CEO – RTW 101 SERIES Disability Retirement Services Overview CEO – RTW 101 SERIES Disability...

CEO – RTW 101 SERIESCEO – RTW 101 SERIESDisability Retirement Services Disability Retirement Services

OverviewOverview

Presented by Presented by Shari AltmarkShari Altmark

Disability Retirement Services Division Disability Retirement Services Division SupervisorsSupervisors

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Terms Service-connected Disability

Eligible from 1st day of employment Must be permanently disabled Must have a direct causational link to the

workplace

Nonservice-connected Disability Must have at least 5 years of service (60 months) Must be permanently disabled No direct link to the workplace

Service Retirement Concurrent with Disability Application Waive reinstatement rights

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Comparison Workers’ Compensation vs. Retirement Law Workers’ Comp. system provides different benefits

from County Retirement System: Temporary Disability Permanent Disability Rehab or supplemental job displacement benefit

LACERA’s Board of Retirement not bound by Workers’ Comp. system; not party to Workers’ Comp. Decisions

LACERA is separate, legal entity – findings made in Workers’ Comp. cases are not binding on County Retirement System

LACERA grants only Permanent Incapacity

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Contents Within Employee’s Disability Retirement Contents Within Employee’s Disability Retirement PacketPacket

Disability Retirement BrochureDisability Retirement Brochure Disability Retirement Eligibility and Application InstructionsDisability Retirement Eligibility and Application Instructions Application for Disability RetirementApplication for Disability Retirement Physician Statement for Disability RetirementPhysician Statement for Disability Retirement Claims Against Third Parties FormClaims Against Third Parties Form Authorization to Obtain and Release Records and Authorization to Obtain and Release Records and

Information, signed by applicantInformation, signed by applicant

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Contents Within Employer’s PacketContents Within Employer’s Packet Disability Retirement brochureDisability Retirement brochure Disability Retirement Eligibility and Application Disability Retirement Eligibility and Application

Instructions (Department version)Instructions (Department version) Application for Disability RetirementApplication for Disability Retirement

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EMPLOYEEAPPLICATION

EMPLOYER APPLICATION

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Department’s Responsibilities G.C. 31721 Department may file an application on behalf of the

employee

Employee’s Options Comply with Employer Application File Employee Application Do Nothing

LACERA’s Responsibilities Within 30 days notify employee department has filed an

application on their behalf If applicant complies with Employer Application, they should

submit Authorization to obtain and release records and

information (DIS 104) Claims Against Third Parties (DIS 117) Missed Medical Appointment form (pg. 8)

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LACERA’s Responsibilities (cont’d) Upon receipt employer application is

completed and processed Once the Board of Retirement takes action, the

department is notified and an effective date for the Salary Supplement is established

If the application is denied, appeal rights are not affected

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LACERA’S ROLELACERA’S ROLE Initial application includes signed

information release from employee Allows LACERA to:

Retrieve all Workers’ Comp records from TPA Retrieve additional records from outside

sources Kaiser/personal physicians/chiropractors/therapists

Retrieve personnel records Active, retired or deceased

Ask for additional documentation/information as necessary

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LACERA’S ROLE (cont’d)

Interview member to get timeline Job classifications during career

Prior job assignments and overall duties Current job assignment and duties

Focus on specific job duties within last assignment Physical requirements

Were there modifications provided to the applicant? If offered, when? (before or after retirement) If so, were they temporary or permanent?

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LACERA’S ROLE (cont’d)

Chronological history of injuries/illnesses Mechanics of the injury

Where did it happen? What did they feel? Were there any witnesses?

