TN 12 (01-14)

A. Form SSA-671, Railroad Employment Questionnaire

Use of the SSA-671 is optional. You should rarely use it. The SSA-671 provides information on railroad earnings and employment information, but this information is usually already available from application screens and interviewer questions reported on a report of contact (RPOC) screen.

B. Electronic data collection

SSA collects the railroad earnings and employment information on the following Modernized Claims System (MCS) Direct Application Data Entry (DADE) screens:

• Additional Benefits (ADDB)

• CL Railroad Employment (CLRR)

• NH Additional Benefits (NHAB)

• NH Railroad Employment (NHRR)

• SP Railroad Employment (SPRR)

C. Exhibit of SSA-671, Railroad Employment Questionnaire

 View PDF Version of Form SSA-671