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DISABILITY APPLICATION FORMS

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

Form no.	Form Description
Form 7	7-Requesting Disability Retirement Benefits
Form 709	709-Estimating Your Disability Retirement Benefits
Form 7A	7A-Medical Report for Disability Eligibility Review
Form 7FR	7FR-Requesting Disability Status from the Firefighters' and Rescue Squad Workers' Pension Fund

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

Form no.	Form Description
Form 7E	7E-Choosing Your Disability Retirement Payment Option

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

Form no.	Form Description
Form 700	700-Required Employer Information
Form 701	701-Requesting the Short-Term of Benefits through the Disability Income Plan of North Carolina
Form 703	703-Medical Report for Eligibility Review of Short-Term Disability Benefits
Form 704	704-Requesting Additional Benefits through the Disability Income Plan of North Carolina
Form 711	711-Determining the Maximum Monthly Benefit During the Short Term
Form 714	714-Employer's Payment Record, Reimbursement Calculation, and Service Credit Report
Form 7A	7A-Medical Report for Disability Eligibility Review
Form HMDIS	HMDIS-Disability Plans Health Insurance Enrollment Guide