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CEO – RTW 101 SERIESCEO – RTW 101 SERIESDisability Retirement Services Disability Retirement Services
OverviewOverview
February 23, 2012 February 23, 2012
Presented by Presented by Shari Altmark & Richard SchlosserShari Altmark & Richard Schlosser
Disability Retirement Services Division Disability Retirement Services Division SupervisorsSupervisors
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Terms
Service-connected Disability Eligible from 1st day of employment Must be permanently disabled Must have a direct causational link to the
workplace
Nonservice-connected Disability Must have at least 5 years of service (60 months) Must be permanently disabled No direct link to the workplace
Service Retirement Concurrent with Disability Application Waive reinstatement rights
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Comparison Workers’ Compensation vs. Retirement Law
Workers’ Comp. system provides different benefits from County Retirement System:
Temporary Disability Permanent Disability Rehab or supplemental job displacement benefit
LACERA’s Board of Retirement not bound by Workers’ Comp. system; not party to Workers’ Comp. Decisions
LACERA is separate, legal entity – findings made in Workers’ Comp. cases are not binding on County Retirement System
LACERA grants only Permanent Incapacity
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Contents Within Employee’s Disability Retirement Contents Within Employee’s Disability Retirement PacketPacket
Disability Retirement BrochureDisability Retirement Brochure Disability Retirement Eligibility and Application InstructionsDisability Retirement Eligibility and Application Instructions Application for Disability RetirementApplication for Disability Retirement Physician Statement for Disability RetirementPhysician Statement for Disability Retirement Claims Against Third Parties FormClaims Against Third Parties Form Authorization to Obtain and Release Records and Authorization to Obtain and Release Records and
Information, signed by applicantInformation, signed by applicant
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Contents Within Employer’s PacketContents Within Employer’s Packet
Disability Retirement brochureDisability Retirement brochure Disability Retirement Eligibility and Application Disability Retirement Eligibility and Application
Instructions (Department version)Instructions (Department version) Application for Disability RetirementApplication for Disability Retirement
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EMPLOYEEAPPLICATION
EMPLOYER APPLICATION
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Department’s Responsibilities G.C. 31721 Department may file an application on behalf of the
employee
Employee’s Options Comply with Employer Application File Employee Application Do Nothing
LACERA’s Responsibilities Within 30 days notify employee department has filed an
application on their behalf If applicant complies with Employer Application, they
should submit Authorization to obtain and release records and
information (DIS 104) Claims Against Third Parties (DIS 117) Missed Medical Appointment form (pg. 8)
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LACERA’s Responsibilities (cont’d) Upon receipt employer application is
completed and processed Once the Board of Retirement takes action, the
department is notified and an effective date for the Salary Supplement is established
If the application is denied, appeal rights are not affected
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LACERA’S ROLELACERA’S ROLE
Initial application includes signed information release from employee Allows LACERA to:
Retrieve all Workers’ Comp records from TPA Retrieve additional records from outside
sources Kaiser/personal physicians/chiropractors/therapists
Retrieve personnel records Active, retired or deceased
Ask for additional documentation/information as necessary
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LACERA’S ROLE (cont’d)
Interview member to get timeline Job classifications during career
Prior job assignments and overall duties Current job assignment and duties
Focus on specific job duties within last assignment Physical requirements
Were there modifications provided to the applicant? If offered, when? (before or after retirement) If so, were they temporary or permanent?
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LACERA’S ROLE (cont’d)
Chronological history of injuries/illnesses Mechanics of the injury
Where did it happen? What did they feel? Were there any witnesses?