Reporting and care after the injury/illness Follow-up treatment, if any Current symptoms and reason they cannot

return

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LACERA’S ROLE (cont’d)

Current symptoms/level of activity Witness statements

Contact supervisor Confirm “actual” job duties/physical requirements Obtain information regarding injury/illness Applicant’s current condition/ability to perform

duties Contact co-worker(s)

Obtain information regarding injury/illness Query personal awareness of applicant’s condition

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LACERA’S ROLE (cont’d)

Contact RTW Coordinator Confirm medical leave status Confirm past and present work

restrictions Research accommodation, if any

Temporary or permanent

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LACERA’S ROLE (cont’d)

Medical opinion from LACERA specialist Mechanism of injury History of injury/illness and treatment rendered Confirm or refute permanent incapacity Advise on any permanent work restrictions Comment on ability to perform permanent

modified position Confirm or refute job causation

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LACERA’S ROLE (cont’d)

Contact RTW Coordinator again Address department’s ability to accommodate

LACERA doctor’s permanent work restrictions If so, what would the duties be? If not, why not?

*** Response needs to be in writing!!! Email, letter or fax

Important that person giving response is authorized to make statement

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Reasonable Accommodation Workers’ Compensation versus

Disability Retirement Workers’ Comp (Form of Voc. Rehab)

In Worker’s Pre-Injury Job Class (Modified Work) In New Job Class (Alternative Work)

Disability Retirement In Applicant’s Pre-Injury job class, therefore

Applicant not Permanently Incapacitated In new job class, but only after found to be

Permanently Incapacitated (re-employment plan pursuant to §31725.65)

* Both are with employer as of date of injury

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Employee working within Reasonable Accommodation Workers’ Compensation

Within worker’s job class (Modified Work) Employer may provide modification to applicant’s

assignment or offer another assignment in job class Written offer If worker accepts offer, and accommodation is

successful, a disability retirement application is avoided

In new job class (Alternative Work) Employer provides permanent accommodation in

new job class Written offer to worker Worker either returns to work or may file a

disability application

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Employee working within Reasonable Accommodation (cont’d) Disability Retirement

In Applicant’s Pre-Injury job class, Applicant not considered Permanently Incapacitated

Board of Retirement (BOR) has fiduciary duty to independently investigate and determine availability of reasonable accommodation

BOR decision not dependent on whether employer has actually offered accommodation to applicant

BOR is a separate legal entity, empowered to make its own finding of fact

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Employee working within Reasonable Accommodation (cont’d) Disability Retirement

If BOR determines reasonable accommodation is available within applicant’s pre-injury job class:

Applicant Is Not Permanently Incapacitated

Disability Retirement Is Denied

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Questions RTW Cannot Ask

What medical conditions did the employee apply for?

Proposed date of service retirement? What is the Board recommendation? What do we think the Board action will be? How much will employee make if they get

the disability retirement?

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Questions RTW Can Ask

Time frame to process Status of case Name of Investigator Service retirement date, once

confirmed by Board

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Processing Timeframes Minimum amount of time to process a

disability application is 9 to 12 months Assuming only one claim of disability involved; Extra time is needed for extensive investigation

or delays in obtaining medical evidence; or Additional medical specialties evaluations are

needed

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SUPPLEMENTAL DISABILITY ALLOWANCE

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Supplemental Retirement Allowance How do we retain disabled members in County

Service? County Departments face critical budget cuts, lay offs,

and hiring freezes. Salary Supplement is the process of retaining experienced employees in rehabilitation positions.

Government Codes §31725.5, 31725.6 and 31725.65 Applications are to be treated like any other application;

the criteria is that the applicant must be found disabled from the ORIGINAL position.

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Section 31725.5 Applies to nonservice-connected

disability retirements only Section 31725.6 and/or 31725.65

Applies to service-connected disability retirements only

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Department’s Responsibilities Department may file an application on behalf of the

employee Confirm the employee has applied for disability

retirement benefits with the salary supplement Department may keep employee in current job

classification while performing new job duties during the application process

Department may place an employee on “Y-Rate” with CEO approval pending the Board of Retirement’s approval

The employee’s salary remains unchanged during the disability retirement application process

Submit supporting documentation with the application including the lower item job classification, essential job functions and salary

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Conditions of Supplemental Allowance Contingent on:

The offer of a permanent position with a lower salary schedule which accommodates the employee’s permanent work restrictions

The acceptance of this position by the employee

Engaging the Process The Disability Retirement Services Division

works closely with County Departments’ Human Resource managers and Return to Work Coordinators to facilitate a better awareness of the Salary Supplement options.

