Public School Employees Retirement System Let s Talk About Disability Retirement Benefits Publication # 9540 4/2012
The Public School Employees Retirement System (PSERS) provides this document for educational and informational purposes. Information in this document is general in nature, does not cover all factual circumstances, and is not a complete statement of the law or administrative rules. The statements in this document are not binding. In any conflict between the statements in this document and applicable law or administrative rules, the law and administrative rules will prevail. This document is designed solely to provide an overview of benefi ts available to PSERS members and is not intended to be a substitute for retirement counseling. If you are considering a disability retirement, you are encouraged to contact PSERS to meet with a PSERS Regional Representative. The representative will guide you through the process to ensure timely fi lling of your application.
Table of Contents What is a Disability Benefi t?... 1 Eligibility... 2 Monthly Payments... 3 How do I Apply?... 5 Charges for Requesting Medical Information... 6 Eligibility Determination... 7 Date of Retirement Determination... 7 Appeals Process... 7 What if Appeals Process is Exhausted?... 8 Length of Benefi t... 8 Benefi t Renewal Process... 9 Working While Receiving a Disability Benefi t... 9-10 Earnings Limitations... 10-12 Health Insurance Choices... 13-14 Premium Assistance... 15 Taxes on Benefi t... 15 Retirement Options... 16-17 Topics to Discuss with Employer... 17 Contacting PSERS... 18 Comparison of Benefi ts... 19-20
The disability retirement benefit What is it? Unlike an insurance policy, a disability retirement benefi t is an actual retirement benefi t. You must fi le an Application for Disability Retirement (PSRS-49) to be considered for the benefi t. Benefi ts are subject to approval, denial, or renewal based on your medical documentation and your job description. PSERS reserves the right to review and/ or revoke your disability benefi t at any time. Generally, a disability retirement benefi t is designed to provide at least one-third of your fi nal average salary. If granted disability benefi ts, you will receive a monthly retirement benefi t payment for as long as you are deemed disabled and comply with the necessary requirements. Your benefi t is subject to an annual earnings limitation and ongoing submission of medical documentation. You may receive a disability retirement benefi t from PSERS and receive a disability benefi t from another plan such as workers compensation, social security, and/or an independent insurance company. Receiving other disability benefi ts will not affect your PSERS disability retirement benefi t; however, your PSERS disability retirement benefi t may affect other disability benefi ts. Your insurance provider or workers compensation carrier may require you to reimburse them for any retroactive disability retirement 1
benefi ts paid to you by PSERS. It is your responsibility to contact those insurance carriers regarding PSERS payments. Am I eligible? To apply for a disability retirement benefi t, you must: Have become disabled while an active member of PSERS and still be disabled at the time you submit your application. NOTE: Should you become disabled after you terminate service with your employer, you are not eligible for a PSERS disability retirement benefi t. Have at least fi ve years of credited service with PSERS. Be physically or mentally unable to perform the duties as stated in your job description. Apply for disability retirement benefi ts within two school years of your last day of service or paid leave, whichever is later; and you must be disabled at the time of application.* *For example, if you leave service in March of the current school year, you have two school years (July 1 through June 30) from the close of the current school year to apply. If you do not apply within the two school years, you will forfeit all rights to apply for a disability retirement benefi t. 2
PSERS does not require you to terminate your position to be eligible to apply for a disability retirement benefi t. If you apply while an active contributing member, you must go on unpaid leave or terminate employment within 30 days of submitting your application to PSERS. If at a later date you are able to return to the job, there is no guarantee that your employer will keep the position open for you. You may want to discuss this with your employer. You may not switch from a normal or early retirement benefi t to a disability retirement benefi t. A disability retirement benefi t is not available to members who are already receiving a normal or early PSERS retirement benefi t. How much retirement income will I receive if I retire with a disability retirement benefit? Provided you have reached at least 16.667 years of credited service, your disability retirement benefi t is equal to the Maximum Single Life Annuity (MSLA) minus any reductions for options chosen by you. If you have less than 16.667 years of credited service, additional factors are applied. 3 A disability supplement may be included as a part of your disability retirement benefi t. The disability supplement removes the effects of early retirement penalties if you have not reached normal retirement age. If you have reached normal retirement age, the
