Québec Pension Plan– Forms concerning disability

  • Our PDF forms can be printed and the majority of them can also be completed on screen. Some documents are not available online but can be ordered.
  • There are several ways to obtain our forms.

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, 837 kB
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    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.

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: January 2016.

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.
RRQ-004 form. Last update: January 2016.
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