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.