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Member’s Future Earnings The calculation is based upon the member’s actual

earnings at the time the benefit is granted. The calculation does not allow for future item raises and cost-of-living increases.

The member can be promoted in the new position career chain. When the member receives a pay raise, it is reviewed against the original item number salary and the salary supplement allowance is lowered accordingly. If the new item number salary exceeds the original position’s salary, the Salary Supplement allowance stops.

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Example #1 – Deputy Sheriff I permanently demoted to Dispatcher:

Previous position monthly salary = $6077.36 NEW position monthly salary = $3996.82 Difference in salary = $2080.54 SCD Supplemental Retirement Allowance $2080.54 SCD Benefit if member retires (50% FAS) $3038.54

Savings to system $ 958.00

SCD SUPPLEMENTAL RETIREMENT CALCULATION

(GC §31725.65)

NSCD Supplemental Retirement Calculation

(GC §31725.5)

Example #2 – Supervisory Staff Nurse permanently demoted to Intermediate Clerk:

Previous position monthly salary = $8013.52 NEW position monthly salary = $2878.00 Difference in salary = $5135.52 NSCD Supplemental Retirement Allowance $2706.12 NSCD Benefit if member retires (1/3 FAS) $2706.12

Difference, not paid by supplement $2429.40 Reason: Supplemental Allowance cannot exceed maximum

NSCD benefit allowed

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Plan E to DTransfers

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How it Works?Frequently Asked Questions

QUESTION:To receive a Disability Retirement as a Prospective Member is there a time requirement?

Yes, completion of two continuous years of active service after his or her most recent transfer date, or

Earned five years of retirement service credit under Retirement Plan D after his or her most recent transfer date. (Sec. 31494.5(e).)

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How it Works?Frequently Asked Questions

QUESTION:

When is a prospective transferee eligible for a SCD? A prospective Plan D transferee must satisfy one of two

(2) waiting periods in order to apply for a disability retirement.

1. Complete two continuous years of active service after his or her most recent transfer date, or

2. Earn five years of retirement service credit under Retirement Plan D after his or her most recent transfer date. (Sec. 31494.5(e).)

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How it Works?Frequently Asked Questions

QUESTION:When is a prospective transferee eligible for a Nonservice-connected disability retirement?

One is eligible to apply for a nonservice-connected disability under Plan D, regardless of the date of injury, once they have a minimum of five years of County service credit, and have met one of the Plan D service credit options previously listed.

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How it Works?Frequently Asked Questions

QUESTION:Can a paid leave of absence be “active service”?

A paid leave of absence or part-time work schedule is nevertheless considered “active service,” unless “the leave of absence or part-time service is necessitated by a pre-existing disability, injury, or disease.” (Sec. 31494.5(g)(1).) (Emphases added.)

Cynthia LauLegislative Affairs Officer

AB 1902

Comparison of Plan E and Plan D –

New Hire Elects One

Contributory Vesting Final Comp Active Disability/Death Benefits

Retirement Benefit

Plan E No 10 yrs. 3 yrs. No Lower

Plan D Yes 5 yrs. 1 yr. Yes Higher

Prospective Plan Transfer (PPT)D E

E DMay transfer back and forth – may transfer

between plans no more than once every 3 years while in period of “active employment.”

What happens if member is disabled while in Plan D?To apply for disability retirement, PPT transferee must have either:Two yrs. continuous active service after transfer, or Earned 5 yrs. service credit under Plan D after transferRequirements prevent Plan E member from transferring to Plan D and immediately filing for disability retirement.

Issue – Member may be disabled, but ineligible to apply for LACERA disability retirement due to failure to meet 2 yr./5 yr. requirement.

County Long-Term Disability Plan (LTD)

• Provides benefits for Plan D and Plan E members who are sick or injured and cannot work.

• Benefits expire at age 65, or when no longer disabled.

• After 2 yrs. on LTD, County requires Plan D (contributory) members to file for retirement in order to continue LTD.