supplement is not included in the benefi t calculation. For Class T-C or Class T-E members, PSERS disability retirement benefi t is intended to provide you with at least one-third of your fi nal average salary if you are not eligible for normal retirement. For Class T-D or Class T-F members, a PSERS disability retirement benefi t is intended to provide you with 40% of your fi nal average salary if you are not eligible for normal retirement. PSERS suggests that you obtain a disability retirement estimate before applying for the benefi t. Contact PSERS to receive a Request for Retirement Estimate (PSRS-151) form. This form is also found on the PSERS website. When you complete the estimate request, be sure to check the Disability box to request a disability retirement estimate. Return the completed form to the PSERS fax number or address listed on the form. PSERS will prepare and send you a regular retirement estimate and a disability retirement estimate by return mail. 4
How do I apply for a disability retirement benefit? PSERS strongly suggests that you attend a disability retirement counseling session conducted by a PSERS Regional Representative before applying for a disability retirement benefi t. By attending a PSERS counseling session, you avoid some of the common mistakes which may lead to a delay in processing. At the counseling session, the Representative will review your retirement estimates, explain the application process, and assist you in completing the PSERS Application for Disability Retirement Packet which will be provided at that session. Attendance at a counseling session will ensure that you are provided with the information you need to have your benefi t processed timely. The contact information to schedule an appointment with a PSERS regional offi ce is found on page 18. To apply for a disability retirement benefi t, you must complete and submit the following forms to PSERS no earlier than 30 days before you begin an unpaid leave or your date of termination: Application for Disability Retirement (PSRS-49). You will complete this application during or after your PSERS counseling session. Job Description (PSRS-1236). Your employer completes this form. 5
Physician s Medical Report(s) (PSRS-1237). Your physician(s) complete this form. Your physician should provide an evaluation of your medical history as it affects your ability to perform assigned duties. This information should refl ect your physical and/or mental condition as of your last day of paid service as well as your current condition. If the medical information submitted is insuffi cient to make a determination, the PSERS medical examiners will request that you provide additional information from your physician(s). If you are applying prior to your termination or unpaid leave start date, your employer must electronically submit to PSERS an unpaid leave status or a termination date within 30 days of the date your application is received by PSERS. The effective date of your unpaid leave status or termination must be within 30 days of your application. Any missing and/or insufficient required medical information will delay the processing of your application. Who is responsible for charges incurred to provide the medical information? You are responsible for any cost to obtain the medical information needed to determine your disability status. 6
Who determines my eligibility for the disability retirement benefit? PSERS determines approval or denial of the disability retirement benefi t with recommendation from PSERS medical examiners. How is my date of disability retirement determined? The benefi t effective date of a disability retirement is the day after your last day of paid service or paid leave, whichever is later. You may not select your own disability retirement effective date. What if my request for a disability retirement is denied by PSERS? If your request is denied by PSERS, you may appeal the denial and request an Administrative Hearing by writing to: Offi ce of Chief Counsel Public School Employees Retirement Board 5 N 5th Street Harrisburg PA 17101-1905 This hearing is held before an independent hearing examiner. Legal counsel may represent you and you may appear before the hearing examiner. 7
If you do not receive a favorable result at the conclusion of the administrative hearing process, you may appeal the decision to the Commonwealth Court. What if I have exhausted all steps in the appeals process and I m still denied? There are a number of options available to you if you are denied a disability retirement benefi t. Different membership classes and circumstances have different benefi t eligibility requirements. Contact your PSERS Regional Offi ce to speak to a counselor regarding the choices available to you. More information is also found on the PSERS website and in the PSERS publication Your Retirement Benefi ts and Leaving Employment (PSRS-9580). How long am I entitled to a disability retirement benefit? At the time your disability retirement benefi t is approved, PSERS will determine the terms and conditions of your benefi t. The length of time of your disability is determined by the fi ndings of the PSERS medical examiners review. You may be subject to a periodic renewal and/or review process. 8
How will I know when it s time to renew the benefit? PSERS sends an Application to Reapply for Disability Benefi ts (PSRS-1238) to those retirees subject to a periodic renewal. The renewal application must be completed by your physician and returned to PSERS by the date stated on the application. If you fail to return the application by the due date, you risk having your monthly disability retirement benefi t suspended. Continued failure to return the application will result in the denial of your disability retirement renewal and stop your disability retirement benefit. You will also need to return to PSERS any overpayment of your benefit. If your renewal is denied, you have the right to appeal the decision. Refer to What if my request for a disability retirement benefi t is denied? on page 7. If you are denied a continuation of your disability retirement benefi t and you are eligible to receive an early retirement benefi t, your retirement benefi t is calculated using the reducing factors in effect at the time of your original disability retirement date. May I work while receiving a disability retirement benefit? 9 You may be employed while receiving a disability retirement benefi t from PSERS. You are not, however,
