Notice of Lien Transmittal Letter

UNITED STATES OF AMERICA

RAILROAD RETIREMENT BOARD

CURRENT

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NOTICE OF LIEN

In reply refer to
Name:
SS No.:
Date Injured:

The individual named above has applied for sickness benefits under the Railroad Unemployment Insurance Act (RUIA).
This letter is notice of the Railroad Retirement Board's (RRB) right to reimbursement of these sickness benefits from any
sum payable on account of liability based on the injury or illness of the individual.
Section 12(o) of the RUIA (45 U.S.C. 362(o)) provides that sickness benefits are to be paid regardless of the liability of
any person to pay damages for the same infirmity. The provisions make it clear, however, that the RRB is to be
reimbursed from any sum or damages paid or payable on account of any liability based upon such infirmity. The RRB
does not have a subrogation claim, but its right to reimbursement is, upon notice, protected by a statutory lien. The
purpose of the provisions of section 12(o), as shown in its legislative history, is to provide the employee with income
while the personal-injury claim is pending, subject to the RRB's right to reimbursement if damages are paid. This is
your lien as prescribed in section 12(o) of the RUIA. In view of this lien you should see that the RRB is reimbursed if
any settlement is made with the individual. Otherwise, you may have to reimburse the RRB. To protect your interests,
please follow these instructions:
1.

If you have liability insurance, give this letter to your insurance company and notify the RRB of the complete name
and address of the insurance company by completing and returning the enclosed Form ID-30K-1. If you have any
agreement whereby a third party may have assumed liability, make sure that the third party knows about this notice.

2.

If it appears that through legal action or out-of-court settlement, a sum or damages may become payable for
personal injury to the individual, please ask the RRB by letter or telephone how much has been paid in sickness
benefits. Address your inquiry to the Office of Programs - Operations, Claims Adjustment and Settlement Section, at
the address and telephone number shown below. If the inquiry is received before 2:00 P.M. (Central Time), it will
normally be answered the next business day.

3.

If a sum becomes payable for personal injury, make sure that any amount due in reimbursement for sickness
benefits is withheld and paid to the RRB. Regulations require that you notify the RRB within 5 days of a settlement
or judgment and that you pay the RRB the amount withheld to satisfy the lien within 30 days of the settlement or
judgment. Please report the amount of the personal injury settlement by completing the enclosed Form ID-30K-1
and send it to the RRB with your remittance. Amounts that are not paid within 30 days are subject to interest
charges from the date of settlement or judgment.

If the individual has received, or is to receive, worker's compensation, please contact the RRB. You are not to withhold
and pay to the RRB any of the worker's compensation payments; but the RRB will need to know about them.
RRB OFFICE HANDLING INQUIRIES IN PERSONAL INJURY SETTLEMENT CASES
U.S. Railroad Retirement Board
Office of Programs - Operations
Claims Adjustment and Settlement Section
844 North Rush Street
Chicago, Illinois 60611-1275
Telephone Number: 312/751-4820
Facsimile Number: 312/751-7185
Enclosure
Form ID-30K-1

ID-30B2 (08-17)