Applicant’s Statement of Disability

Standard Form 3112A (Applicant’s Statement of Disability) is a form requiring the disability retirement applicant to state his or her injury or disease; to describe how the injury or disease “interferes with the performance” of one’s duties, attendance or conduct; and further asks one to describe “any other restrictions” of any activities which may be imposed by the disease or injury.

It is a simple-looking form – but its simplicity should not be mistaken for its importance.

An applicant’s Statement of Disability must be carefully formulated, and must be characterized by accuracy and thoroughness. One of the major problems often encountered when the Statement of Disability is filled out in a careless manner, is that the Office of Personnel Management will only consider those diseases or injuries which you have discussed in your Statement of Disability.

Thus, by way of example, if an individual is suffering from a physical as well as a psychiatric disability, but only puts down the physical injury on his SF 3112A — OPM will not consider any of the medical reports which reference the psychiatric disability. This problem becomes further compounded when your disability retirement packet has been denied at the initial stage, and you try to “amend” your application by adding other disabilities, because the Office of Personnel Management will not allow for such amendments.

Extra care must be taken when formulating your Statement of Disability.

When I prepare a client’s application for disability retirement, the very last form which I fill out is the SF 3112A — the “Applicant’s Statement of Disability”. Furthermore, I spend anywhere from 2 – 4 hours in constructing a detailed description of the disability. The Statement of Disability should be prepared only after a thorough and comprehensive review of the entirety of the medical documentation available — including the history, progress notes, diagnostic test results, etc. Care in preparation at the inception of the disability retirement process is very important, and therefore it is often wise to consult with an experienced attorney.

If you are considering filing for OPM Disability Retirement, I am available for a free initial consultation at 1-800-990-7932. You may also email me at

Robert R. McGill, Esquire

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