records maintained by the Board are checked and if necessary, further evidence is obtained from the employee, the employer, fellow employees, public records and any other person or source available. The Bureau makes a decision on the application in the first instance. An applicant dissatisfied with the Bureau's decision may, upon filing notice within 1 year from the date the decision is mailed to the applicant, appeal to the Office of Hearings and Appeals. There he may have an oral hearing before a referee of which a stenographic record is made, submit additional evidence, be represented, and present written and oral argument. If dissatisfied with the decision of the referee, the applicant may appeal to the Board itself. This appeal must be made on a prescribed form within 4 months of the date a copy of the referee's decision was mailed to him. If new evidence is received, the Board may remand the case to the referee for investigation and recommendation on the new evidence. (For details on all appeals procedure, see Part 260 of this chapter.) An applicant, after he has unsuccessfully appealed to the Board itself and has thus exhausted all administrative remedies within the Board, may obtain a review of a final decision of the Board by filing a petition for review, within 1 year after the entry of the decision on the records of the Board and its communication to the applicant, in the U.S. court of appeals for the circuit in which the applicant resides, or in the U.S. Court of Appeals for the Seventh Circuit, or in the U.S. Court of Appeals for the District of Columbia Circuit.

(b) Unemployment, sickness, and maternity benefits. (1) Claims for unemployment benefits are handled by a comprehensive organization set up in the field. Under agreements between the Railroad Retirement Board and covered employers, the employers select employees of theirs to act as unemployment claims agents. These agents perform their services, specified in the agreement, in accordance with instructions issued by the Board but under general supervision and control of the employer. In accordance with the agreements, employers are reimbursed for such services at the rate of 50 cents for each claim taken by an unemployment claims agent and transmitted to the Board. There are some 13,000 such contract claims agents. An unemployed person who wishes to file a

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claim for unemployment benefits need only consult his recent railroad employer to be directed to the unemployment claims agent with whom he may file his claim.

(2) When an employee makes his first claim in any benefit year, he identifies himself and fills out an application for unemployment benefits (UI-1), an application for employment service (Form ES-1), and a pay rate report (Form UI-1a) to be used in determining the rate at which benefits may be paid. The employee is given an informational booklet UB-4 and an Unemployment Bulletin No. UB-3 informing him of his responsibilities and explaining the statements to which he is required to certify and to which he does certify when he registers for benefits. When the applications and pay rate report are completed, the unemployment claims agent sends them to the nearest field office of the Board. That office inspects the applications to detect errors and omissions and to note items requiring investigation. The office also attempts to verify the employee's statement about his pay rate unless the unemployment claims agent has already done so. The application for unemployment benefits and the pay rate report are then sent to the appropriate regional office of the Board. The application for employment service is retained in the field office for use in referring the claimant to suitable job openings. On the basis of the information furnished on the application for unemployment benefits, the regional office determines whether the applicant is a qualified employee (that is, whether he earned $500 or more from covered employment in the base year). The applicant is notified by letter if he is found to be not qualified.

(3) In addition to the application forms and pay rate report, the claimant executes a registration and claim for unemployment insurance benefits (Form UI-3). In substance, registration consists of his appearing before an unemployment claims agent during the agent's working hours and signing his name on the registration and claim form for the days he wishes to claim as days of unemployment. Registration for any day must be made on the day or not later than the sixth calendar day thereafter, except that, if such calendar day is not a business day, the claimant may make his registration on the next following business day. In other words, a claimant must ordinarily appear for registra

tion at seven-day intervals. Under certain circumstances, such as illness, employment, looking for employment, etc., an employee may make a delayed registration for any day for which he is unable to register within the time limit mentioned above. The unemployment claims agent sends the claim to the nearest field office where it is inspected with a view to calling the claimant in for interview or referral to job openings, detecting errors and omissions, and noting items requiring investigation. The claim is then forwarded to the regional office.

(4) Claims for sickness benefits are handled by the field organization of the Board. An employee need not register in person for sickness benefits but claims for such benefits must be made on the forms prescribed by the Board and executed by the individual claiming benefits except that, if the Board is satisfied that an employee is so sick or injured that he cannot sign forms, the Board may accept forms executed by someone else in his behalf. Forms used in connection with claims for sickness benefits may be obtained from a railroad employer, a railway labor organization, or any Board office. An application for sickness benefits (Form SI-1a) and the required statement of sickness (Form SI-1b) may be mailed to any office of the Board (see Part 335 of this chapter). It is important that a statement of sickness be filed promptly, for no day can be considered as a day of sickness unless a statement of sickness with respect to such day is filed at an office of the Board within ten days. The application and statement of sickness are forwarded to a regional office where they are examined. If it appears that the employee is entitled to benefits, the regional office will send him a claim form covering a 14-day registration period, and a pay rate report (Form SI-1d). The employee completes the forms, indicating on the claim form the days during the period he claims as days of sickness and returns both forms to the regional office to which the claim form is preaddressed. When additional medical information is needed, a form for supplemental doctor's statement is sent to the employee. This should be filled out by a doctor and returned to the Board.