Reporting and care after the injury/illness Follow-up treatment, if any Current symptoms and reason they cannot
return
1212
LACERA’S ROLE (cont’d)
Current symptoms/level of activity Witness statements
Contact supervisor Confirm “actual” job duties/physical requirements Obtain information regarding injury/illness Applicant’s current condition/ability to perform
duties Contact co-worker(s)
Obtain information regarding injury/illness Query personal awareness of applicant’s condition
1313
LACERA’S ROLE (cont’d)
Contact RTW Coordinator Confirm medical leave status Confirm past and present work
restrictions Research accommodation, if any
Temporary or permanent
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LACERA’S ROLE (cont’d)
Medical opinion from LACERA specialist Mechanism of injury History of injury/illness and treatment rendered Confirm or refute permanent incapacity Advise on any permanent work restrictions Comment on ability to perform permanent
modified position Confirm or refute job causation
1515
LACERA’S ROLE (cont’d)
Contact RTW Coordinator again Address department’s ability to
accommodate LACERA doctor’s permanent work restrictions
If so, what would the duties be? If not, why not?
*** Response needs to be in writing!!! Email, letter or fax
Important that person giving response is authorized to make statement
1616
Reasonable Accommodation Workers’ Compensation versus
Disability Retirement Workers’ Comp (Form of Voc. Rehab)
In Worker’s Pre-Injury Job Class (Modified Work) In New Job Class (Alternative Work)
Disability Retirement In Applicant’s Pre-Injury job class, therefore
Applicant not Permanently Incapacitated In new job class, but only after found to be
Permanently Incapacitated (re-employment plan pursuant to §31725.65)
* Both are with employer as of date of injury
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Employee working within Reasonable Accommodation Workers’ Compensation
Within worker’s job class (Modified Work) Employer may provide modification to applicant’s
assignment or offer another assignment in job class Written offer If worker accepts offer, and accommodation is
successful, a disability retirement application is avoided
In new job class (Alternative Work) Employer provides permanent accommodation in
new job class Written offer to worker Worker either returns to work or may file a
disability application
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Employee working within Reasonable Accommodation (cont’d)
Disability Retirement In Applicant’s Pre-Injury job class, Applicant not
considered Permanently Incapacitated Board of Retirement (BOR) has fiduciary duty to
independently investigate and determine availability of reasonable accommodation
BOR decision not dependent on whether employer has actually offered accommodation to applicant
BOR is a separate legal entity, empowered to make its own finding of fact
1919
Employee working within Reasonable Accommodation (cont’d)
Disability Retirement If BOR determines reasonable
accommodation is available within applicant’s pre-injury job class:
Applicant Is Not Permanently Incapacitated
Disability Retirement Is Denied
2020
Questions RTW Cannot Ask
What medical conditions did the employee apply for?
Proposed date of service retirement? What is the Board recommendation? What do we think the Board action will be? How much will employee make if they get
the disability retirement?
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Questions RTW Can Ask
Time frame to process Status of case Name of Investigator Service retirement date, once
confirmed by Board
2222
Processing Timeframes Minimum amount of time to process a
disability application is 9 to 12 months Assuming only one claim of disability involved; Extra time is needed for extensive investigation
or delays in obtaining medical evidence; or Additional medical specialties evaluations are
needed
2323
SUPPLEMENTAL DISABILITY ALLOWANCE
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Supplemental Retirement Allowance
How do we retain disabled members in County Service?
County Departments face critical budget cuts, lay offs, and hiring freezes. Salary Supplement is the process of retaining experienced employees in rehabilitation positions.
Government Codes §31725.5, 31725.6 and 31725.65
Applications are to be treated like any other application; the criteria is that the applicant must be found disabled from the ORIGINAL position.
2525
Section 31725.5 Applies to nonservice-connected
disability retirements only Section 31725.6 and/or 31725.65
Applies to service-connected disability retirements only
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Department’s Responsibilities Department may file an application on behalf of the
employee Confirm the employee has applied for disability
retirement benefits with the salary supplement Department may keep employee in current job
classification while performing new job duties during the application process
Department may place an employee on “Y-Rate” with CEO approval pending the Board of Retirement’s approval
The employee’s salary remains unchanged during the disability retirement application process
Submit supporting documentation with the application including the lower item job classification, essential job functions and salary
2727
Conditions of Supplemental Allowance
Contingent on: The offer of a permanent position with a lower
salary schedule which accommodates the employee’s permanent work restrictions
The acceptance of this position by the employee
Engaging the Process The Disability Retirement Services Division
works closely with County Departments’ Human Resource managers and Return to Work Coordinators to facilitate a better awareness of the Salary Supplement options.
