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 HOW TO COMPLETE THE SF 3112 DOCUMENTATION IN SUPPORT OF DISABILITY RETIREMENT APPLICATION

If you are applying for disability retirement, you must complete an SF 3112, Documentation in Support of Disability Retirement Application in addition to the application for immediate retirement. If you have questions about completing the form, contact the Benefits Line and ask to speak to a retirement specialist.

SF 3112A, APPLICANT'S STATEMENT OF DISABILITY

Fully describe your medical condition and how it interferes with the performance of your duties, your attendance, or your conduct.

SF 3112B, SUPERVISOR'S STATEMENT

Ask your immediate supervisor to complete this form. The supervisor must attach a copy of your position description, a copy of your performance standards, and latest performance appraisal of record; identify critical elements for which performance is deficient; and describe specific instances of deficient performance. If the performance appraisal of record reflected fully successful performance, your supervisor must document specific instances of less than successful performance since the date of the performance appraisal. After your supervisor has completed the form, he or she should give you a copy. Include the original with your application.

SF 3112C, PHYSICIAN'S STATEMENT

Complete the information at the top of the form, sign and date the form, and attach a copy of your position description. Give the form to your personal physician and ask him or her to provide the medical documentation requested on the back of the form. You are responsible for any costs incurred in connection with providing this documentation.

SF 3112D, AGENCY CERTIFICATION OF REASSIGNMENT AND ACCOMMODATION EFFORTS

Ask your activity Coordinator for Employment of the Handicapped or your local Human Resources Office to complete this form.

SF 3112E, DISABILITY RETIREMENT APPLICATION CHECKLIST

The Civilian Benefits Center will complete this form.

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