Disability

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Our PDF forms can be printed and the majority of them can also be completed on screen. However, you must have Acrobat Reader , version 7 or later.  Some documents are not available online but can be ordered.

There are several ways to obtain our forms.

Application for a Disability Benefits

Use this form to apply for a disability pension or a pension for a disabled person's child. Complete section 1 of the Medical Report form included with the application and then give it to your attending physician.

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B-071, 18 pages, 579 KB
janvier 2012

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Application for Review

Use this form to apply for a review of a decision rendered by the Régie with respect to a disability pension or a pension for a disabled person's child.

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B-026-2, 2 pages, 232 KB
octobre 2009

Medical Report (For physicians only)

This form is to be used by the physician in order to submit a report to the Régie about the state of health of a person who has applied for a disability pension.

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B-076, 6 pages, 247 KB
janvier 2012

New Application for a Disability Pension

Use this form to make a new application for a disability pension if your disability pension ended fewer than 24 months ago. It also allows you to apply for a pension for a disabled person's child if you have any children under 18 years of age.

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B-004, 6 pages, 418 KB
février 2012

Consent and Application for Remittance of Disability Benefits to an Insurer (For the use of insurance companies only)

Insurance companies can use this form to obtain an applicant's consent to the reimbursement of disability benefits to the insurer. This form is also used to file the insurer's application for remittance.

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RRQ-004, 2 pages, 77 KB
février 2008

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