2828
Member’s Future Earnings The calculation is based upon the member’s actual
earnings at the time the benefit is granted. The calculation does not allow for future item raises and cost-of-living increases.
The member can be promoted in the new position career chain. When the member receives a pay raise, it is reviewed against the original item number salary and the salary supplement allowance is lowered accordingly. If the new item number salary exceeds the original position’s salary, the Salary Supplement allowance stops.
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Example #1 – Deputy Sheriff I permanently demoted to Dispatcher:
Previous position monthly salary = $6077.36 NEW position monthly salary = $3996.82 Difference in salary = $2080.54 SCD Supplemental Retirement Allowance $2080.54 SCD Benefit if member retires (50% FAS) $3038.54
Savings to system $ 958.00
SCD SUPPLEMENTAL RETIREMENT CALCULATION
(GC §31725.65)
NSCD Supplemental Retirement Calculation
(GC §31725.5)
Example #2 – Supervisory Staff Nurse permanently demoted to Intermediate Clerk:
Previous position monthly salary = $8013.52 NEW position monthly salary = $2878.00 Difference in salary = $5135.52 NSCD Supplemental Retirement Allowance $2706.12 NSCD Benefit if member retires (1/3 FAS) $2706.12
Difference, not paid by supplement $2429.40 Reason: Supplemental Allowance cannot exceed maximum
NSCD benefit allowed
3030
3131
Plan E to DTransfers
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How it Works?Frequently Asked Questions
QUESTION:
To receive a Disability Retirement as a Prospective Member is there a time requirement?
Yes, completion of two continuous years of active service after his or her most recent transfer date, or
Earned five years of retirement service credit under Retirement Plan D after his or her most recent transfer date. (Sec. 31494.5(e).)
3333
How it Works?Frequently Asked Questions
QUESTION:
When is a prospective transferee eligible for a SCD?
A prospective Plan D transferee must satisfy one of two (2) waiting periods in order to apply for a disability retirement.
1. Complete two continuous years of active service after his or her most recent transfer date, or
2. Earn five years of retirement service credit under Retirement Plan D after his or her most recent transfer date. (Sec. 31494.5(e).)
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How it Works?Frequently Asked Questions
QUESTION:
When is a prospective transferee eligible for a Nonservice-connected disability retirement?
One is eligible to apply for a nonservice-connected disability under Plan D, regardless of the date of injury, once they have a minimum of five years of County service credit, and have met one of the Plan D service credit options previously listed.
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How it Works?Frequently Asked Questions
QUESTION:
Can a paid leave of absence be “active service”?
A paid leave of absence or part-time work schedule is nevertheless considered “active service,” unless “the leave of absence or part-time service is necessitated by a pre-existing disability, injury, or disease.” (Sec. 31494.5(g)(1).) (Emphases added.)
Cynthia LauLegislative Affairs Officer
AB 1902
Comparison of Plan E and Plan D –
New Hire Elects One
Contributory Vesting Final CompActive Disability/Death Benefits
Retirement Benefit
Plan E No 10 yrs. 3 yrs. No Lower
Plan D Yes 5 yrs. 1 yr. Yes Higher
Prospective Plan Transfer (PPT)
D EE DMay transfer back and forth – may transfer
between plans no more than once every 3 years while in period of “active employment.”
What happens if member is disabled while in Plan D?
To apply for disability retirement, PPT transferee must have either:Two yrs. continuous active service after transfer, or Earned 5 yrs. service credit under Plan D after transferRequirements prevent Plan E member from transferring to Plan D and immediately filing for disability retirement.
Issue – Member may be disabled, but ineligible to apply for LACERA disability retirement due to failure to meet 2 yr./5 yr. requirement.
