27 Miss. Code. R. 210-45B-104 - Medical determination of eligibility for disability benefits

1. The employer must provide the following information, which will be considered by the Medical Board in its determination for eligibility:

a. The job description and duties of the member; (Miss. Code Ann. § 25-11-113(1) a) (1972, as amended))

b. Whether the employer has offered the member other duties without material reduction in compensation; (Miss. Code Ann. § 25-11-113(1) (a)(1972, as amended))

c. Whether the employer has complied with the applicable provisions of the Americans With Disabilities Act in affording reasonable accommodations which would allow the employee to continue employment. (Miss. Code Ann. § 25-11-113(1) (a)(1972, as amended))

d. In the case of an application for hurt on the job benefits, the employer shall certify whether, to the best of its knowledge, the sickness or injury was caused or sustained by reason of service or discharge of duties. (Miss. Code Ann. §§ 21-29-35, 21-29-133, 21-29-241 (1972, as amended))

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. Refusal to submit to such examination or to otherwise provide the requested additional information within ninety (90) days of such request, shall result in the member's application being considered void. (Miss. Code Ann. § 25-11-113(1) (d)(1972, as amended))

a. In order to be considered eligible for disability benefits the Medical Board must certify to the Board of Trustees that the Firemen's and Policemen's Disability and Relief Fund 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.

b. 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 Municipal System 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. (Miss. Code Ann. § 25-11-113(1) (a)(1972, as amended))

3. The Medical Board shall certify to the Board of Trustees whether the member, based on the medical evidence, 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:

a. Disability, for members of the General Municipal Retirement System, governed by MCA Chapter 29, Article 1, shall be defined as a total and permanent incapacity from duty as well as from any gainful occupation for compensation or profit. (Miss. Code Ann. § 21-29-35 and 21-29-39 (1972, as amended))

b. Disability, for members of the Firemen's and Policemen's Disability and Relief Fund, governed by MCA, Chapter 29, Articles 3 and 5, shall be defined as a total inability to discharge duties as a fireman or policeman. Such disability may be due to physical or mental incapacity/illness.

c. As part of the determination process, the Medical Board shall consider certification from the employer as to whether or not reasonable accommodations have been requested by the employee and agreed to by the employer as provided under the Americans with Disabilities Act.

4. In applying for job related disability benefits, a member must provide medical proof satisfactory to the Medical Board that his disability is a.) the natural and proximate result of the actual performance of duty without willful negligence, if a member under Article 1, the General Municipal System, or b.) a sickness or injury caused or sustained by reason of service or discharge of his duty, if a member under Article 3 or 5, the Firemen's and

Policemen's Disability and Relief Fund. (Miss. Code Ann. §§ 21-29-35, 21-29-133, and 21-29-241 (1972, as amended))

5. A disability benefit applicant must provide a statement certifying all gainful employment or other such income statements as may be requested by PERS.

6. 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 Regulation 42. (Miss. Code Ann. § 25-11-120 (1972, as amended) and Regulation 42)

a. Appeals of decisions made under Regulation 42 by the PERS Board of Trustees may be made by members of the Firemen's and Policemen's Disability and Relief Fund to the Board of Disability and Relief Appeals as provided in Miss. Code Ann. § 21-29-113 and 21-29-215 (1972, as amended).

7. 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 in order 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.

8. Retirement on and receipt of service retirement benefits results in the member's forfeiture of any rights to pursue disability benefits.

Notes

27 Miss. Code. R. 210-45B-104