5b
and the date last worked before this claim for the nonrailroad
employer, in Item 5c.
Also, if you have stopped working for that nonrailroad employer,
give the reason why in Item 5d.
If you have not stopped working for that nonrailroad employer,
enter "Still Working" in Item 5d.
Item 6
If you worked in train and engine service or passenger
service, 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. Also show 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 answer all of the questions in Item 7. Be sure
to explain your answer if you complete a box that has an
asterisk (*) in front of it. 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 on 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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