Answers to your questions about the OPSRP disability program

You should apply as soon as you are physically off the job, regardless of whether you are on paid leave. You can apply during the 90 consecutive day period; you do not need to wait until the 90-day period of disability has been met. You must be off all work at the time you submit your application.

Contact Member Services at 888-320-7377 for an OPSRP disability program application packet.

You should speak to your physicians before applying for the OPSRP disability program and let them know PERS will contact them to confirm and document your disabling condition. Ask your providers if they require their own information release. If so, complete their required form and submit it to PERS with your application.

If your disability is duty-related, you will need to provide a copy of your workers’ compensation report to PERS for review. Note: Some workers’ compensation carriers will only release records to you and will not release records directly to PERS.

PERS requires specialists for certain disabling conditions:

• Mental and emotional disorders require a report from a psychiatrist or a psychologist.
• Orthopedic injuries or disease require a report from a treating or consulting neurosurgeon, orthopedic surgeon, or physical medicine and rehabilitation specialist.
• Neurological injuries or disease require a report from a treating or consulting neurologist or neurosurgeon.
• Fibromyalgia requires a report of diagnosis from a rheumatologist and ongoing treatment from a rheumatologist or physical medicine and rehabilitation specialist.
• PERS may require reports from other specialized physicians depending on your condition.

If you are not sure your specialist meets PERS criteria, contact Member Services for assistance.

When you complete your application for OPSRP disability, list the physicians who have treated your disabling condition. PERS will require medical documentation from the time you stopped working to the time you apply for disability benefits.

You must be unable to perform any work you are qualified to perform, not just your last or usual job.

When you submit your OPSRP disability application, you will also complete a medical/nonmedical release form.

Once your forms are received, PERS will:

• Send requests to your doctor(s), hospital, or clinic for medical information.

• Request documentation from your employer and, if applicable, worker’s compensation carrier, and any disability insurance company.

After medical documentation is received, PERS staff and medical advisor will review your records to determine eligibility using Oregon Revised Statutes and Oregon Administrative Rules.

Yes, if you became disabled while an active member (still employed in a qualifying position with a PERS-participating employer), you can apply within five calendar years of your last date of work for your PERS-participating employer.

• The disabling condition must have been continuous from your last day worked to your disability application date (supported by medical documentation from your specialist).
• You must not have terminated OPSRP membership.

• You must not have worked in any capacity, including non-PERS employment or self-employment during this time.

The disability determination can take up to six months, sometimes longer, from the date PERS receives your initial application.

If your application for OPSRP disability is approved, you will receive an approval packet in the mail. This packet includes the required forms you will need to complete to initiate your disability benefits.

Your employer also must submit mandatory information to PERS before disability benefits can be paid.

After you are approved for OPSRP disability, your effective date of disability is the first of the month following any month you received paid salary or paid leave.

No benefit can be paid until the required 90-consecutive-day period of incapacity has elapsed, except for terminal cases.

After the 90-day period, benefits are paid retroactive to your effective date of disability, which is based on information we receive from your physician and employer.

You are not required to exhaust all your vacation and sick leave; however, disability benefits will not begin until you receive the last of any paid leave from a participating employer, including any lump-sum payment for accrued vacation leave or compensatory time.

Upon approval, your disability benefit will be calculated to equal 45% of your last full month’s gross salary prior to your disability.

No, the OPSRP disability program does not include any survivorship options.

You may apply to retire (with a reduced benefit) in a general service position when you reach 55 years of age. If you are a police officer or firefighter, you may apply to retire (with a reduced benefit) when you reach age 50. Applying for retirement under the early retirement provision will end your OPSRP disability benefits.

Yes, periodic reviews of your disability status continue. until normal retirement age or staff determines reviews are no longer warranted.

Schedule routine visits with your treating physicians so that current information (within three months of your review date) will be available for your periodic review.

Your claim will be reviewed until you reach normal retirement age, at which time your disability benefit will stop.

As part of the review, PERS also will contact the Oregon Employment Department to determine if you are working and may request you submit a copy of your annual tax return.

Yes, you may cancel your application for OPSRP disability any time before the date your first disability benefit is issued. You must complete a cancellation form provided by PERS.

PERS will notify you by regular and certified mail. The first notification, an “intent to deny” letter, is considered a preliminary denial. The letter will cite the reasons for the determination and explain next steps. You will have 30 days to provide PERS with additional documentation to support your claim. You also will have the option of requesting a time extension of 30 additional days.

If PERS does not receive additional information supporting your claim or if the additional information does not change the determination, we will notify you by regular and certified mail. This is considered a formal denial. This letter will provide you with your appeal rights, and you will have 45 days to submit your appeal of the denial of your disability benefit.

Your employer may provide health insurance coverage. You should contact your payroll or personnel office for information.

If you are medically released before you are normal retirement age, or return to work in any capacity, you are required to notify PERS immediately. Your disability benefit will be discontinued, and you will be invoiced for any benefits for which you were not entitled.

You should notify PERS immediately when your start work as you will no longer be eligible for OPSRP disability benefits. Your disability benefit will be discontinued as of the first of the month that you returned to work, and you will be invoiced for any benefits for which you were not entitled.

You must report unemployment benefits received to PERS and report your disability benefit received from PERS to the Employment Department.

Note that while receiving unemployment benefits, you must be physically and mentally able to work, available for work, and actively seeking work. If this is the case, this may affect your eligibility for continuing disability benefits, which requires that a member be totally disabled and unable to perform any work for which you are qualified.

Yes, but a member who is receiving OPSRP disability benefits who withdraws their Individual Account Program (IAP) account will have their disability benefits ended and their OPSRP membership terminated. The member will not receive any benefits or payments from their OPSRP pension when withdrawing.

A member who is receiving OPSRP disability benefits who has reached early retirement age is eligible to retire their IAP, but their OPSRP disability payments will be ended, and they must apply for an early OPSRP service retirement .