Pension proposal would modify disability benefits

A few of our members asked recently, via our Facebook page, whether there could be changes in store for the OPERS disability program when pension redesign takes place.

The answer is yes. While our disability program hasn’t been substantially modified for decades, the redesign plan that the OPERS Board of Trustees approved in November 2009 contains a series of recommended changes.

First, here’s some background on the program: Currently, members who have five years of service credit may be eligible for long-term disability benefits. This coverage is provided to law enforcement and public safety officers regardless of their length of service if the disability is due to an on-duty injury or illness.

All members who apply for disability benefits from OPERS must first be determined to be medically disabled by their own physician. They also must be examined by an independent physician, with whom we contract, to determine if the member is disabled from the duties of their most-recent public employment.

Then, an independent medical advisor reviews the recommendations and makes a final recommendation to the OPERS Board of Trustees, which approves all disability benefits.

At year end 2009, we covered 22,651 members with disabilities. In 2010 we received 1,502 disability benefit applications. We approved 969 and denied 140, with the remainder still being processed.

The most significant proposed change, which will require action by the Ohio General Assembly, is to modify the standard for determining disability.

We use an “own occupation” standard when members are evaluated for disability eligibility. In other words, are they incapable of performing the duties in their occupation? Disability recipients are re-evaluated yearly to determine if they can return to their own occupation.

According to our proposed changes, members first applying for a disability benefit on or after the legislation effective date will initially be evaluated on the “own occupation” standard. But after three years they will be checked yearly according to an “any occupation” guideline to determine if they’re capable of performing another job that’s different than their original position, with certain qualifying criteria.

Under this “any-occupation” standard, the disability benefit would be terminated if the recipient can perform any occupation other than the one from which they were determined to be disabled. The new criteria include that the new position:

  • Replaces 75 percent of final average salary
  • Is reasonably to be found in the member’s regional job market
  • Is one that the member is qualified for by experience or education

Our goal is to modernize the program to reflect the fact that many people who have a disability still can be gainfully employed in another job and can return to work.

As part of a greater package of disability program improvements, the Board in 2009 approved standardizing the initial disability determination process and annual re-examinations. Last year OPERS hired Managed Medical Review Organization to help us implement these standards.

For more information about all of the proposed changes to the OPERS disability program, click on this link.

This entry was posted in Benefits, Pension Reform, Pensions and tagged , , , . Bookmark the permalink.

42 Responses to Pension proposal would modify disability benefits

  1. Carl Zellner says:

    Will this change for a person already on disability, 10yrs, as there is no longer a position available to me??

    • Michael Pramik says:

      Carl, the proposed changes to our disability program will not apply to those already on disability. If a disability is terminated after the bill’s effective date and the individual reapplies, then the changes would apply. Please remember that these changes are part of our Board of Trustees’ pension redesign proposal and must be enacted by the Ohio legislature.

      – Ohio PERS

  2. KRYSTA says:

    I have been on disability, for 6 yrs now, am i understanding correctly this new information will not affect those of us who have been on disability benefits?

  3. The BEST pension plan in the country by far !!!, Well run , GREAT Service !!!, thank You !!!

  4. Frank says:

    Will the proposed changes in disability affect the date that a current disability recipient will convert to an age/service retirement? (Currently, I’m due to convert when I’m 65. Will that change to when I’m 67, the proposed new full retirement age?) Thanks.

    • Michael Pramik says:

      Frank, there are too many variables in play to fully answer your question without more information. It depends in part on your eligibility for age and service retirement, and which of the transition groups you would fall into in our proposed pension legislation (as well as whether the state legislature adopts our recommendations).

      If you would be in Group C, for instance, we have asked that the current pension bill be amended to increase the conversion age to 67. However, if you are in one of the other groups the conversion age could depend on your age at the time you were awarded the disability benefit.

      For a more complete answer to your individual case, contact our Member Services department at 800-222-7377.

      – Ohio PERS

  5. Karen says:

    I understand that you indicated these changes would not affect those of us who have been on disability for a number of years, however, in the language of the bill on the website, I understand it to read “The bill establishes a new disability standard for a recipient to whom all of the following apply: (1) the benefit has been paid for three years or longer and (2) the recipient is not considered on leave of absence due to receiving rehabilitative services acceptable to the Board. Under the new “any occupation” standard, the disability benefit will be terminated if the recipient is not physically or mentally incapable of performing the duties of a position that meets all of the following criteria: (1) Replaces not less
    1. an 75% of the member’s final average salary, adjusted each year by the actual average increase in the Consumer Price Index; Is reasonably to be found in the member’s
    (2) regional job market; (3) Is one that the member is qualified for by
    experience or education. ds the current forfeiture of a retirement.”
    Many disability retirees may fit right into this little paragraph. I understand it to read, our disability benefits most certainly can and may very well be terminated if this bill passes. Please explain to me how this info translates to “the proposed changes to our disability program will not apply to those already on disability”. Thanks.

