Current through Register Vol. 24-18, September 15, 2024
This section applies to you if you are a PSERS member who
becomes disabled.
This section covers disability benefits in RCW 41.37.230.
Disability provisions are designed primarily to provide an income to members
who have been forced to leave the workforce because of an incapacitating
disability. This section applies equally to on-or-off-the-job injuries and/or
illnesses.
Members may also be eligible for benefits from the Washington
state departments of labor and industries (workers' compensation benefits) and
social and health services, the U.S. Social Security Administration, employers,
disability insurers, and others. Please contact these organizations directly
for more information.
Definitions. As used in this section:
Disabled - A person who is totally incapacitated
to perform the essential functions of their PSERS eligible position.
(1)
How do I apply for a disability
benefit?
(a) You or your representative
must contact the department to request an application. The three-part
application must be completed by the proper persons and returned to the
department.
(b) The department must
receive:
(i) A completed disability retirement
application. When the department receives Part 1 of your application, you are
considered to be an applicant for disability benefits. However, your
eligibility will not be determined until the department receives all three
parts of the application;
(ii)
Additional information required by the department; and
(iii) Any other material you want the
department to consider.
(c) The process for determining eligibility
for a disability benefit can be lengthy and may require additional
documentation to complete.
(2)
Is there a time limit for filing an
application for disability benefits? There is no time limit for
applying. However, your eligibility for a benefit will be based on your
condition at the time of separation.
(3)
What happens if I become disabled
after I retire? Your medical condition at the time of separation will
determine whether you qualify for a disability retirement.
(4)
What evidence will the department
use to determine whether I am entitled to benefits under this section?
(a) To determine if you are entitled to
disability benefits, the department will consider any relevant information
submitted by you or your employer, or otherwise available to the department,
including:
(i) Information and determinations
by the department of labor and industries (L&I), a self-insurer or the
Social Security Administration;
(ii) Medical, vocational, and other
information about your disability;
(iii) Your job description;
(iv) Your membership records, maintained by
the department;
(v) Independent
medical reviews made by DRS contracted vendors; and
(vi) Any other relevant evidence.
(b) The department reserves the
right to consult with a contracted vendor for the purpose of providing an
independent medical review of any PSERS member who applies for disability
benefits.
(5)
What
would disqualify me for disability benefits? You are not eligible for
disability benefits if any of the following apply:
(a) Your application does not provide
adequate proof that you are disabled;
(b) Your disability is the result of your
criminal conduct committed after July 1, 2006 (RCW 41.37.100).
"Criminal conduct" means:
(i) If a member is a defendant in a criminal
proceeding or has been formally charged in court with a crime, and the member
is applying for or receiving a disability retirement benefit for a disability
that is the result of the alleged criminal conduct, the department shall
withhold payment of any disability benefits until:
(A) The case or charges, or both if both are
pending, are dismissed; or
(B) The
member is found not guilty in the criminal case or prevails in the criminal
proceeding; or
(C) The member is
convicted or found to have engaged in criminal conduct in the criminal
proceeding.
(ii) If the
case or charges are dismissed or if a member is found not guilty or prevails in
the criminal proceeding, the department shall pay the member a disability
benefit if they otherwise qualify.
(iii) If the member is convicted or found to
be liable for criminal conduct in a criminal proceeding, and the member's
disability is the result of the criminal conduct, the department shall not pay
the member a disability benefit.
(iv) In the absence of a criminal conviction,
a superior court may determine by a preponderance of the evidence whether the
person participated in criminal conduct.
(6)
Who decides if I meet the
requirements for benefits under this section? The director of the
department of retirement systems (DRS) or their designee will decide if you
meet the requirements for benefits under this section.
(7)
What if I disagree with a decision
made by the director or their designee? If you disagree with the
decision of the director of DRS or their designee, you may petition for review
under chapter 415-04 WAC.
(8)
Are disability benefits subject to court or administrative orders?
Your benefits may be subject to orders for spousal maintenance, child support,
property division, or any other administrative or court order expressly
authorized by federal law. For more information, see RCW 41.37.090(3) or
contact the department.
(9)
How is my disability benefit affected if I am a member of more than one
retirement system? If you are a member of more than one retirement
system, your benefit is governed by portability law. See chapters 41.54 RCW and
415-113 WAC. You may apply for disability only from your active system.
However, if you qualify for a disability benefit from your active system, you
will also be eligible for a service retirement calculated under the laws
governing the inactive system.
(10)
How long will I continue to receive a monthly disability
allowance? You may receive a monthly disability allowance throughout
your lifetime, subject to the provisions of subsection (11) of this
section.
(11)
Is it possible
to lose my monthly disability allowance after I begin receiving it?
(a) The department may, at its expense,
require comprehensive medical examinations to reevaluate your eligibility for
disability benefits. You will no longer be eligible to receive a disability
allowance if the following apply:
(i) Medical
evidence indicates you have recovered from the disability for which the
department granted your disability benefits; and
(ii) You have been offered reemployment by an
employer, as defined in RCW 41.37.010, at comparable compensation;
and
(iii) If your monthly
disability allowance is from a catastrophic duty disability, also refer to WAC
415-106-550.
(b) If you
return to employment and reenter PSERS membership, your benefits will
cease.
(12)
If I
take my disability benefit in a lump sum and return to work, may I restore my
service credit? Yes. You may restore your service credit if you take a
lump-sum benefit and return to PSERS membership at a later date.
(a) You may restore your service credit
within two years of reentering membership or prior to retirement, whichever
comes first. You must pay back the lump-sum amount you received, minus the
monthly amount for which you were eligible, plus interest as determined by the
director.
(b) If you restore your
service after two years, you must pay the actuarial value of the resulting
increase in your future retirement benefit. See RCW 41.50.165 and
41.37.200.
(13)
Are my disability benefits taxable? You should consult with your
tax advisor regarding all questions of federal or state income, payroll,
personal property or other tax consequences regarding any payments you receive
from the department. The department does not:
(a) Guarantee that payments should or should
not be designated as exempt from federal income tax;
(b) Guarantee that it was correct in
withholding or not withholding taxes from disability payments;
(c) Represent or guarantee that any
particular federal or state income, payroll, personal property or other tax
consequence will occur because of its nontaxable determination; or
(d) Assume any liability for your compliance
with the Internal Revenue Code.
