LACERA CEO - RTW 101 Series 093010

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LACERA CEO - RTW 101 Series 093010 Powered By Docstoc
					    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




                                                                  2
   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



                                                                  3
   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




                                                                         4
   Contents Within Employer’s Packet

       Disability Retirement brochure
       Disability Retirement Eligibility and Application Instructions
        (Department version)
       Application for Disability Retirement




                                                                         5
 EMPLOYEE
APPLICATION




 EMPLOYER
APPLICATION




              6
   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)
                                                                          7
   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




                                                           8
                       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

                                                                        9
             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?



                                                                       10
          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
                                                     11
          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

                                                                        12
              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



                                                     13
      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



                                                            14
    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
                                                          15
   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
                                                                        16
   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
                                                                              17
   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




                                                                   18
   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




                                                             19
        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
                                              21
   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




                          23
   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.



                                                                       24
   Section 31725.5
       Applies to nonservice-connected disability
        retirements only
   Section 31725.6 and/or 31725.65
       Applies to service-connected disability
        retirements only




                                                     25
   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

                                                                 26
   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.


                                                                  27
   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.
                                                                   28
    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




                                                              29
    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

                                                                          30
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).)




                                                                       32
                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).)




                                                                          33
              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.




                                                                   34
              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)

                                                          49
            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
                                                                                                50

				
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