1. The employer must provide the following
information that will be considered by the Medical Board in its determination
for eligibility:
a. The job description and
duties of the member; §
25-11-113(1)(a)
b. Whether the employer has offered the
member other duties without material reduction in compensation; §
25-11-113(1)(a)
c. Whether the employer has complied with the
applicable provisions of the Americans with Disabilities Act in affording
reasonable accommodations that would allow the employee to continue employment;
§
25-11-113(1)(a)
and
d. In the case of an
application for duty-related disability benefits, the employer shall certify
whether, to the best of its knowledge, a physical injury was sustained from an
accident or a traumatic event caused by external violence or physical force
that occurred in the performance of duty. §
25-11-114(6)
2. The member shall submit medical evidence
of the disability to the Medical Board for review. The Medical Board may
require an independent medical evaluation or such other examination or report
as is necessary to determine the member's eligibility for benefits. Failure to
provide the requested information within 90 days of such request or refusal to
submit to an examination shall result in the member's application being
considered void. The executive director may extend the 90-day period if the
applicant can demonstrate that failure to submit to such examination or to
provide the requested information or report(s) was due to circumstances beyond
his or her control. §
25-11-113(1)(f)
To be considered eligible for disability benefits, the
Medical Board must certify to the Board of Trustees (i) that the member is
mentally or physically incapacitated for the further performance of duty, (ii)
that such incapacity is likely to be permanent, and (iii) that the member
should be retired.
The Board of Trustees does not automatically accept a Social
Security Administration disability determination as evidence of disability
benefit eligibility. If, however, a Social Security Administration disability
benefit determination has been received during the medical evaluation process,
such determination along with (i) the supporting medical documentation, (ii)
the condition upon which PERS disability benefits are claimed, and (iii) the
facts of the case will be taken into consideration as a part of the Medical
Board's independent evaluation and determination. §
25-11-113(1)(a)
3. For purposes of §
25-11-113,
medical evidence shall be defined as "objective medical evidence," which means:
reports of examinations or treatments; medical signs which are anatomical,
physiological, or psychological abnormalities that are observed and documented
by medical professionals; psychiatric signs which are medically demonstrable
phenomena indicating specific abnormalities of behavior, affect, thought,
memory, orientation, or contact with reality; or laboratory findings which are
anatomical, physiological, or psychological phenomena that are shown by
medically acceptable laboratory diagnostic techniques, including, but not
limited to, chemical tests, electrocardiograms, electroencephalograms, X-rays,
and psychological tests. Non-medical information not documented by test
results, such as an applicant's description of pain, is not considered
objective medical evidence.
4. The
applicant is responsible for providing sufficient objective medical
documentation to the Medical Board in support of his or her claim for
disability. PERS does not have the burden of proving that an applicant is not
disabled. The Medical Board shall certify to the Board of Trustees whether,
based on the objective medical evidence, the member is mentally or physically
incapacitated for further performance of duty and that such incapacity is
likely to be permanent and whether, based on all other facts, the member should
be retired on a disability allowance. In making this determination, the Medical
Board shall use the following definition:
Disability shall be defined as the inability to perform the
usual duties of employment or the incapacity to perform such lesser duties, if
any, as the employer in its discretion may assign without material reduction in
compensation or the incapacity to perform the duties of any employment covered
by the PERS that is actually offered and is within the same general territorial
work area without material reduction in compensation. §
25-11-113(1)(a)
As part of the determination process, the
Medical Board shall consider certification from the employer as to whether
reasonable accommodations have been requested by the employee and agreed to by
the employer as provided under the Americans with Disabilities Act.
For purposes of disability determination, a material
reduction in compensation shall be defined as a salary not in excess of 10
percent less than the current salary of the applicant.
5. In applying for duty-related disability
benefits, a member must provide medical proof satisfactory to the Medical Board
that his or her disability is a direct result of a physical injury sustained
from an accident or a traumatic event caused by external violence or physical
force occurring in the performance of duty. In addition, permanent and total
disability resulting from a cardiovascular, pulmonary, or musculoskeletal
condition that was not a direct result of a physical injury sustained from an
accident or a traumatic event caused by external violence or physical force
occurring in the performance of duty shall be deemed an ordinary disability. A
mental disability based exclusively on employment duties occurring on an
ongoing basis shall be deemed an ordinary disability. Further, the employer
must certify on a form prescribed by PERS or by means of other acceptable
documentation that an accident or injury has occurred in the performance of
duty which precipitated the employee's claim for disability benefits.
Acceptable documentation may include an accident or injury report, a Workers'
Compensation claim form, or such other similar document signed by an authorized
representative of the employing agency as proof of the occurrence of an event
in the nature of an accident or injury while on the job. A duty-related
disability benefit determination by PERS is independent of any determination of
benefit eligibility that may be made by an insurance company or other agency of
the State. §
25-11-114(6)
6. No inactive member shall be eligible to
apply for duty-related disability benefits regardless of years of service if
withdrawal from service occurred before July 1, 1984, which was the date that
such benefits were first authorized.
7. Any active or inactive member must provide
a statement certifying all gainful employment at the time the disability is
claimed, whether such employment is covered employment or not.
a. Any inactive member applying for
disability after one calendar year from date of termination from covered
service must provide copies of tax returns with corresponding income
documentation to provide information as to the type of employment and income
from any gainful occupation during the period of inactive service.
b. Where the inactive member is found to have
engaged in any gainful occupation paying an amount equal to or more than the
average compensation used in calculating the benefits, the inactive member
shall be deemed ineligible for benefits.
8. If the Medical Board determines that a
member is not eligible for disability benefits, a final administrative
determination will be issued to the member. The member may appeal the
determination to the Board of Trustees in accordance with the provisions of
Board Regulation 42, Rules of Hearing Practice and Procedure before the
Board of Trustees, and Miss. Code Ann. §
25-11-120
(1972, as amended).
9. Upon
certification of eligibility by the Medical Board, if the Board of Trustees
concurs with such report of eligibility, the member will be added to the
retiree payroll. The Board of Trustees authorizes the executive director to
initiate benefits on behalf of the members who are certified by the Medical
Board as being disabled in accordance with the statutes to ensure timely
payment of benefits to such members, provided that the executive director shall
present such approved members along with any supporting information to the
Board of Trustees for ratification at a subsequent meeting of the
Board.
10. A disability
determination will be made based on the member's inability to perform the job
duties associated with a covered position and not a second position where only
wages are covered pursuant to Miss. Code Ann. §
25-11-103(k)
(1972, as amended); however, the average compensation will be calculated taking
into consideration all covered wages from all positions.
