Disability Application Forms

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To apply for disability retirement benefits, you may need a form for…

Requesting Disability Retirement Benefits	Form 7
Medical Report for Disability Eligibility Review	Form 7A
Requesting Disability Status from the Firemen's and Rescue Squad Workers' Pension Fund	Form 7FR

Depending on your situation, RSD will send you the following form, if applicable.

Choosing a Disability Retirement Payment Option Form

To apply for disability benefits from the Disability Income Plan of North Carolina, you (TSERS only) may need a form for…

Requesting Short-Term Benefits Through the Disability Income Plan of North Carolina	Form 701
Requesting Employer Information Required for Member Disability Income Plan Benefits	Sample Form 700
Medical Report for Eligibility Review of Short-Term Disability Benefits	Form 703
Medical Report for Disability Eligibility Review	Form 7A
Requesting Additional Benefits Through the Disability Income Plan of North Carolina	Form 704
Determining and Recording Short-Term Disability Benefits	Sample Form 711
Requesting Reimbursement and Service Credit for the Short-Term Period	Sample Form 714