105 Kar 1:310. Fred Capps Memorial Act

Link to law: http://www.lrc.ky.gov/kar/105/001/310.htm
Published: 2015

      105 KAR 1:310. Fred Capps Memorial

Act.

 

      RELATES TO: KRS 16.505-16.652,

61.510-61.705, 78.510-78.852

      STATUTORY AUTHORITY: KRS 61.645(9)(g)

      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.)
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