LACERA Investigators

1
LACERA Investigators RTW Coordinators How
Your Efforts Help Us (and hopefully you too)
Presented by Richard Schlosser Shari
Altmark Disability Retirement Section Supervisors
2
DISABILITY RETIREMENT GENERAL TERMS
Service Connected Disability Eligible from 1st
day of employment Must be permanently
disabled Must have a direct causational link to
the workplace Non Service 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
3
DISABILITY RETIREMENT vs. WORKERS COMPENSATION
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 LACERAs Board of
Retirement not bound by Workers Comp. system
and is not a party to Workers Comp. Decisions
LACERA grants only Permanent Incapacity
4
EMPLOYEES APPLICATION
EMPLOYERS APPLICATION
5

• Contents Within Employees 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

6

• Contents Within Employers Packet
• Disability Retirement brochure
• Disability Retirement Eligibility and Application
  Instructions (Department version)
• Application for Disability Retirement

7

• Discovery and Obtaining of Records
• Following records obtained prior to interviewing
  the member
• (where applicable)
• Medical/Psychiatric Records through TPA or
  private
• Personnel Records (cooperative effort with county
  departments)
• Performance Evaluations
• Grievance Filing/Internal Investigations
• Workers Compensation Files
• Benefit Awards
• Notice of Work Restrictions
• List of All Claims Filed
• Electronic Access Listing
• Third Party Administrator Assistance
• CEO Office Communication

8

• Member Interview
• Prepare a Disability Evaluation Summary Report
• The interview with employee is conducted to
  obtain information regarding the following
• History of Injury/Illness
• Occupational History/Physical Requirements
• Light Duty/Accommodated Assignments
• Current Symptoms/Complaints
• Retroactive Recommendation

9

• Witness Statements
• Investigator contact with supervisor and/or
  co-workers
• Statements to verify the witnessing of
  injury/illness
• actual duties
• Physical requirements
• Frequency of movements
• Ability to perform duties
• Return-to-work Coordinator statements regarding
  accommodation

10

• Medical Examination
• Send Medical Records and Summary Report to Panel
  Physician (Panel Physician Guidelines)
• The mechanism of injury
• Show history and track treatment rendered
• General medical history
• Board Preparation
• Notify the member/attorney in writing of exam
  date
• Notify the Member/Attorney in writing of Board
  date
• Member/Attorney may attend the closed session,
  but he/she may not address the Board regarding
  the application

11

• Processing Timeframes
• Minimum amount of time to process a disability
  application is 7 to 9 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

12
REASONABLE ACCOMMODATION DISABILITY RETIREMENT

• What is a Reasonable Accommodation?
• Position within Applicants current job class
  that is modified to accommodate permanent work
  restrictions.
• The employer may choose to modify the applicants
  current assignment or offer another assignment,
  so long as it is within the same job class.
• The offer must be written
• The BORs decision is not dependent on whether or
  not the Applicant accepts position.

13
REASONABLE ACCOMMODATION DISABILITY RETIREMENT

• Board of Retirement (BOR) is a separate legal
  entity, empowered to make its own findings of
  fact
• 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.
  However, if there is a written offer of a
  permanent accommodation within applicants job
  class
• Applicant is found to be not permanently
  incapacitated
• Disability retirement is denied

14
SUPPLEMENTAL RETIREMENT ALLOWANCE

• Supplemental Retirement Allowance is a good way
  retaining 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 and 31725.6/.65
• Applications are to be treated like any other
  application the criteria is that the applicant
  must be found disabled from the ORIGINAL position.

Section 31725.5 Applies to nonservice-connected
disability retirements.
Section 31725.6/.65 Applies to service-connected
disability retirements.
15
VOLUNTARY DEMOTION

• A voluntary Demotion can be done two ways
• Demoted to lesser position, lesser salary, and no
  provisions to supplement for the pay cut. These
  cases will have the supplement start on either
  the date of application or the date of demotion
  per Section 31724.
• Demoted to lesser position, with a Y-Rate,
  assigned at the time of demotion. Pay stays the
  same until disability is determined.

16
CONDITIONS FOR SUPPLEMENTAL RETIREMENT ALLOWANCE

• Contingent on
• The offer of a permanent position with a lower
  salary schedule which accommodates the employees
  permanent work restrictions
• The acceptance of this position by the employee

17
SALARY SUPPLEMENTAL ALLOWANCE

• 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.
• Departments Responsibilities are
• Confirm the employee has applied for disability
  retirement benefits with the salary supplement
• Place the employee on a Y-Rate pending the
  Board of Retirements action
• Ensure the employees salary remains unchanged
  during the disability retirement application
  process

18
ENGAGING THE PROCESS

• LACERAs Responsibilities
• 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

19
MEMBERS FUTURE EARNINGS
The calculation is based upon the members 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 positions salary, the
Salary Supplement allowance stops.
20
SUPPLEMENTAL RETIREMENT CALCULATION

• Example 1
• Previous position monthly salary 4,000
• Disability Allowance 1,333
• New Position monthly salary 3,000
• LACERA pays 1,000
• Example 2
• Previous position monthly salary 4,000
• Disability Allowance 1,333
• New Position monthly salary 2,000
• LACERA pays 1,333
• Cannot exceed Disability Allowance amount

21
(No Transcript)