County Long-Term Disability Plan (LTD)
• Provides benefits for Plan D and Plan E members who are sick or injured and cannot work.
• Benefits expire at age 65, or when no longer disabled.
• After 2 yrs. on LTD, County requires Plan D (contributory) members to file for retirement in order to continue LTD.
• LTD benefit is offset (reduced) by amount of retirement allowance
• County does not require Plan E members to file for retirement after 2 yrs. to continue LTD.
Under certain circumstances, it may be more advantageous for the affected member to continue LTD benefits under Plan E than under Plan D.Influencing factors include: Member’s ageAmount of service creditStatus of LTD Health Insurance
Currently (Pre-AB 1902)
To continue LTD benefits, a disabled Plan D PPT transferee who fails to meet 2 yr./5
yr. requirement may only apply for a service retirement.
Effective January 1, 2011 (Post-AB 1902)
Disabled Plan D PPT transferee who fails to meet 2 yr./5 yr. requirement has options: May transfer back to Plan E and continue under the County LTD programOr may file for a service retirement under Plan D
How can you help?
Be aware of this new provision and communicate it to employees. Effective 1-1-11.
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Obstacles LACERA faces
Timeliness of response to Retirement Board once doctor’s opinion is received
Workers’ Comp vs. Disability Retirement Open labor market vs. independent
classification Restrictions governed by old law Retirement Board policy changes Turnover within RTW divisions
NOTE:
Plan D members electing deferred retirement are ineligible for LTD benefits.
4949
Resources
If you have questions, call (626) 564-2419 Log on to www.lacera.com
Click “Benefits” tab (upper right hand side) Click “Active Member” tab (left side) Click “Disability Retirement” (lower left side)
Contact the individual investigator (see attached listing)
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DISABILITY RETIREMENT SERVICES DIVISION TELEPHONE ROSTER
NAME INTERNAL EXT. OUTSIDE (626) E-MAIL
Debbie Juul, Manager 4462 564-2401 [email protected]
James Castranova, Sr. Staff Counsel 4382 564-2456 [email protected]
Penelope Rodriguez, Sr. Secretary 4403 685-4622 [email protected]
SUPPORT TEAM
Laura Gonzalez, Supervisor 2323 564-2323 [email protected]
Roena Bernard, Applications 2338 564-2419 [email protected]
Sandra Cortez, Medical Appointments 4618 685-4618 [email protected]
Hank Osmundson, Word Processing 3587 564-6000 ext. 3587
Melissa Norris, Word Processing 3498 564-6000 ext. 3498
Kathleen Medina, Appeals 4419 564-2339 [email protected]
Mary Ortiz, Appeals 2420 564-2420 [email protected]
Bonnie Weise, Appeals 3499 564-2499 [email protected]
TEAM SHARI (1)
Richard Schlosser, Supervisor 4489 564-2489 [email protected]
Andrew Demetroulis, Investigator 3537 685-4621 [email protected]
Vickie Neely, Investigator 3528 685-4672 [email protected]
Anna Kwan, Investigator 3540 685-4627 [email protected]
Kerri Wilson, Investigator 3538 685-4624 [email protected]
Debbie Semnanian, Investigator 3218 564-2418 [email protected]
Maisha Coulter, Investigator 3539 685-4626 [email protected]
Maria Muro, Investigator 2454 564-2454 [email protected]
TEAM RICHARD (2)
Shari Altmark, Supervisor 4405 564-2405 [email protected]
Darren Huey, Investigator 3506 685-4636 [email protected]
Debra Martin, Investigator 3217 564-2417 [email protected]
Jim Alvarez, Investigator 4414 564-2414 [email protected]
Tamara Caldwell, Investigator 2415 564-2415 [email protected]
Nichelle Porter, Investigator 3541 564-2441 [email protected]
Mercie Martinez, Investigator 2403 564-2404 [email protected]
CONFERENCE ROOM 2429 Intercom 02
FAX 564-6177
Effective 1/1/09
