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CEO – RTW 101 SERIES
Disability Retirement Services Overview
September 30, 2010
Presented by
Shari Altmark & Richard Schlosser
Disability Retirement Services Division
Supervisors
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 Packet
Disability Retirement Brochure
Disability Retirement Eligibility and Application Instructions
Application for Disability Retirement
Physician Statement for Disability Retirement
Claims Against Third Parties Form
Authorization to Obtain and Release Records and Information,
signed by applicant
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Contents Within Employer’s Packet
Disability Retirement brochure
Disability Retirement Eligibility and Application Instructions
(Department version)
Application for Disability Retirement
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EMPLOYEE
APPLICATION
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 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
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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
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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
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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
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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
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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
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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?
20
Questions RTW Can Ask
Time frame to process
Status of case
Name of Investigator
Service retirement date, once confirmed
by Board
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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
22
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.
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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
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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.
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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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SCD SUPPLEMENTAL RETIREMENT CALCULATION
(GC §31725.65)
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
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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
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Plan E to D
Transfers
31
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).)
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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?
Oneis 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.)
35
Cynthia Lau
Legislative Affairs Officer
AB 1902
Comparison of Plan E and Plan D –
New Hire Elects One
Active Disability/ Retirement
Contributory Vesting Final Comp
Death Benefits Benefit
Plan E No 10 yrs. 3 yrs. No Lower
Plan D Yes 5 yrs. 1 yr. Yes Higher
Prospective Plan Transfer (PPT)
D E
E D
May 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
transfer
Requirements 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 age
Amount of service credit
Status 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 program
Or 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.
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
47
NOTE:
Plan D members electing deferred
retirement are ineligible for LTD benefits.
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 djuul@lacera.com
James Castranova, Sr. Staff Counsel 4382 564-2456 jcastranova@lacera.com
Penelope Rodriguez, Sr. Secretary 4403 685-4622 prodriguez@lacera.com
SUPPORT TEAM
Laura Gonzalez, Supervisor 2323 564-2323 ldelgado@lacera.com
Roena Bernard, Applications 2338 564-2419 rbernard@lacera.com
Sandra Cortez, Medical Appointments 4618 685-4618 scortez@lacera.com
564-6000
Hank Osmundson, Word Processing 3587 hosmundson@lacera.com
ext. 3587
564-6000
Melissa Norris, Word Processing 3498 mnorris@lacera.com
ext. 3498
Kathleen Medina, Appeals 4419 564-2339 scortez@lacera.com
Mary Ortiz, Appeals 2420 564-2420 mortiz@lacera.com
Bonnie Weise, Appeals 3499 564-2499 bweise@lacera.com
TEAM SHARI (1)
Richard Schlosser, Supervisor 4489 564-2489 saltmark@lacera.com
Andrew Demetroulis, Investigator 3537 685-4621 ademetroulis@lacera.com
Vickie Neely, Investigator 3528 685-4672 vneely@lacera.com
Anna Kwan, Investigator 3540 685-4627 akwan@lacera.com
Kerri Wilson, Investigator 3538 685-4624 kwilson@lacera.com
Debbie Semnanian, Investigator 3218 564-2418 dsemnanian@lacera.com
Maisha Coulter, Investigator 3539 685-4626 mcoulter@lacera.com
Maria Muro, Investigator 2454 564-2454 mmuro@lacera.com
TEAM RICHARD (2)
Shari Altmark, Supervisor 4405 564-2405 rschlosser@lacera.com
Darren Huey, Investigator 3506 685-4636 dhuey@lacera.com
Debra Martin, Investigator 3217 564-2417 dmartin@lacera.com
Jim Alvarez, Investigator 4414 564-2414 jalvarez@lacera.com
Tamara Caldwell, Investigator 2415 564-2415 tcaldwell@lacera.com
Nichelle Porter, Investigator 3541 564-2441 nporter@lacera.com
Mercie Martinez, Investigator 2403 564-2404 mmartinez@lacera.com
CONFERENCE ROOM 2429 Intercom 02
FAX 564-6177
Effective 1/1/09
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