What is Standard Form 3112C?

Standard Form (SF) 3112C is entitled ” Physician’s Statement” and is contained in SF 3112: “Documentation in Support of Disability Retirement Application.” You must provide your physician a completed, signed copy of this form with a copy of your most recent official position description. Your physician is then required to compose a letter, which addresses all five (5) items listed under “Section B – Medical Documentation.” Note that it is extremely important that your physician clearly describe how your medical conditions prevent you from performing your job. Sometimes physicians assume that by simply listing your symptoms, OPM will automatically arrive at the conclusion that you are unable to perform your duties, but your physician must clearly link your symptoms to your inability to perform one or more of the essential functions of your official position using concrete examples (e.g., “As a direct result of Ms. Smith’s major depression and anxiety disorder, she experiences several episodes of panic and racing thoughts throughout the day, which render her completely unable to concentrate and focus; therefore, Ms. Smith is unable to complete budget analysis reports in a timely and efficient manner and is weeks behind in her assignments.”). Finally, given how busy doctors are these days, you may want to consider writing a draft of the letter yourself to give to your physician as a starting point.

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