N.J. Admin. Code § 17:1-7.10

Current through Register Vol. 56, No. 23, December 2, 2024

Section 17:1-7.10 - Ordinary disability applications; medical examinations

(a) Applicants for disability retirement shall submit with their applications all the medical information they can supply relative to their disability, including reports of their personal physicians and consulting physicians, hospital records, diagnostic test results, and any other medical information which would assist the Medical Review Board and the Board or Commission of the retirement system in determining eligibility of the applicants for disability retirement. The Disability Review Section shall forward the applications and the accompanying medical information to the Medical Review Board.

1. The applicant must submit all required documentation within six months of submitting the disability retirement application, or the disability retirement application will be cancelled. The member will then be required to complete a new disability application for a future retirement date.

2. If additional documentation that existed at the time of the independent medical examination (IME) is submitted after the IME, the applicant will be charged for the cost of the addendum to the disability retirement application.

(b) If the medical information supplied by the applicant is sufficient for the Medical Review Board to make a medical recommendation, it shall return the case to the Disability Review Section with its recommendation. If the Medical Review Board deems that the medical information supplied by the applicant is not sufficient for it to make a medical recommendation, it shall advise the Disability Review Section to arrange to have the applicant examined by a physician or physicians under contract with the Division to perform disability examinations, or to obtain additional information needed to make its medical recommendation.

(c) The Board or Commission that governs the pension fund or retirement system may request that an applicant be examined or reexamined by a physician or physicians under contract with the Division or that additional information be obtained, if it deems that the medical information available is insufficient to make a decision on the eligibility of the applicant for ordinary disability retirement.

(d) All accidental disability retirement applicants are required to undergo an IME after all medical documentation has been submitted.

(e) The Division reserves the right to require a member to sign a sworn certification that no underlying condition existed related to the disability for which the member is seeking a benefit and that all available medical reports related to the disability have been disclosed to the IME prior to the examination.

(f) A member filing for any type of disability retirement shall not file a separate application for any other type of retirement while an ordinary or accidental disability application is pending.

(g) If a disability retirement application is denied by the Board and the applicant qualifies for any other retirement benefit, the applicant will be required to amend the application for retirement for that benefit. If the applicant amends the application for retirement within 30 days of the Board's decision, the applicant may retain the retirement date designated on the disability retirement application.

(h) The member's disability retirement application will be processed on the basis of the medical conditions described on the disability retirement application submitted. If the disability retirement application is denied, the member may file an appeal within 45 days, based on the medical conditions described on the original application.

(i) If a disability retirement application is denied by the Board and the applicant wishes to reapply for a disability retirement based on a new incident date or different or additional medical condition, the applicant will be required to submit a new application for retirement with a new retirement date. The applicant must also continue to meet the requirements of N.J.A.C. 17:1-6.4(a). All supporting documentation required must be submitted in support of the new medical conditions listed on the application.

(j) Members who are granted an accidental disability retirement benefit will receive certification of the award and will be advised that they are responsible for notifying the Division if the disabling condition improves enough to allow the member to return to gainful employment, or if the member becomes employed again. This certification must be signed and returned to the Division before any retirement benefits will be paid.

N.J. Admin. Code § 17:1-7.10

Amended by 48 N.J.R. 1306(a), effective 6/20/2016