DISABILITY RETIREMENT ALLOWANCE

Transcription

1 DISABILITY RETIREMENT ALLOWANCE Eligibility p.1 Employer Responsibility p.1 Employee Responsibility p.4 SURS Responsibility p.9 Rev

2 ELIGIBILITY DISABILITY RETIREMENT ALLOWANCE (DRA) One or more licensed and practicing physicians appointed by or acceptable to the Board must certify that the applicant has a medically determinable physical or mental impairment which would prevent him or her from engaging in any substantial gainful activity, or which has lasted or can be expected to last for a continuous period of more than 12 months. The terms medically determinable physical or mental impairment and substantial gainful activity shall have the meanings ascribed to them in the Social Security Act. Payment begins on the first day of the month following expiration of the disability benefit and continues until the physical or mental impairment no longer prevents the participant from engaging in any substantial gainful employment, the participant dies, or the participant elects to receive a retirement annuity. EMPLOYER RESPONSIBILITY The responsibility of SURS-covered employers at the time of application for DRA is the same under the Traditional and Portable plans. The Self-Managed plan does not include the DRA benefit. The employer must submit an Employer Summary Request Report (Figs. 1 & 2). The Employer Summary Report is a computer-generated form showing only the fields of information that are relevant to a particular retiring employee. 1

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5 Part A Member Information SURS will have completed this part of the form (Fig. 2) when the disability claim was entered into our system: employee s name, Social Security number, and date disability is to expire. Part B Employer Information 1. Enter the employment status of the retiring employee (Fig.2). If the employee has any time as a Police/Firefighter, enter the effective date he or she became a police/firefighter and the date that status ended (ending date). 2. Enter the actual date of the employee s termination ( usually the same date the disability expired, which is provided in Part A). 3. Enter the Last Payroll Date as the last day of the last payroll period for which the employee was paid. 4. Enter the number of vacation days that were paid at termination and the amount paid for these vacation days. 5. Enter the number of unpaid/unused sick leave days at termination. 6. If the employee transferred to you from another agency, indicate whether you accepted transfer of the employee s sick leave that was earned while he/she was employed at the other agency. If transfer of sick leave was accepted, enter the number of workdays that were transferred and the name of the employer where the sick leave was earned. EMPLOYEE RESPONSIBILITY Prior to expiration of the disability benefit, SURS will mail the participant a notification of benefits and options available, as well as the DRA application (Figs. 3,4,5,&6). If the member believes he or she will be eligible, they must complete and return the application to SURS immediately. Once eligibility has been established and the benefit begins, the member must submit continuing evidence of their disability as often as requested. If eligible to be gainfully employed, the member should notify SURS immediately. 4

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10 SURS RESPONSIBILITY When SURS receives the completed application, the employee s file will be directed to a member of the Disability Process Team. If any information is missing or is not filled out correctly, SURS will contact the employee concerning what remains to be done. The survivor refund letter may be mailed at this time if the member is in the Traditional Retirement Plan. The Medical Claims Processor will review the medical documentation and determine, based on this information, whether the member is eligible for the DRA. Any needed additional information will be requested from the doctor and the member will receive a letter. If the DRA is approved, the claim will be sent to a Member Service Representative to calculate, then to the Insurance Team, and finally to the Pay Benefits Department for payment. An Awards Letter is mailed to the member at this time. If the disability claim is denied, SURS will inform the employee in writing and instruct him/her what needs to be done if he/she disagrees with the decision. Once approved, SURS will pay the DRA benefit on the first working day of the month. It is SURS s responsibility to pay DRA recipients accurately and on a timely basis. It is also SURS s responsibility to monitor and recheck all DRA claims on a regular basis. 9

11 DISABILITY RETIREMENT ANNUITY PROCESS EMPLOYER 1. Submit to SURS Employer Summary Request Report, if necessary. EMPLOYEE 1. Complete the application. 2. Mail all seven parts back to SURS. 3. Submit continuing evidence of their disability as often as requested. 4. If eligible to be Gainfully Employed should notify SURS immediately. SURS Data Entry receives Application for Disability Retirement Annuity And sends on to the Medical Claims Processor. Medical Claims Processor reviews all documentation for accuracy and completion. Decision is made based on all information received. If additional information is necessary, SURS will Once the claim is calculated, the Pay contact the employee or employer. Benefits Department will process the check and mail to the employee on the If approved, the claim will be sent to the first working day of the month. claims processor to calculate. If denied, member will be contacted and given the SURS will continue to monitor the 10 opportunity to appeal the decision or examine other alternatives. employees disability on a regular basis.