(5) Maternity benefits must be applied for on a form prescribed by the Board. A statement of maternity sickness, executed by a person authorized to execute statements of sickness (see Part

An

335 of this chapter), is required also. The necessary forms may be obtained from a railroad employer, a railway labor organization, or any Board office. application for maternity benefits (Form SI-101) and the statement of maternity sickness (Form SI-104) may be filed in person or by mail with any Board office. It is important that the statement of maternity sickness be filled promptly since no day can be considered as a day of sickness in a maternity period unless a statement of maternity sickness with respect to the day is filed at an office of the Board within ten days. As in the case of claims for sickness benefits, the forms are forwarded to a regional office. Claim forms are mailed to the claimant and are pre-addressed for return to the regional office.

(6) Whether benefits are payable to a claimant and, if so, the amount of benefits payable, is determined with respect to claims for unemployment, sickness, and maternity benefits, by the regional office. The names and addresses of claimants to whom benefits are found payable, and the amounts payable to them, are certified to the local disbursing office of the Treasury Department which mails the benefit checks to the claimants. If a claim is denied in whole or in part, an explanation is given to the claimant by letter.

(7) The rate at which benefits are payable is determined from the claimant's railroad wages earned in a base year period or from his daily pay rate for his last railroad employment in the base year period, whichever will result in the higher benefit rate. His daily benefit rate will be at least 60 per centum of his daily pay rate for his last railroad employment in the base year period, but not exceeding $10.20.

(8) Any qualified employee whose claim for benefits under the Railroad Unemployment Insurance Act has been denied in whole or in part may, within one year from the date such denial is communicated to him, appeal from the initial determination, and such appeal will be heard before an impartial referee. An unsuccessful claimant in an appeal before such referee may appeal to the Board. (For further details of appeals procedure by claimants for benefits and for appeals procedure by employers, see Parts 319 and 320 of this chapter.)

Any claimant, or any railway labor organization organized in accordance with

the provisions of the Railway Labor Act, of which the claimant is a member, or any other party aggrieved by a final decision pursuant to the Railroad Unemployment Insurance Act, may, only after all administrative remedies within the Board will have been availed of and exhausted, obtain a review of such final decision of the Board by filing a petition for review within 90 days after the mailing of notice of such decision to the claimant or other party, or within such further time as the Board may allow, in the United States court of appeals for the circuit in which the claimant or other party resides or will have had his principal place of business or principal executive office, or in the United States Court of Appeals for the Seventh Circuit, or in the United States Court of Appeals for the District of Columbia Circuit.

(c) Current compensation and service records. Current compensation and service records are maintained by the Bureau of Data Processing and Accounts. These records are obtained from reports made periodically on either a quarterly or annual basis by employers and employee representatives. General instructions in this regard may be found in Part 250 of this chapter. Special instructions to employers and employee representatives are issued from time to time by the Director of Data Processing and Accounts.

(d) Collection of contributions. The Office of Budget and Fiscal Operations acts as the collecting agency of the Board in receiving contributions due under the Railroad Unemployment Insurance Act. Contributions are, with some few exceptions, due quarterly and with the payment, the employer must file a report, Form DC-1, Employers Quarterly or Annual Report of Contributions under the Railroad Unemployment Insurance Act. (For further details see Part 345 of this chapter.)

(e) Employment service. Employers needing workers may avail themselves of the Board's employment service by making requests of any field office for referrals, in writing, on forms provided by the Board, or by telephone.

[15 F.R. 6752, Oct. 6, 1950, as amended at 21 F.R. 4808, June 29, 1956; Board Order 62-115, 27 F.R. 9254, Sept. 19, 1962; Board Order 67-67, 32 F.R. 9064, June 27, 1967; 35 FR. 14548, Sept. 17, 1970]

§ 200.2 Designation of forms and in

structions.

(a) Following are the forms to be used by applicants, employers and others, together with a description of each form and instructions for each. Subparagraphs (1) through (31) of this paragraph describe the basic forms to be used in filing applications for benefits under the retirement act, the report forms required of beneficiaries, and the related appellate forms. Subparagraphs (32) through (34) of this paragraph describe the forms used in registration of railroad employees and the crediting of service months and wages to their accounts. Subparagraphs (35) through (44) of this paragraph describe the compensation and contribution report forms to be used by railroad employers and nationallabor organization "employers." Subparagraphs (45) through (59) of this paragraph describe the basic application, claim and report forms to be used in applying for benefits under the unemployment insurance act, and related appellate forms. Forms may be secured upon application in person or by mail at any of the Board's offices.