• LTD benefit is offset (reduced) by amount of retirement allowance

• County does not require Plan E members to file for retirement after 2 yrs. to continue LTD.

Under certain circumstances, it may be more advantageous for the affected member to continue LTD benefits under Plan E than under Plan D.Influencing factors include: Member’s ageAmount of service creditStatus of LTD Health Insurance

Currently (Pre-AB 1902)To continue LTD benefits, a disabled Plan D PPT transferee who fails to meet 2 yr./5

yr. requirement may only apply for a service retirement.

Effective January 1, 2011 (Post-AB 1902)

Disabled Plan D PPT transferee who fails to meet 2 yr./5 yr. requirement has options: May transfer back to Plan E and continue under the County LTD programOr may file for a service retirement under Plan D

How can you help?

Be aware of this new provision and communicate it to employees. Effective 1-1-11.

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Obstacles LACERA faces

Timeliness of response to Retirement Board once doctor’s opinion is received

Workers’ Comp vs. Disability Retirement Open labor market vs. independent

classification Restrictions governed by old law Retirement Board policy changes Turnover within RTW divisions

NOTE:

Plan D members electing deferred retirement are ineligible for LTD benefits.

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Resources If you have questions, call (626) 564-2419 Log on to www.lacera.com

Click “Benefits” tab (upper right hand side) Click “Active Member” tab (left side) Click “Disability Retirement” (lower left side)

Contact the individual investigator (see attached listing)

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DISABILITY RETIREMENT SERVICES DIVISION TELEPHONE ROSTER NAME INTERNAL EXT. OUTSIDE (626) E-MAIL

Debbie Juul, Manager 4462 564-2401 djuul@lacera.com

James Castranova, Sr. Staff Counsel 4382 564-2456 jcastranova@lacera.com

Penelope Rodriguez, Sr. Secretary 4403 685-4622 prodriguez@lacera.com

SUPPORT TEAM

Laura Gonzalez, Supervisor 2323 564-2323 ldelgado@lacera.com

Roena Bernard, Applications 2338 564-2419 rbernard@lacera.com

Sandra Cortez, Medical Appointments 4618 685-4618 scortez@lacera.com

Hank Osmundson, Word Processing 3587 564-6000 ext. 3587 hosmundson@lacera.com

Melissa Norris, Word Processing 3498 564-6000 ext. 3498 mnorris@lacera.com

Kathleen Medina, Appeals 4419 564-2339 scortez@lacera.com

Mary Ortiz, Appeals 2420 564-2420 mortiz@lacera.com

Bonnie Weise, Appeals 3499 564-2499 bweise@lacera.com TEAM SHARI (1)

Richard Schlosser, Supervisor 4489 564-2489 saltmark@lacera.com

Andrew Demetroulis, Investigator 3537 685-4621 ademetroulis@lacera.com

Vickie Neely, Investigator 3528 685-4672 vneely@lacera.com

Anna Kwan, Investigator 3540 685-4627 akwan@lacera.com

Kerri Wilson, Investigator 3538 685-4624 kwilson@lacera.com

Debbie Semnanian, Investigator 3218 564-2418 dsemnanian@lacera.com

Maisha Coulter, Investigator 3539 685-4626 mcoulter@lacera.com

Maria Muro, Investigator 2454 564-2454 mmuro@lacera.com TEAM RICHARD (2)

Shari Altmark, Supervisor 4405 564-2405 rschlosser@lacera.com

Darren Huey, Investigator 3506 685-4636 dhuey@lacera.com

Debra Martin, Investigator 3217 564-2417 dmartin@lacera.com

Jim Alvarez, Investigator 4414 564-2414 jalvarez@lacera.com

Tamara Caldwell, Investigator 2415 564-2415 tcaldwell@lacera.com

Nichelle Porter, Investigator 3541 564-2441 nporter@lacera.com

Mercie Martinez, Investigator 2403 564-2404 mmartinez@lacera.com

CONFERENCE ROOM 2429 Intercom 02

FAX 564-6177 Effective 1/1/09