When a railroad worker's disability annuity claim rests on epilepsy or another seizure disorder, the Railroad Retirement Board asks the treating physician for this report. It records a description and type of the seizures, first and last seizure dates, frequency over the past year and who has verified it, precipitating factors, treatment, compliance, blood drug levels, mental status, postictal behavior, neurological findings and EEG results.
The treating physician or neurologist, called the medical examiner on the form, completes the whole report and signs the Section 15 certification. The applicant does not complete any part.
Download the current version from the source each time; forms change without notice.
Report of Seizure Disorder
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Yes. The form says your report may be made on the form or as a narrative on your own stationery. The narrative must still furnish all the information the form requests about the applicant's seizure disorder, including treatment, compliance, blood drug levels and EEG findings.
The RRB explains that applicants are responsible for presenting medical evidence from their own physicians, so any fee for completing the report is a personal matter between the applicant and the physician. The exception is when the RRB specifically contracts for an examination.