Application for Performance of Duty Disability Retirement (RS6047-A) For NYSLRS correction officers 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your NYSLRS ID and Social Security Number. Ensure accuracy as this information is crucial for processing your application.
3. In the 'INFORMATION ABOUT YOU' section, check off the benefits you are applying for, such as heart-related issues or HIV. This helps categorize your claim effectively.
4. Fill in your personal details including name, date of birth, address, and contact numbers. Make sure to type clearly or print plainly.
5. Indicate your length of service and payroll status. If you are not receiving a salary, provide an explanation in the designated field.
6. Detail your medical conditions and list any doctors who have treated you. Use additional sheets if necessary to provide comprehensive information.
7. Document any hospitalizations and occurrences related to your disability claim. Be thorough in describing these events in Section 14.
8. Finally, ensure that you sign the application on the reverse side before submitting it to the Retirement System in a marked envelope.

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