State Teachers Retirement System - Disability Benefits - Disability - medical evidence and appointments.


Published: 2021-06-03

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Each applicant or recipient shall be responsible for providing medical evidence needed by the retirement system and for cooperating fully with all assigned medical examinations, as follows:

(A) Medical evidence or reports from an attending physician shall be filed with the retirement system within fifteen calendar days of the date the retirement system requests such information. The information shall provide objective and pertinent medical evidence supporting the conditions the applicant or recipient claims as disabling.

(B) The retirement system shall provide written notice of the independent medical examiners who will conduct medical examinations and testing. The applicant or recipient shall, within fifteen days of notice from the retirement system, schedule appointments so that examination or testing is completed within the following ninety days, as instructed in the notice. In the event the appointment times available with an independent medical examiner preclude completion of the examination or testing within ninety days, a request for extension to the earliest practicable appointment date may be granted by the retirement system.

(C) The applicant or recipient shall travel to the offices of the assigned independent medical examiners, unless the chair of the medical review board determines that medical evidence submitted by the attending physician of the applicant or recipient demonstrates that he or she is medically unable to travel to the examination site. A request that the chair of the medical review board make such a determination shall be made by the applicant or recipient within fifteen days of notice of the assignment of the independent medical examiners.

(D) The applicant or recipient shall be responsible for all travel costs incurred.

(E) The retirement system will accept responsibility only for the cost of the independent medical examination assigned by the retirement system and requested testing completed at the independent medical examiner's office. The retirement system will also accept responsibility for a missed appointment fee if an applicant or recipient fails for good cause demonstrated to the retirement system to keep the first appointment scheduled with an independent medical examiner, but in no case will payment of more than one such fee per applicant or recipient be made.

(F) An applicant or recipient may request an extension or exception to the foregoing requirements. Any such request shall be in writing directed to the retirement system, and will be granted only if the request demonstrates good cause to the retirement system in its sole discretion. In the event an applicant fails to carry out the foregoing duties in a timely manner, the application for disability benefits will be cancelled. In the event a recipient fails to carry out the foregoing duties in a timely manner, notice will be given by the retirement system to the recipient that the failure will be deemed a refusal if the required examinations and testing are not completed by a specified date. If the recipient has not by that date submitted to the required examination and/or testing, benefits will be suspended as of the first of the month following the specified date. If the failure continues for one year or the disability benefit is terminated for any reason during the one-year period, all of the recipient's rights to the disability benefits shall be terminated as of the effective date of the original suspension.

(G) Any costs incurred by the applicant or recipient in the application or reexamination process, except as noted in this rule, will not be reimbursed by the retirement system.

Last updated June 3, 2021 at 9:09 AM