Current through Register Vol. 50, No. 6, December 1, 2023
RELATES TO: KRS 16.505-16.652, 61.510-61.705,
78.510-78.852
NECESSITY, FUNCTION, AND CONFORMITY:
KRS
61.621, The Fred Capps Memorial Act, enables
an employee of a state-administered retirement system who is killed or disabled
from a duty-related injury to receive death or disability benefits equal to
those received by hazardous employees under
KRS 16.582.
This administrative regulation establishes the application and appeal procedure
for duty-related death or injury benefits for nonhazardous employees.
Section 1. Application for Duty-related
Injury Death Benefits.
(1)
(a) A written request for duty-related injury
death benefits may be made by the surviving spouse, or dependent child, or
parent or guardian of dependent child at the Frankfort office of the Kentucky
Retirement Systems.
(b) A claim for
duty-related injury death benefits shall be verified by the deceased employee's
immediate supervisor and agency head on the "Form 6800, Application for Death
Benefits Duty Related/In Line of Duty".
(2)
(a) The
employer, surviving spouse, or dependent child shall submit the following
documents:
1. A copy of the death
certificate;
2. The employer death
investigation report; and
3. An
employee job description.
(b) The retirement system may request
additional information or medical records, including hospital, emergency room,
autopsy, or other related records, and police or other crime report, if
necessary, from the employer, surviving spouse, or dependent child.
(3) The application for
duty-related injury death benefits shall be reviewed by the board's medical
examiners and administered in the same manner as provided in
KRS 16.582
and
61.665.
Section 2. Application for
Duty-related Injury Disability Benefits.
(1)
(a) A claim for duty-related injury
disability benefits shall be filed by the employee at the Frankfort office of
the Kentucky Retirement Systems.
(b) An application for duty-related injury
disability benefits shall be made by the employee on the "Form 6000,
Notification of Retirement".
(2) The application for duty-related injury
disability benefits shall be reviewed by the board's medical examiners and
administered in the same manner as provided in
KRS 16.582
and
61.665.
Section 3. Time Period for Filing.
(1)
(a) The
application or reapplication for duty-related injury death or duty-related
injury disability benefits shall be filed at the retirement office within
twenty-four (24) months from the employee's last day of paid employment in a
regular full-time position.
(b) The
filing period shall begin on the day after the last day of paid employment in a
regular full-time position and shall end at close of business on the following
730th calendar day.
(c) If the last
day of the filing period is a Saturday, Sunday, or a state or federal holiday,
then the application shall be timely filed if received in the retirement office
by the close of the next business day following the weekend or
holiday.
(2) If
rejected, an employee's reapplication for duty-related injury disability
benefits based on the same claim of incapacity shall be reconsidered for
disability if accompanied by new objective medical evidence. The reapplication
shall be filed at the retirement office within twenty-four (24) months from the
employee's last day of paid employment in a regular full-time
position.
Section 4.
(1) If the retirement systems requires an
applicant to submit to a medical or psychological examination under
KRS
61.665(2)(j) or (3)(c), the
retirement systems shall reimburse the applicant for mileage from the
applicant's home address as it is on file at the retirement systems, to the
place of the examination or evaluation, and returning to the applicant's home
address on file at the retirement systems. The applicant shall be reimbursed
for the most direct and usually traveled routes.
(2) Mileage shall be based on the "Kentucky
Official Highway Map", mileage software, or the most recent edition of the
"Rand McNally Road Atlas." The applicant shall complete and submit a Form 8846,
Independent Examination Travel Voucher indicating the mileage the applicant
traveled from the applicant's home address as it is on file at the retirement
systems, to the place of the examination or evaluation, and returning to the
applicant's home address on file at the retirement systems. The applicant shall
use the most direct and usually traveled routes.
(3) The mileage certified by the applicant
shall not be greater than the mileage indicated by the "Kentucky Official
Highway Map", mileage software, or the most recent edition of the "Rand McNally
Road Atlas" for the most direct and usually traveled route from applicant's
home address as it is on file at the retirement systems, to the place of the
examination or evaluation, and returning to the applicant's home address on
file at the retirement systems. If the mileage certified by the applicant is
greater than the mileage indicated by the "Kentucky Official Highway Map",
mileage software, or the most recent edition of the "Rand McNally Road Atlas"
the retirement systems shall pay the applicant the mileage indicated by the
"Kentucky Official Highway Map", mileage software, or the most recent edition
of the "Rand McNally Road Atlas."
(4) Reimbursement for use of a privately
owned vehicle shall be made at the IRS established standard mileage rate which
changes periodically; and shall not exceed the cost of commercial coach
fare.
(5) Actual costs for parking
shall be reimbursed upon submission of receipts. The applicant shall submit the
originals of the parking receipts along with a written request for
reimbursement.