permitted to return to work for a Pennsylvania public school employer without the loss of your monthly benefi t unless you qualify for specifi c exceptions. These exceptions are further explained in the PSERS publication, PSERS Return to Service Guidelines (PSRS-9682), located on the PSERS website. If you are employed while receiving a PSERS disability benefi t, an earnings limitation is imposed on the amount you earn yearly. See Is my disability retirement benefi t affected by other earnings that I may have? next. Please note: Your ability to be employed in any capacity, inside or outside of Pennsylvania, may raise questions about your medical eligibility to receive a disability retirement benefi t. Is my disability retirement benefit affected by other earnings that I may have? Each year PSERS sends an Annual Earnings of a Disability Annuitant letter to each retiree under normal retirement age receiving a disability retirement benefi t. The purpose of this letter is to determine whether or not you are working in another job, and if so, whether you are exceeding the amount you may earn per year without having to return money to PSERS. 10
Your yearly earnings plus your yearly disability benefi t cannot exceed your annual earnings limitation, which is generally based on your last school year salary. For example - Your last school year salary was $40,000. This makes your earnings limitation also $40,000. If your annual PSERS disability retirement benefi t is $25,000, you cannot earn more than $15,000 of additional earned income per year without having to return money to PSERS. If your yearly income exceeds your earnings limitation, you will need to return the difference to PSERS. You may choose to return the excess earnings in one of two ways: A lump-sum payment within 30 days Your monthly benefi t is reduced by the amount of the disability supplement until the overpayment is recovered. When completing the Annual Earnings Statement, you should only report earned income. Earned income is compensation received by you for work as an employee of any business or by being self-employed. The following are not earned income and should not be reported: 11
Disability payments Retirement benefi ts Social Security benefi ts Workers compensation Investment income Dividends Child support Spousal support Additionally, you should not report wages received from your school employer earned before the effective date of your disability retirement. The Annual Earnings Statement should be completed and returned to PSERS as soon as possible, but no later than the date specifi ed on the statement. If this form is not completed and returned to us by the requested date, your monthly disability retirement benefi t will be suspended. Continued failure to return the form will result in the forfeiture of all rights to the disability retirement benefi t in excess of any early or normal retirement annuity to which you were entitled. You will need to complete an Annual Earnings Statement yearly until you reach superannuation age. For superannuation requirements, refer to the PSERS publication, Your Benefi ts and Leaving Employment (PSRS-9580) found on the PSERS website. 12
What health insurance choices are available to me? 1. You may be eligible to have private health insurance coverage, including individual or spousal. Such coverage, however, does not qualify for premium assistance. (See following question.) 2. You may be eligible to remain in your employer s group health insurance plan. Consult with your employer regarding continuance of their health insurance coverage. 3. The PSERS Health Options Program (HOP) is available for all retirees, their dependents and survivors. HOP offers comprehensive medical coverage before and after you become eligible for and enroll in Medicare. You and your eligible dependents may enroll in HOP within 180 days of a qualifying event: 13 You retire or lose health care coverage under your school employer s health plan. (Coverage under your school employer s health plan includes any COBRA continuation of coverage you may elect under that school employer plan.) You involuntarily lose health coverage under a non-school employer s health plan. (Coverage under your non-school employer s
health plan includes any COBRA continuation of coverage you may elect under that non-school employer s health plan.) You or your spouse reach age 65 or become eligible for Medicare. You experience a change in family status (including divorce, your death or the death of a spouse, addition of a dependent through birth or adoption, your marriage, or loss of a dependent through loss of eligibility.) You become eligible for premium assistance due to a change in legislation. A plan approved for premium assistance terminates, or you move out of a plan s service area. HOP provides pre-65 health insurance coverage for individuals not eligible for Medicare. You may choose a managed care plan, where available, or a fee-for-service plan. HOP also provides Medicare supplemental and Medicare Advantage if you are eligible for Medicare. You must be receiving Medicare Part A and B coverage to enroll in a Medicare supplemental and Medicare Advantage plan. Comprehensive descriptive material and enrollment information is available upon request by contacting the HOP Administrative Unit at 1-800-773-7725 or on the HOP website at www.hopbenefi ts.com. 14
