TN 3 (02-01)
OPM will furnish medical evidence on individuals who have filed for civil service
These records may include:
A letter from the treating source(s)
A Certificate of Medical Examination (with detailed clinical signs and laboratory
A report from the employing agency describing job duties and the employee's ability
to perform those duties.
Follow the instructions below to request the evidence.
Send the request to:
Include a signed SSA-827.
Include the claimant's:
Date of birth
Civil service claim number, or, when not immediately available, last government employer,
location, dates of employment, and date of retirement.
If a response is not received within 45 calendar days from the date of the initial
request, send a followup request.
See DI 22505.035 for additional followup procedures.