(6) Actual bridge
and highway toll charges shall be reimbursed if the bridge or highway is on the
most direct and usually traveled route. The applicant shall submit the
originals of the bridge and highway toll receipts along with a written request
for reimbursement.
(7) The
applicant shall file at the retirement office a completed Form 8846,
Independent Examination Travel Voucher, within fifteen (15) days of the date of
the examination or evaluation in order to receive reimbursement for travel
expenses.
Section 5.
Benefit Payment Procedures.
(1) If the
employee's application for duty-related injury disability benefits is approved,
the employee's disability benefit shall be paid retroactive to the month
following the month of the employee's last day of paid employment in a regular
full-time position.
(2) If the
employee did not receive early retirement benefits or disability retirement
benefits under
KRS 61.600,
upon the employee's selection of a payment option, the retirement office shall
pay the employee the total monthly retirement allowances owed.
(3)
(a) If
the employee did receive early retirement benefits or disability retirement
benefits under
KRS 61.600,
the retirement office shall calculate and pay to the employee the difference
between the early retirement benefit or disability retirement benefit which was
paid to the employee and the duty-related disability benefit.
(b) The employee shall not change his payment
option.
(4) If benefits
are payable to a dependent child, the child's parent or guardian shall submit
the following documents:
(a) A "Form 6456,
Designation of Dependent Child";
(b) If the child is age eighteen (18) or
over, verification of full-time student status;
(c) A copy of the birth certificate of each
dependent child; and
(d) If a
dependent child is a minor, a "Form 6110, Affidavit of Authorization to Receive
Funds on Behalf of Minor". If the minor has a court appointed guardian or
conservator and the court appointed guardian or conservator completed the Form
6110, Affidavit of Authorization to Receive Funds on Behalf of Minor, the
guardian or conservator shall submit a copy of the court order appointing the
guardian or conservator;
(e) The
parent or guardian shall:
1. Notify the
retirement system of the death or marriage of a dependent child or if the
dependent child ceases to be a full-time student; and
2. Submit a copy of the dependent child's
verification of full-time student status with the retirement system for each
semester of study within thirty (30) days following the start and within thirty
(30) days following the end of each semester.
(5) Any increases provided to recipients
under
KRS 61.691
shall be applied to the employee's disability benefit and payments to a
dependent child in determining the total retroactive payments owed to the
employee and dependent child.
(6)
If upon review in accordance with
KRS
61.610 or other applicable statute, the board
determines that an employee receiving duty-related injury disability benefits
no longer meets eligibility requirements, then the board shall determine if the
employee is eligible for disability benefits under
KRS
61.600.
Section 6.
(1) A recipient shall complete a "Form 6130,
Authorization for Deposit of Retirement Payment", to have the monthly
retirement allowance deposited to an account in a financial
institution.
(2) The recipient and
the financial institution shall provide the information and authorizations
required for the electronic transfer of funds from the State Treasurer's Office
to the designated financial institution.
(3)
(a) At
any time while receiving a retirement allowance, the recipient may change the
designated institution by completing a new "Form 6130, Authorization for
Deposit of Retirement Payment", and filing the form at the retirement office in
Frankfort.
(b) The last "Form 6130,
Authorization for Deposit of Retirement Payment", on file at the retirement
office shall control the electronic transfer of the recipient's retirement
allowance.
(4) The
recipient may complete a "Form 6135, Request for Payment by Check".
(5) The retirement office shall not process
the retirement allowance until the recipient has filed a completed "Form 6130,
Authorization for Deposit of Retirement Payment", or filed a completed "Form
6135, Request for Payment by Check".
Section 7. Incorporation by Reference.
(1) The following material is incorporated by
reference:
(a) Form 6800, "Application for
Death Benefits Duty Related/In Line of Duty", April 2003;
(b) Form 6000, "Notification of Retirement",
July 2004;
(c) Form 6110,
"Affidavit of Authorization to Receive Funds on Behalf of Minor", May
2003;
(d) Form 6456, "Designation
of Dependent Child", July 2004;
(e)
Form 6130, "Authorization for Deposit of Retirement Payment," May 2008;
and
(f) Form 6135, "Request for
Payment by Check", February 2002.
(2) This material may be inspected, copied,
or obtained, subject to applicable copyright law, at the Kentucky Retirement
Systems, Perimeter Park West, 1260 Louisville Road, Frankfort, Kentucky 40601,
Monday through Friday, 8 a.m. to 4:30 p.m.
28 Ky.R. 1002;
eff. 12-19-2001; 29 Ky.R. 778; 1255; eff. 11-12-2002; 32 Ky.R. 393; eff.
11-5-2004; 35 Ky.R. 121; Am. 542; eff. 10-3-2008; Certified to be amended,
filing deadline 7-29-2021.
STATUTORY AUTHORITY:
KRS
61.645(9)(g)