* The regular railroad occupation is: 1) the occupation in which the employee has
been engaged for more calendar months than any other occupation during the last
preceding 5 calendar years, whether consecutive or not; or 2) the occupation
which the employee has been in service for not less than one-half of all months
in which the employee has been engaged in service during the last 15 consecutive
calendar years; or 3) if an employee last worked as an officer or employee of a
railway labor organization and if that employment is no longer available, the
regular occupation shall be the position to which the employee holds seniority
rights or the position left to work for the railway labor organization.

The above-named railroad employee has applied for an occupational disability benefit under section 2(a)(iv) of the Railroad Retirement Act. Railroad Retirement Board (RRB) regulation 20 CFR 220.13 (b)(2) provides that railroad employers may furnish pertinent information concerning the job duties the employee is required to perform. If you wish to provide job duty information on the above-named employee, it must be received by the RRB no later than

EMPLOYER INFORMATION

The attached list of job duties indicate those duties generally performed by the employee.

Please provide any additional information on the duties the employee performed over the last 5 years, or 15 years if appropriate.

This information can be entered in the Remarks section or attached to this form.

G-251a(12-97)

Section 7 (b)(6) of the Railroad Retirement Act (RRA) allows the Railroad Retirement Board (RRB) to collect this information. While you are not required to respond, the information you provide will be used by the RRB in determining an applicant's eligibility for an occupational disability under the RRA.

We estimate that this form takes an average of 20 minutes per response to complete, including the time for reviewing the instructions, getting the needed data, and reviewing the completed form. Federal agencies may not conduct or sponsor, and respondents are not required to respond to, a collection of information unless it displays a valid OMB number. If you wish, send comments regarding the accuracy of our estimate or any other aspects of this form, including suggestions for reducing the completion time to: Chief of Information Management, Railroad Retirement Board, 844 North Rush Street, Chicago, IL 60611-2092 and to the Office of Management and Budget, Paperwork Reduction Project (3220-0193), Washington DC 20503. Please do not return this form to either of these addresses.

G-251a (12-97)

* The regular railroad occupation is: 1) the occupation in which the employee has
been engaged for more calendar months than any other occupation during the last
preceding five calendar years, whether consecutive or not; or 2) the occupation
which the employee has been in service for not less than one-half of all months
in which the employee has been engaged in service during the last 15 consecutive
calendar years; or 3) if an employee last worked as an officer or employee of a
railway labor organization and if that employment is no longer available, the
regular occupation shall be the position to which the employee holds seniority
rights or the position left to work for the railway labor organization.

The above-named railroad employee has applied for an occupational disability benefit under
section 2(a)(iv) of the Railroad Retirement Act. Railroad Retirement Board (RRB) regulation
20 CFR 220.13 (b)(2) provides that railroad employers may furnish pertinent information
concerning the job duties the employee is required to perform. If you wish to provide job duty
information on the above-named employee, it must be received by the RRB no later than

EMPLOYER INFORMATION

You may wish to provide the RRB with job duty information. If so, the job information that
is needed for a disability decision should include a full description of the basic duties to perform
the occupation listed. For example, list the types of machinery, tools and/or equipment used,
technical knowledge or skills involved, and number of people supervised. Also include the types
of physical activities involved in a typical 8 hour work day, such as how many hours of walking,
standing or sitting, what items are lifted and carried and how much these items weigh, and how
often bending, crouching, kneeling, reaching and climbing are performed. If exposure to
environmental hazards, such as working at heights or around dangerous machinery, in extreme
temperatures or excessive noise are present, also list these.

G-251b(12-97)