    • Michael Pramik says:

      Karen, the intent of the proposed changes to the disability program is to administer them only to applications filed after the bill’s effective date. We periodically update our Comparative Summary chart and will make that notation the next time that we do. Thanks.

      – Ohio PERS

  6. Bob says:

    The review board said they can’t find a doctor within 25 miles so they found one OVER 100 miles away. They expect her to go. Her disability makes this very difficult on top of the expense with gas prices being soooooo high. Just how far can they go with their orders? What can we do?

    PLEASE help.

    • Michael Pramik says:

      Bob, the company that we contract with for disability program assistance, Managed Medical Review Organization, is charged with finding physicians within a 75-mile radius of the member’s address. They have agreed to explore optional solutions on a case-by-case basis. Please contact MMRo, at 866-516-6676, to discuss your concern.

      – Ohio PERS

  7. Frank says:

    Would you please direct me to where I can find the proposed changes to the disability plan including the different “groups”? Thanks!

  8. Darrell Huber says:

    My wife was granted disability due to fibromyalsia and manic depression for one year. She was then ordered to go to one of pers doctors who did not spend 15 minutes looking at hardly any of her medical records and was told she is denied and beifits were cut off. We appealed and it has been 4 months and we are still fighting them and she cannot work with this disability. What do we need to do, sue because she can’t get disability and she cannot work? ohio pers is very unfair and Ohio Law makers need to get into the act for those who truly need the disability to live! We are are baffled and stranded!!!!!

    • Jon says:

      If you have a medical condition and it does not go away, how can you not be disabled? OPERS and the time made to wait causes a person world to crumble. OPERS claims to be for Ohio families, how it takes money to run a family and being denied.

      • Joe says:

        OPERS, a person works 15 plus years in the same field.
        Skills you are not in market for different work.
        What does Opers do to help people that have a disability find work since its almost impossible to get disability and maintain a family?
        Legally. being out of work over 12 months is that not a disability?
        Why does the state help inmates find work yet people such as myself kept the public safe from them?
        Opers shame on you!
        Web site suggest you are helpful yet paperwork and waiting says other?

  9. Brady Budzik says:

    thanks for the good work

  10. Kimberly Blackburn says:

    What type of qualifications are required for a person with Multiple Sclerosis to file for disability?

    • Michael Pramik says:

      Kimberly,

      We do not have a list of qualifications for disability pertaining to specific diseases. Each member must qualify following our general disability rules on a case-by-case basis. The disability pamphlet linked here gives members the basics of how to determine if they are eligible to apply for a disability benefit.

      https://www.opers.org/pubs-archive/leaflets/ISL-K.pdf#zoom=80

      For more assistance, please contact our Member Services department at 800-222-7377.

      – Ohio PERS

  11. Rebecca Rhodes says:

    I’ve been on disability through OPERS since 2007. My treating physician doesn’t do this anymore leaving me to find another doctor to see me. I have been trying for 4 months to find a doctor in Central Ohio who understands this pension and will do the paperwork, either w/ my insurance or if I pay cash. If anyone knows of a doctor I could possibly see, please email me. Carpal Tunnel complications is my diagnosis. I am without an income while I look and need your help now! Thanks!

  12. Cindy Nash says:

    I have been on disability since 2003 from law enforcement will my medical insurance be cut off? Im to young to apply for medicare.

    • Michael Pramik says:

      Cindy,

      If you are currently receiving a disability benefit, the current law changes would not affect you. Also, you would not have to apply for Medicare.

      –Ohio PERS

  13. Nora says:

    I have been on disability since 2007. I fell at work on the ice in the parking lot 2 times and as a result of these injuries I have had to have 2 neck surgeries and may be “looking forward (lol)to number 3″. I also have other medical problems. I have 22 1/2 years of service. I do not enjoy being on disability. I am not , and will never be able to go back to a 40hr a week job ANYWHERE. Despite this, in order to contribute more to my medical insurance/expenses, I would be willing to TRY to work part time somewhere. I would be happy to contribute in any way that I can. Why must disability recipients live in fear of losing their health care/and or disablity benefits by trying to do what they ARE capable of doing? This makes no sense to me. If I am to be charged more for my health insurance, why not give me the chance to pay for it without losing my car, apartment, or having to be a burden to others?

