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School Employee, Teacher and Public Employee Disability Benefits: When Do You File and What Should You Know?

December 17, 2021

The process for filing disability under all three state systems is quite similar. To file, you would contact your retirement system and ask for a disability application packet to be sent to you (the OPERS application is available online at www.opers.org/disability). All applications require that your Attending Physician certify your disability on a specific report form and that your employer complete a report regarding your prior employment. You will also need to provide information regarding your disability and why you feel you are unable to continue working. If you have worked in more than one of the three systems, you must file in the system where you have the most credits. The time requirements for returning the parts of the application are very important and must be complied with or your application may be dismissed. Once the retirement system receives your application, it will be forwarded for review by their medical review organization. You will be asked to be examined by a physician of their choosing. That physician will make a recommendation as to whether your benefits should be approved or denied. Ultimately, the retirement board will vote to accept or deny your claim and you will be notified of this decision, in writing, by mail.

You have extremely short deadlines for filing appeals of these claims if they are denied. You do not want to delay in contacting representation if you are denied, and we recommend retaining counsel prior to filing your application to put you in the best position for submitting a complete and appropriate disability application. You are entitled to one appeal of a disability denial, which goes before the retirement board. If that appeal is denied your options are either to pursue the claim into Court or, if you have time within the one or two-year filing requirement, to file a new claim alleging new disabling impairments or worsening of a previously alleged impairment.

School Employees Retirement System of Ohio Disability Claims: There are two plans for disability benefits with the School Employees Retirement System of Ohio - the New Plan (for those who became members on or after July 29, 1992) and the Old Plan (for those who were members before July 29, 1992, unless you exercised a one-time option to switch to the new plan.) Under the Old Plan, you must file for disability prior to age 60. Under both plans you must have 5 years of service credit to file for disability and you must file your disability application no more than 2 years from the date that your contributing service ended. You must have a condition or conditions that prevents you from working in your own SERS-covered job. Moreover, you will not be eligible to file for disability for any condition that resulted from your commission of a felony or that occurred after your employment ended. You will also be ineligible to file for disability if you withdrew your funds from your retirement account or elected to receive a service retirement benefit. Once your complete application package is received by SERS, they will contact your employer to obtain information on your most recent job duties and payroll information. After sending you to see an SERS-appointed doctor, the SERS retirement board's medical advisory committee or the chair of the committee will review the doctor's report and your complete application package and make a recommendation to the Board either to approve or deny your claim. Under current standards, you are provided 15 days from the date on the notice of denial to file your notice of intent to appeal the Board's decision. The Board then must receive your additional evidence in support of the appeal within a specified period of time. You may request a personal appearance before the board with legal counsel and/or your doctor - but this request must also be submitted within 15 days of the Board's denial of your application.

State Teachers Retirement System of Ohio Disability Claims: There is also an old and a new plan for disability in the STRS system based on whether you were a member before July 29, 1992. For anyone hired after June 30, 2013, you must have at least 10 years of qualifying service credit with STRS. In Ohio, in order to be eligible to file for disability, your application must be received within one year of the last date you contributed to service in any of the three state retirement systems. If you were a member on or before June 30, 2013, you need only have 5 years of qualifying service credit and you are given two years to file a disability application. You must also file your application before you turn age 60 and not be receiving service retirement benefits. In order to be eligible for disability benefits - you must have a medical condition or conditions that prevents you from performing the duties of your occupation as a teacher. Once you receive the application package from STRS, the Report by Employer must be returned to STRS with a copy of your most recent official job description. The attending physician statement must be completed by a medical doctor (M.D.) or a doctor of osteopathic medicine (D.O.) - a report from a nurse practitioner or a psychologist will not be acceptable. That doctor must have examined you within the last two months. Your doctor must certify that your medical condition is and will continue to be disabling for at least 12 months from the date STRS receives the application. For applications received on or after June 7, 2019, the doctor must be a medical specialist - that is - not a primary care physician, but someone who has completed further education to specialize in the treatment of your disabling condition. If your application is denied, you have only 15 days from receipt of the denial notice to submit notice of your intent to appeal with notice that you intend to submit additional medical evidence contrary to the findings of the independent medical examiner(s), as well as notice if you are requesting an in-person appearance before the board, with or without legal counsel. You will then have a short period of time to submit your additional medical evidence after your notice of intent to appeal is filed. If your appeal is denied, your recourse is to file a claim in Court or, if you have additional time remaining, to file a new claim alleging a new disabling condition or worsening of a previously alleged impairment.

Ohio Public Employee Retirement System Disability Claims: Under this system, an applicant has two years from their last date of contribution to file an application for disability benefits. If you apply for disability benefits on or after January 7, 2013, then your application will initially be evaluated under an “own occupation” disability standard - meaning whether you are physically or mentally incapable of performing the duties of your last public employment position. Your condition must be permanent (that is defined as expected to last for a continuous period of at least one year following the date of filing.) You will continue to be evaluated under the own occupation standard for the first three years you receive disability benefits (if your claim is approved.) However, after three years, OPERS will review your claim under an “any occupation” standard and you will have to show that your medical condition(s) prevents you from the duties of any position that you are qualified to do, reasonably found in your region, and that replaces at least 75% of your inflation-adjusted final average salary (FAS). If you are filing under the Original Plan (a member before July 29, 1992) Group A or B, you must file for disability before age 60. If you are in the Original Plan Group C, you must file for disability before age 62. If you are in the revised plan, you can apply at any age. If your claim is denied, you have 30 days from the date of notice of denial to appeal the decision. You then must, within 45 days, submit a completed Report of Physician along with additional objective medical evidence in support of your appeal.

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