Québec Pension Plan– Forms concerning disability

Online Document Transmission

Application for Disability Benefits Under the Québec Pension Plan

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: January 2018.
  • PDF - Application for Disability Benefits Under the Québec Pension Plan (B-071) download, 18 pages, 832 kB
  • By mail: add to cart
    Maximum: 75 copies

Medical Report (For physicians only) - Québec Pension Plan

This form is to be used by the physician to submit to Retraite Québec report on the state of health of a person who has applied for disability benefits.
b-076 form. Last update: January 2018.

Notice to disabled persons

This PDF document may contain barriers to accessibility. You can obtain assistance by calling us.

New Application for Disability Benefits under the Québec Pension Plan

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: November 2019.

Consent and Application for Remittance of Disability Benefits to an Insurer - Québec Pension Plan (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.

Important

By signing this form, you are agreeing to file an application subsequently for disability benefits with Retraite Québec. We recommend that you review the clauses of your contract with your insurance company because you may not be required to complete the form.

RRQ-004 form. Last update: November 2019.

Notice to disabled persons

This PDF document may contain barriers to accessibility. You can obtain assistance by calling us.
  • Top of page