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Disability Retirement Resources for Local Safety Agencies

The following list of resources can help guide you through the initial and post-disability retirement process. As a local safety employer, it’s important to remember that the disability or industrial disability determination for the member is made by the local safety agency and not CalPERS. However, we must first determine the member’s eligibility to apply for disability retirement prior to an agency making a medical determination.

Resources

Here are the necessary applications, forms, guides, and sample questions to assist with the initial and post-disability retirement process:

Applications

Circular Letters

Forms

Guides & Publications

Resolutions

Sample Questions for Medical Specialist

The following questions should be sent to the Independent Medical Examination (IME) specialist along with medical reports before the date of the IME appointment. An IME specialist should not fill out the Local Safety Physician’s Report on Disability form (CalPERS-1010). If the following questions are not fully answered, or if you need clarifications on the specialist’s opinion, such as when there is conflicting information in the report, then a clarification report from the IME specialist is needed. After the IME appointment or after you receive the IME report, if you receive additional information/medical reports that you need the IME specialist to review and opine, you will need to request a supplemental report from the IME specialist. You will then submit the IME report with the clarification/supplemental report (if applicable) when sending your medical determination to CalPERS.

Questions for Initial Determination

Medical Qualifications
To qualify for a disability retirement, a CalPERS member must be substantially incapacitated for the performance of his or her duties. This "substantial incapacity" must be due to a medical condition of permanent or extended duration that is expected to last at least 12 consecutive months or will result in death. Where the medical condition would likely be responsive to reasonable treatment if the member were to undertake it and the member unreasonably refuses to undertake such treatment, the member may not be entitled to a disability retirement.

 

The law distinguishes between a person who suffers some impairment and one who suffers impairment sufficient to become eligible for disability retirement. The courts have concluded that the test is whether the member has a substantial inability to perform the usual and customary duties of the position. Difficulty in performing certain tasks alone is not enough to support a finding of disability. It is the inability to perform the essential functions of the actual and present job duties that determines whether the member is substantially incapacitated for the performance of his or her job duties.

If the member cannot substantially perform the duties of the position, then they are disabled for CalPERS retirement purposes; otherwise, the member is not disabled. A CalPERS disability retirement must be based upon an actual and present (not prospective) inability to substantially perform the member's actual and usual job duties. Furthermore, prophylactic restrictions are not a basis for a disability retirement. If a disability is not currently present but just may occur in the future, the member is presently ineligible for a CalPERS disability retirement.

Questions

Based on the Medical Qualifications for Disability Retirement Standard (Listed Above), Answer the Following:

  1. Does the member have an actual and present [examination type] [insert condition(s)/body parts(s)] impairment that arises to the level of substantial incapacity to perform their usual job duties?
  2. Considering the member’s subjective complaints and the objective findings (or lack thereof) on the exam, what findings lead you to the conclusion the member is or is not substantially incapacitated? Explain fully.
  3. If you find the member to be substantially incapacitated, is the incapacity permanent or temporary? As specified in California Public Employee’ Retirement Law G.C. 20026, if temporary, will the incapacity last longer than 12 months? Explain in detail.
  4. List the specific job duties and/or physical requirements of position the member is unable to perform for each substantially incapacitated body part/condition.
  5. As of what date did the member’s condition become “substantially incapacitating”? What objective medical evidence leads to your conclusion the member is substantially incapacitated based on the date provided?
  6. Is the member cooperating with the examination and putting forth their best effort, or do you feel there is exaggeration of complaints?
  7. Optional question — how did you factor in the investigative report and surveillance video provided to make your medical opinion?

Questions for Re-Evaluations

Medical Qualifications

To continue to qualify for a disability retirement, a CalPERS retiree must remain currently substantially incapacitated for the performance of his or her job duties as determined by the board, or in the case of a local safety member, by the governing body of the contracting agency employing the member. This “substantial incapacity” must be on the basis of competent medical opinion. Where the medical condition would likely be responsive to reasonable treatment if the retiree were to undertake it and the retiree unreasonably refuses to undertake such treatment, the retiree may not be entitled to a continuing disability retirement.

The law distinguishes between a person who suffers some impairment and one who suffers impairment sufficient to become eligible for disability retirement. The courts have concluded that the test is whether the retiree has a substantial inability to perform the usual and customary duties of the position. Difficulty in performing certain tasks alone is not enough to support a finding of disability. It is the inability to perform the essential functions of the actual and present job duties that determines whether the retiree is substantially incapacitated for the performance of his or her job duties.

If the retiree cannot substantially perform the duties of the position, then they are disabled for CalPERS retirement purposes; otherwise, the retiree is not disabled. A CalPERS disability retirement must be based upon an actual and present (not prospective) inability to substantially perform the retiree's actual and usual job duties. Furthermore, prophylactic restrictions are not a basis for a disability retirement. If a disability is not currently present but just may occur in the future, the retiree is presently ineligible for a continuing CalPERS disability retirement.

Questions

Based on the Medical Qualifications for Continuing Disability Retirement Standard (Listed Above), Answer the Following:

  1. Does the retiree have an actual and present [examination type] [insert condition(s)/body parts(s)] impairment that arises to the level of substantial incapacity to perform their usual job duties? Include when there are multiple body parts. Explain in detail which body part(s) arise(s) to the level of substantial incapacity and which body part(s) does(do) not.
  2. Considering the retiree’s subjective complaints and the objective findings (or lack thereof) on the exam, what findings lead you to the conclusion the retiree is or is not substantially incapacitated? Explain fully.
  3. If you find the retiree to be substantially incapacitated, is the incapacity permanent or temporary? If temporary, how long will the incapacity last? Explain in detail.
  4. List the specific Job Duties and/or Physical Requirements of Position the retiree is unable to perform for each substantially incapacitated body part/condition (In order to answer this question, we have enclosed for your review the retiree’s duty statement/job description and physical requirements of their current position).
  5. Is the retiree cooperating with the examination and putting forth their best effort, or do you feel there is exaggeration of complaints?
  6. Optional question — how did you factor in the investigative report and surveillance video provided to make your medical opinion?

List of Documents for Disciplinary Process

Disability retirement can't be used as a substitute for the disciplinary process. If the member has a pending adverse action, was terminated for cause, resigned in lieu of termination, signed an agreement to waive their reinstatement rights, or is being investigated for or has been convicted of a work-related felony submit the following documents to us so that we may determine the member’s eligibility to apply for disability retirement.

  • Fitness for Duty Reports
  • Medical Reports
  • Accident Reports
  • Injury Reports
  • Work Performance Evaluations
  • Report(s) of Adverse Action
  • Internal Investigative Reports
  • Letter(s) of Corrective Action
  • Date of Separation from Employment
  • Early Intervention Reports
  • Letter of Dismissal
  • Skelly Hearing results
  • Reasonable Accommodation Information
  • Current Status of Any Pending Hearings or Appeals
  • Last Day on Pay

Public Employees’ Retirement Law (PERL)