HOLIDAY SCHEDULE

Our office will be closed for the Christmas and New Year holidays starting December 24th and will reopen on Monday, January 5th.
Staff will be available on a limited basis on December 24th, 29th, 30th and 31st.

Non-Veteran Total and Permanent Disability Physicians / Optometrist Certification/Statement of Gross Income - Forms Download


Physician’s Certification of Total and Permanent Disability - DR 416 Form

Optometrist’s Certification of Total and Permanent Disability - DR 416B Form

Statement of Gross Income - DR 501A Form

Applicants who are Hemiplegic, Paraplegic, or require wheelchair use for mobility (except Quadriplegic) must file Form DR 501A along with their Physician/Optometrist Certification.

PDF Reader Required
Download a copy of Acrobat Reader to view the above PDF files.

Home Privacy and Use Policy Accessibility Statement Browser Troubleshooting Employment Feedback Contact Us Public Record Request Policy ADA Notice