Régie des rentes du Québec

Québec Pension Plan– Forms concerning disability

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There are several ways to obtain our forms.

Québec Pension Plan

Application for Disability Benefits

Use this form to apply for a disability pension, a pension for a disabled person's child or the additional amount for disability for retirement pension beneficiaries. Complete section 1 of the Medical Report form included with the application and then give it to your attending physician.
B-071 form. Last update: April 2013.
  • PDF - Application for Disability Benefits (B-071) download, 18 pages, 619 kB
  • By mail: Application for Disability Benefits (B-071) add to cart

Application for Review of a Decision - Disability

Use this form to apply for a review of a decision rendered by the Régie with respect to disability benefits.
B-026-2 form. Last update: October 2009.

Medical Report (For physicians only)

This form is to be used by the physician to submit to the Régie a report on the state of health of a person who has applied for disability benefits.
B-076 form. Last update: January 2013.

New Application for Disability Benefits

Use this form to make a new application for disability benefits if your disability benefits ended fewer than 24 months ago. The form also allows you to apply for a pension for a disabled person's child if you have any children under 18 years of age (in the case of the disability pension only).
B-004 form. Last update: April 2013.

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.
RRQ-004 form. Last update: February 2008.
  • PDF - Consent and Application for Remittance of Disability Benefits to an Insurer (For the use of insurance companies only) (RRQ-004) download, 2 pages, 58 kB
  • By mail: Consent and Application for Remittance of Disability Benefits to an Insurer (For the use of insurance companies only) (RRQ-004) add to cart

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