(1) Form AA-1, Application for Employee (Age and Service) Annuity Under The Railroad Retirement Act. This form must be executed by each individual who wishes to file claim for an em.. ployee annuity under the Railroad Retirement Act on a basis other than disability. Information to be included on the form consists of data required to identify the employee on the records of the Board and on the employer's payroll or other records; a statement as to whether or not credit for military service is claimed; statements as to his marital status and whether he has children under age 18 or disabled; and the date on which the individual wishes to have the annuity begin. Form AA-1 must be signed by the individual in accordance with § 210.4 of this chapter.

(2) Form AA-1a, Request for Supplemental Information When Annuitant or Pensioner Attains Age 65. This form is used when supplemental information is requested. Information requested includes the claimant's social security account number, his marital status in some detail, and whether he has children who are under age 18 or disabled.

(3) Form AA-1b, Application for Recomputation of Employee Annuity Under the Railroad Retirement Act. This form is for use of annuitants who wish to

apply for a recomputation of an annuity to include service rendered after the annuity beginning date.

(4) Form AA-1d, Application for Employee (Disability) Annuity Under the Railroad Retirement Act. This form must be executed by each individual who wishes to file claim for an employee annuity under the Railroad Retirement Act on the basis of disability. Information to be included on the form consists of data required to identify the employee on Board and employer records; his work history; answers to questions about his disabilities; statements as to his marital status and children under age 18 or disabled; and the date on which the individual wishes to have the annuity begin. This form is also an application to establish a period of disability under the guaranty provisions.

(5) Form AA-1f, Application to Establish Period of Disability. This form is to be executed by an individual whose claim for a period of disability was denied when he filled Form AA-1d, Application for Employee (Disability) Annuity. Should his physical condition retrogress to the point where he could be considered disabled under the Social Security Act, he may file this form to secure a new decision on his claim for a period of disability to increase employee, spouse, or insurance annuities under the guaranty provisions.

(6) Form AA-3, Application of Wife for Spouse's Annuity. This form must be executed by the wife of an annuitant in filing claim for a spouse's annuity under the Railroad Retirement Act. The form requires information needed to determine a wife's eligibility for a spouse's annuity.

(7) Form AA-3a, Supplement to Application for Wife's Annuity. This form is to be completed by a wife, who has filed a claim for a spouse's annuity, to provide supplemental information to enable the Board to determine if the wife may have eligibility on the basis of having in her care a disabled child who is 18 years of age or older.

(8) Form AA-4, Application of Husband for Spouse's Annuity. This form must be executed by the husband of a female annuitant in filing claim for a spouse's annuity under the Railroad Retirement Act. This form requires information required by the Board to determine a husband's eligibility for a spouse's annuity.

(9) Form AA–5, Application for Substitution of Payee for Employee or Spouse Annuitant. This form is to be used where a guardian or other legal representative is appointed, or a substitute payee under section 19(a) of the Railroad Retirement Act is requested, for an employee or a spouse after the award of an annuity to him or her. The form requires information needed to show the authority of the legal representative, or the basis for recognizing the substitute payee to receive payment on behalf of the employee or the spouse and requires the signature of the person applying. The form also lists the conditions under which an annuity is not payable and includes a form of agreement concerning the payment of the annuity and for the reporting of events which would affect such payment.

(10) Form AA-11a, Designation Change of Beneficiary. This is a form prescribed in accordance with subsection (f) (2) of section 5 of the Railroad Retirement Act, as amended, on which an individual who was an employee after December 31, 1936, may designate the person or persons whom he wishes to receive any death benefits payable under such paragraph. The form is also to be used to change a designation of beneficiary made on a Form AA-11a previously filed with the Board. It must be signed by the individual and witnessed by two persons who are not designated on the form as beneficiaries.

(11) Form AA-17, Application for Widow's or Widower's Insurance Annuity. This is the form of application for insurance annuity and lump-sum benefits by the widow or widower of a deceased employee; it may be considered as an application also for any insurance benefits payable under Title II of the Social Security Act as amended.

(12) Form AA-17a, Application for Widow's or Widower's Insurance Annuity. This form is to be used where an applicant for widow's or widower's insurance annuity has previously filed an application for a lump-sum death payment, a widow's current insurance annuity, or a spouse's annuity; it may be considered as an application also for any insurance benefits payable under Title II of the Social Security Act as amended. Where the applicant has not previously filed an application for a spouse's annuity, lump-sum death payment, or widow's current insurance annuity, Form AA-17 is to be filed.