Is a disability retiree eligible for Premium Assistance? Premium assistance is a reimbursement of out-of-pocket expenses for the cost of the retiree s basic health insurance. Up to $100 per month is available to eligible PSERS retirees receiving a disability retirement benefi t provided they have an out-of-pocket expense for basic health insurance coverage from one of the following: PSERS Health Options Program A Commonwealth public school employer s group health insurance plan that is certifi ed with PSERS. The amount of premium assistance you receive cannot exceed the actual premium you pay for basic coverage. Premium assistance is a tax-free reimbursement added to your monthly benefi t. Contact the Internal Revenue Service (IRS) if you require further details regarding tax implications. Is my disability retirement benefit taxable? Your PSERS disability retirement benefi t is subject to federal taxes but not to Pennsylvania state or local taxes. If you reside in or you move to another state, you should check with that state regarding taxes that may be due on your disability retirement benefi t. 15
For additional information on taxes, please contact a tax advisor or the Internal Revenue Service (IRS). What disability retirement options are available to me? Maximum Single Life Annuity (MSLA) - You will receive the maximum monthly benefi t for as long as your disability benefi t continues to be granted. If you die, any remaining balance in the present value of your retirement benefi t will be paid to your benefi ciary(ies). Under this option, you may name more than one benefi ciary and you can change your benefi ciary(ies) at any time. Option 2 - You will receive a reduced monthly benefi t based on your age and gender and the age and gender of your survivor annuitant at the time of disability retirement. At the time of your death, your survivor will receive the same amount per month that you would have received if you had retired under a normal or early retirement benefi t. Under this option you may name only one survivor annuitant. Option 3 - You will receive a reduced monthly benefi t based on your age and gender and the age and gender of your survivor annuitant at the time of disability retirement. At the time of your death, your survivor will receive one-half of the amount per month that you would have received if you had retired under a normal or early retirement benefi t. Under this option, you may name only one survivor annuitant. 16
Customized (Special) Option 4 This is a customized payment plan for your monthly benefi t. To select this plan, it must be actuarially equivalent to Maximum Single Life Annuity. As with both Options 2 and 3, the disability supplement (if applicable) is removed for the survivor annuitant. You may not change your survivor annuitant or retirement option under Options 2, 3, or the Customized (Special) Option 4 unless your original survivor annuitant predeceases you or your marital status changes. If this situation occurs, contact PSERS to discuss your next steps. When you receive a PSERS disability retirement benefi t, no matter what option you select, you may not withdraw any portion of your contributions and interest. Special Rules for Class T-E and Class T-F If you are a Class T-E or Class T-F member who has fewer than 10 years of credited service with PSERS, you may only select the Maximum Single Life Annuity option. Before I make a decision, what would you suggest I discuss with my employer? The following is a list of suggested topics to discuss with your employer. There may also be other items to discuss 17
which are unique to your employer or bargaining unit contract. Sick, vacation, personal and emergency paid leave Workers Compensation Sabbatical Leave School-sponsored Disability Insurance Leave of Absence (Paid and/or Unpaid) o Length of leave o How long position will be held Health Insurance Life Insurance Resignation Contacting PSERS You may contact PSERS toll-free at 1-888-773-7748 from 7:30 a.m. to 5:00 p.m., Monday through Friday, except on State holidays. PSERS also has regional offi ces located throughout the state. Their core operating hours are 8:30 a.m. to 5:00 p.m. A complete list of all PSERS regional offi ces is found on PSERS website under Regional Offices. Harrisburg Headquarters 5 N 5th Street Harrisburg PA 17101-1905 Toll-Free: 1-888-773-7748 Local Telephone: (717) 787-8540 Email address: ContactPSERS@pa.gov Website: www.psers.state.pa.us 18
Comparison of Retirement Benefits Terms of Retirement Requires termination of employment to apply Must meet medical eligibility May withdraw contributions and interest at retirement May be revoked by PSERS at any time based on medical status Subject to renewal Subject to yearly earnings statement Restriction of earned income School employment in another state may jeopardize PSERS benefi t May work in Pennsylvania public schools under exceptions allowing retirees to be employed for emergency, shortage of personnel, or extracurricular situations Eligible for cost-of-living adjustments without regard to superannuation qualifi cations Eligible for premium assistance without regard to service credit and/or age 19
Normal/Early Class T-C/T-D Normal/Early Class T-E/T-F Disability Yes Yes No No No Yes Yes No No No No Yes No No Yes No No Yes No No Yes No No Yes Yes Yes Yes No No Yes No No Yes 20
5 N 5th Street Harrisburg PA 17101-1905 www.psers.state.pa.us ContactPSERS@pa.gov