Alternative Record for Illnesses Claimed to be Work-Related OMB No. 2130-0500 Mobile App
This Alternative Record for Illnesses Claimed to be Work-Related form is used to monitor national rail safety.
How does it work?
If there is an employee that claims to have received an illness caused by work-related issues, have this digital form filled out and submitted to the Federal Railroad Administration. This form is a digital form that you can download on your mobile smartphone or tablet, and filled out and submitted without the need of pen or paper.