OMB control number

Request to Disability Annuitant for Information on Physical Condition and Employment

OMB 3206-0143 · OPM.

OMB 3206-0143

Request to Disability Annuitant for Information on Physical Condition and Employment, is used by persons who are not yet age 60 but receive a disability annuity and are subject to inquiry regarding their medical condition as OPM deems reasonably necessary.

The latest form for Request to Disability Annuitant for Information on Physical Condition and Employment expires 2026-06-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form RI 30-1 Request to Disability Annuitant for Information on Physical Condition and Employment Form and Instruction
RI30-001_OMBSuppStmt_2024_04_29.docx Supporting Statement A
RI30-001_30DayFRNPublished_2024_02_20.pdf Supplementary Document
RI30-001_60DayFRNPublished_2023_05_03.pdf Supplementary Document
ARS PIA Final 12212017signed.pdf Supplementary Document
Request to Disability Annuitant for Information on Physical Condition and Employment Form and Instruction

All Historical Document Collections

202404-3206-001 Approved without change	Revision of a currently approved collection	2024-04-30
202403-3206-001 Improperly submitted and continue	Revision of a currently approved collection	2024-03-29
202101-3206-008 Approved without change	Revision of a currently approved collection	2021-01-29
201712-3206-012 Approved with change	Revision of a currently approved collection	2017-12-29
201703-3206-001 Approved without change	No material or nonsubstantive change to a currently approved collection	2017-03-16
201606-3206-005 Approved with change	Revision of a currently approved collection	2016-06-28
201303-3206-007 Approved without change	Revision of a currently approved collection	2013-03-28
201005-3206-001 Approved without change	Revision of a currently approved collection	2010-05-04
200707-3206-001 Approved without change	Revision of a currently approved collection	2007-07-19
200403-3206-001 Approved without change	Revision of a currently approved collection	2004-03-26
200104-3206-002 Approved without change	Revision of a currently approved collection	2001-04-26
199802-3206-003 Approved without change	Reinstatement with change of a previously approved collection	1998-02-11
199406-3206-004 Approved without change	Extension without change of a currently approved collection	1994-06-16
199108-3206-007 Approved without change	Extension without change of a currently approved collection	1991-08-22
199006-3206-005 Approved without change	Reinstatement with change of a previously approved collection	1990-06-01
198911-3206-004 Approved with change	No material or nonsubstantive change to a currently approved collection	1989-11-06
198905-3206-002 Approved with change	No material or nonsubstantive change to a currently approved collection	1989-05-05
198704-3206-015 Approved without change	Revision of a currently approved collection	1987-04-22
198512-3206-001 Approved with change	No material or nonsubstantive change to a currently approved collection	1985-12-18
198403-3206-003 Approved without change	New collection (Request for a new OMB Control Number)	1984-03-22