Form Tpd-App - Discharge Application: Total And Permanent Disability
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8DISCHARGE APPLICATION: TOTAL AND PERMANENT
OMB No. 1845-0065
Form Approved
DISABILITY
Exp. Date 09/30/2019
William D. Ford Federal Direct Loan (Direct Loan) Program / Federal Family
Education Loan (FFEL) Program / Federal Perkins Loan (Perkins Loan)
Program / TEACH Grant Program
TPD-APP
This is an application for a total and permanent disability
If you are granted a discharge based on SSA
discharge of your Direct Loan, FFEL, and/or Perkins Loan
documentation, we will monitor your status during a 3-year
program loan(s), and/or your Teacher Education Assistance
monitoring period. Your discharged loans or TEACH Grant
for College and Higher Education (TEACH) Grant Program
service obligation may be reinstated if you do not meet
service obligation.
certain requirements, as explained in Section 6 of this form.
Throughout this application, the words “we,” “us,” and
Physician Certification
“our” refer to the U.S. Department of Education.
You may qualify for discharge by having a physician
Make sure that Section 2, Section 3, and (if required)
complete Section 4 of this application. The physician must
Section 4 include all requested information. Incomplete or
certify that you are unable to engage in any substantial
inaccurate information may cause your application to be
gainful activity (see definition in Section 5) by reason of a
delayed or rejected.
medically determinable physical or mental impairment that:
To qualify for this discharge, you must submit
1. Can be expected to result in death;
documentation from one of the following sources:
2. Has lasted for a continuous period of at least 60
1. The U.S. Department of Veterans Affairs (VA) OR
months; or
2. The Social Security Administration (SSA) OR
3. Can be expected to last for a continuous period of at
least 60 months.
3. A physician's certification in Section 4 of this form
If you are granted a discharge based on a physician's
Except for VA or SSA determinations described below, a
certification, we will monitor your status during a 3-year
disability determination by another federal or state agency
monitoring period. Your discharged loans or TEACH Grant
does not qualify you for this discharge.
service obligation may be reinstated if you do not meet
certain requirements, as explained in Section 6 of this form.
U.S. Department of Veterans Affairs Documentation
Important Tax Information
If you are a veteran who has been determined by the VA
to be unemployable due to a service-connected disability,
Loan amounts discharged due to total and permanent
you may qualify for discharge by providing documentation
disability may be considered taxable income by the Internal
from the VA showing that you have received one of the
Revenue Service (IRS). Contact the IRS for more information.
following two types of VA disability determinations:
How to Designate Someone to Represent You
1. A determination that you have a service-connected
disability (or disabilities) that is 100% disabling.
If you wish to designate an individual or organization to
2.
A determination that you are totally disabled based
represent you in matters related to your total and
on an individual unemployability rating.
permanent disability discharge request, you must complete
You do not qualify for discharge based on a VA disability
the Applicant Representative Designation: Total and
determination if your disability is not service-connected.
Permanent Disability form. You may obtain this form from
our Total and Permanent Disability Discharge Servicer (see
Social Security Administration Documentation
below for contact information).
If you are eligible for Social Security Disability Insurance
(SSDI) or Supplemental Security Income (SSI), you may
WHERE TO SEND YOUR COMPLETED APPLICATION AND
DOCUMENTATION
qualify for discharge by providing a copy of your notice of
award or Benefits Planning Query (BPQY) from the SSA. You
U.S. Department of Education - TPD Servicing
only qualify for a discharge based on this documentation if it
P.O. Box 87130
shows that your next scheduled disability review will be 5 to
Lincoln, NE 68501-7130
7 years or more from the date of your last SSA disability
Fax: 303-696-5250
determination.
IF YOU NEED HELP COMPLETING THE APPLICATION
If you want to submit a BPQY but do not have one,
contact the SSA office that issued your award and request
Phone: 1-888-303-7818 (TTY: dial 711, then phone no.)
form SSA-2459. You may also request a BPQY by calling
Email:
1-800-722-1213 or by visiting
Website:
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