La. Admin. Code tit. 58 § XVIII-1301

Current through Register Vol. 50, No. 9, September 20, 2024

Section XVIII-1301 - Qualifications for Disability Retirement

A. On behalf of the board of trustees, the executive director is authorized and directed to designate, under R.S. 11:219, outside physicians in any area of medical specialty and from any area of the state either to review case histories or to conduct regular or appeal examinations of disability retirement applicants and beneficiaries.

B. No disability benefits will be considered certified by the board of trustees until the board-designated physician provides sufficient information for the executive director to determine whether the applicant is eligible for disability benefits and the percentage of average final compensation due to the applicant. If the member qualifies for any exemption from the provisions of R.S. 11:221(A) through (C), findings of fact supporting the qualification for the exemption shall be included in the certification by the board-designated physician. For purposes of R.S. 11:2223(B), performance of his official duties shall have the same meaning as injury sustained in the line of duty for survivor's benefits purposes.

C. When evaluating a mental disorder, the board-designated physician shall physically examine the patient, and the physician's diagnosis shall conform to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), American Psychiatric Association (2013) or any subsequent revision thereof.

D. To be eligible for disability benefits under R.S. 11:2223(E)(2) for total loss of use of limb, a board-designated physician must certify that no effective function remains other than that which would be equally served by an amputation. The board-designated physician must also certify the date of the injury that caused the loss of the total use of the limb.

E. If an applicant fails to appear for a medical examination and the board-designated physician charges a cancellation fee, the applicant shall pay the cancellation fee. If the applicant fails to pay the cancellation fee, said fee, plus interest at the actuarial assumed rate of return calculated from the date of payment by the system to the board-designated physician, shall be deducted from any benefit amount determined to be due to the applicant.

F. If the board-designated physician's final certification decision is submitted when there are more than thirty days until the next board meeting, the executive director may, in his sole discretion, approve the disability retirement or file a written appeal on behalf of the board of trustees with the applicant. The executive director shall apply this procedure in a manner consistent with his fiduciary duty and shall report any approvals or appeals to the board of trustees at the next board meeting.

G. Every disability beneficiary shall complete an annual attending physician statement (AAPS) by May 1 for the first five years following the disability retirement and once in every three years thereafter until the earlier of the date the disability attains age 62 or reaches the equivalent age of regular retirement (which depends on age and actual years of service). After reviewing the AAPS, the executive director may require a disability beneficiary to undergo a medical examination by a board-designated physician. Payments to any disability beneficiary who has not yet attained the equivalent age of regular retirement who refuses to submit to a required medical examination by a medical board physician designated by the board of trustees, shall be discontinued until the beneficiary complies. Failure to comply within one year of the request shall result in revocation of benefits by the board of trustees via written notification sent to the disability beneficiary by the executive director.

H. Beginning on May 1, 2021, the benefits of every disability beneficiary who has not attained age sixty-two or reached the equivalent age of regular retirement who has not been certified by a board-designated physician as exempt under R.S. 11:221(A)(2), 222, or 223 who fails to submit the earnings statement required under R.S. 11:221(C) by May first, shall beginning on June 1, be discontinued, without retroactive reimbursement, until the statement is filed. If the earnings statement is not received by the end of the calendar year, the executive director shall notify the retiree that all his rights in and to his disability pension have been revoked by the board of trustees pursuant to R.S. 11:221(C)(1).

I. Retroactive payments of suspended benefits under R.S. 11:220 and 11:221 must be requested in writing. The disability beneficiary must explain why any paperwork required was not submitted by the due date. All retroactive payments must be approved by the board of trustees. No retroactive payments shall be made to disability beneficiaries whose benefits were revoked.

J. Any disability beneficiary subject to R.S. 11:221(D)(1) who receives a financial award solely as a result of his disability shall be required to provide proof of the gross financial award, along with all legal and court costs associated with the settlement. The system staff shall request the actuary to convert the lump sum financial award, net of any related legal fees and court costs, into a whole life annuity equivalent based upon board-approved interest, mortality, and unisex assumptions. The recipient's disability benefit shall be offset by an amount equal to the difference between the inflation-adjusted final average compensation used to determine the disability benefit and the sum of the maximum monthly benefit, whole life annuity equivalent, and other outside earnings under R.S. 11:221. Disability applicants shall disclose any financial awards or pending claims for financial award on the application for disability retirement or within three days of filing a claim. Disability beneficiaries shall submit information regarding financial awards on the notarized annual earnings statement. Disability beneficiaries' benefits shall be reviewed annually for offset until the earlier of the beneficiaries' date of death or date of conversion to a regular retirement benefit. The monthly benefit of any disability beneficiary who is overpaid due to failure to report outside benefits or awards subject to R.S. 11:221(D) shall cease until fully recouped by the system, including interest at the actuarial assumed rate of return and actuarial fees paid by the system in the calculation or collection of amounts.

La. Admin. Code tit. 58, § XVIII-1301

Promulgated by the Department of the Treasury, Board of Trustees of the Municipal Police Employees' Retirement System, LR 471897 (12/1/2021).

AUTHORITY NOTE: Promulgated in accordance with R.S. 11:2225(A)(1).