Md. Code Regs. 22.06.02.02

Current through Register Vol. 51, No. 20, October 4, 2024
Section 22.06.02.02 - Statement of Disability
A. A Statement of Disability submitted to the Retirement Agency shall:
(1) Identify the mental or physical condition that is claimed to have permanently incapacitated the applicant for the further performance of the normal duties of the applicant's position;
(2) Give the applicant's consent to report for one or more independent medical evaluations at the request of the Retirement Agency; and
(3) Provide the information and documents requested by the Retirement Agency, including but not limited to:
(a) A report completed by the applicant's physician in the format required by the Retirement Agency;
(b) A written authorization for the release of medical records and personnel records to the Retirement Agency, medical board, and the physicians designated by the Retirement Agency;
(c) A copy of the applicant's position description that is signed and dated by the applicant's employer;
(d) Any reports of injury filed with the applicant's employer;
(e) Any disability determinations rendered by the Social Security Administration;
(f) The applicant's attendance record for the 12-month period preceding the submission of the Statement of Disability; and
(g) The applicant's most recent written employment performance evaluation, if any.
B. In addition to the requirements set forth in §A of this regulation, if accidental disability retirement is requested, a Statement of Disability shall:
(1) Identify:
(a) Every work-related accident that is claimed to entitle the applicant to accidental disability retirement; or
(b) If the applicant is in the State Police Retirement System or Law Enforcement Officers' Pension System, every work-related accident or work-related condition that is claimed to entitle the applicant to accidental disability retirement; and
(2) Provide any workers' compensation awards related to the claim for accidental disability retirement.
C. An applicant who, at the time of submission of a Statement of Disability, fails to request accidental disability retirement or fails to identify a work-related accident in accordance with §B of this regulation may not later request accidental disability retirement or submit a new claim for accidental disability retirement based upon a work-related accident that took place before the date the applicant submitted the Statement of Disability.

Md. Code Regs. 22.06.02.02

Regulations .02 amended effective 43:23 Md. R. 1280, eff. 11/24/2016