  14. Lee says:

    I work full time and was diagnosed with fibromyalgia almost a year ago. After many years of dealing with pain, being tired, the fibro fog, tingling in my hands, feet, and face, hands that do not work properly, etc. I finally found out the cause of my ailments. My job can be very stressful and that caused the symptoms to flare up even worse. I can’t just quit, I cannot afford to do so. I am at a loss! My bosses do not seem to undertstand or care that I am struggling, they still expect so much from me and make no concessions to make my job easier. My position requires me to type and write. My hands are getting worse over the years and it is becoming harder to do these things. Concentrating is also becoming more difficult and my job requires attention to detail. I have worked for this city for more than 10 years but I am not even close to retirement age. I have children still living at home and we need to help them with college. I had yet another bad day today and no one seems to care. I come home most days so exhausted. When I get up in the morning, I can barely move for the first hour or two. I don’t know anything about disability, don’t know where to start. I also have asthma, high blood pressure and thyroid issues. Can I start the disability process while still working? I can NOT be without pay. But it is literally making more more sick to work! Please, please help me!

  15. Donna says:

    My question is my husband is on disability retirement he is now eligible for age retirement. Does he have to switch? And if he does switch does the Dr have to release him. We have moved to Florida because the warmer air helps with his pain. If he does not switch can he be seen by a Dr here or does he have to travel back to Ohio to be seen by one of opers Dr’s? If he switches to age retirement how long does this take?

    • Michael Pramik says:

      Donna,

      Our Member Services department can answer questions that are specific to your personal situation: 800-222-7377.

      –Ohio PERS

  16. Ron says:

    I know the legislation pension reform passed already but can not help but ask why OPERS did not consider requiring the pending disability employee’s employer to offer the employee other open jobs that said employee meets hiring criteria .
    This should be part of the Ohio Revised Code. If not up front pending disability…at least at the point where the the criteria changes from ” own job” to any job. I was unable to do my current position but could have performed many other jobs open at the time within my agency I would have preferred that…taking a pay cut if necessary. Ironically, I worked for the Developmental Disabilityhey had no interest in keeping one of their own employed once they became disabled.

  17. art mullikin says:

    my doctor is on a religious leave of over 5wks! only problem is that i have continued treatment form due in 14days and if not recvd by pers then i ll lose december 1st check! i am helpless in this as my doctor is the one required to fill this form out as i have no choice but to wait for himt to complete this form etc… in short he will not be completing the form by the deadline so what do i do as im gonna lose dec 1st income and during holiday month! can i get a 30 day extension or talk to a supervisor? thanks

  18. Sue says:

    I have been on disability since 1995 how will the new changes affect my health care for me and my husband and 18 year old son

  19. Florence says:

    I have been on pers disability since 2006 and are planinng on ful, retirment in three more years. with the new reform laws waill my retirment be less than what it is now

    • Michael Pramik says:

      Florence,

      Without knowing what you are receiving now, it’s impossible to say. Your best bet is to contact OPERS Member Services at 800-222-7377.

      –Ohio PERS

  20. Nancy says:

    I have been receiving a medical retirement since November 2008, for stress and depression due to colon cancer in which I am still being treated for. How long am I obligated to see the psychiatric doctor? Some say five years is that the case? Monthly trips to physicians take a toll on me due to my condition. Thank you in advance for your cooperation in this matter.

    • Michael Pramik says:

      Nancy,

      There is no time limit on the question you pose. The five-year limit is part of the new health care plan that goes into effect in January. It limits the time that some new disability recipients can receive benefits. The continuation of treatment typically indicates progress, and compliance is thus required for disability benefits to continue.

      –Ohio PERS

  21. thomas says:

    I have to have neck surgery #2 (not due to work as we know) I have 24 years in PER’S and im only 47 The DR is talking no more work in the prison at all! (Due to one wrong incident could leave me Parilized) Will I be able to apply for Disability Retirement?

  22. Bill mcdonald says:

    I have been on disability since 2000 from getting my back broke at work. I have had 3 surgeries since retirement. If I get a part time job what is the maximum that can be made. Is there a limit of money you can make?

  23. Kim Gitschier says:

    So if I a comprehending the modification correctly, I was approved for disability in 2010. If I was to return to work in the private sector, I would lose my disability benefits. Correct?

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>

Comments Policy