Standard Form (SF) 3112A is entitled “Applicant’s Statement
of Disability” and is contained in SF 3112: “Documentation
in Support of Disability Retirement Application.” You, the applicant,
are responsible for completing this form (and you must provide a copy
to your supervisor in order for your supervisor to be able to complete
SF 3112B: “Supervisor’s Statement”). Take the time to
describe your medical conditions in detail. Note that you are required
to explain how your medical conditions directly prevent you from performing
one or more of the essential functions of your job. In addition, you are
required to explain the adverse impact of your medical conditions on your
personal life and daily activities. Don’t forget to attach your
Social Security Disability application receipt, and don’t forget
to sign and date the “Applicant’s Consent and Certification.”
