DPFP.org | Disability Application Procedure

Disability Pension Application Procedure

Adopted October 19, 1995
Amended Through November 9, 2000

Purpose:

Pursuant to its authority under Article 6243a-1 of the Revised Statutes of Texas and Section 6.03(a) of the Combined Pension Plan (“Plan”), the Board of Trustees ("Board") of the Dallas Police and Fire Pension System ("System") hereby adopts the following as its procedure ("Procedure") for processing disability pension applications of System members ("Member"). This Procedure will establish a coordinated and fully documented means of processing Members’ applications for disability pensions under the Plan.

It is the intent of the Board that this Procedure afford all participants in the disability pension application process (the Dallas Police or Fire Departments, the examining physicians, the System’s Pension Office and the Board with adequate time frames to accomplish their respective responsibilities as set forth herein. (For purposes of this Procedure, the term “physician” means a licensed medical doctor or doctor of osteopathic medicine.) To that end, this Procedure will provide a detailed outline of the steps and time frames involved in the typical disability application process. In addition, Members will be provided with all documents necessary to comply with this Procedure.

Cooperation:

In the absence of a reasonable excuse, the failure of a Member to fulfill the requirements of this Procedure regarding appearances at scheduled appointment(s) with physician(s) will terminate the Member’s application for a disability pension. Accordingly, the Member will be required to recommence the disability pension application process from the beginning.

Procedure:

I. Federal Law

Prior to making application for a disability pension, Members are advised to avail themselves of any rights they may have under federal law to retain a position with their Department or with the City of Dallas (“City”).

II. The Disability Pension Application Process

1. A Member who wishes to apply for a disability pension must first contact the Pension Office and schedule a counseling appointment with a Retirement Counselor, which appointment, generally, will be at the Pension Office.

2. The legal guardian of a Member may apply for a disability pension on behalf of a Member who lacks the capacity to independently make such application; provided, however, that no such application will be fully processed by the Pension Office until such time as legal documents establishing such guardianship are presented to and approved by the System. Where appropriate, references to the Member in this Procedure shall likewise refer to the Member’s legal guardian.

3. Prior to the scheduled counseling appointment, the Pension Office will send a letter to the Member requesting that the following documents be provided to the Retirement Counselor at the counseling appointment:

a. the Member’s birth or similar certificate (e.g. baptismal record);

b. if the Member is married:

(i) a copy of the Member’s marriage certificate (or similar evidence of a legal marriage), and

(ii) a copy of the spouse’s birth certificate or, in rare cases, other credible evidence (e.g. baptismal record) may be accepted; and

c. if the Member has unmarried children who are either under the age of 19 or handicapped, the children’s birth certificate and, if handicapped, evidence of such handicapped status.

4. At the counseling session, a Retirement Counselor will inform the Member of the following:

a. the current status of the Member’s retirement pension benefit, as well as the rights of the Member’s survivors to benefits;

b. the distinction between service-connected and non-service connected disability pensions;

c. the various disability pension options that may be available to the Member, as well as the rights of the Member’s survivorsto benefits;

d. the general prohibition against paying a disability pension until a Member has been prevented, by a disability, from performing the Member’s duties with the Member’s Department for a period of at least 90 consecutive calendar days in the preceding 6 months (the "Ninety Day Rule"); and

e. the time frames and requirements of this Procedure.

f. Written application must be made not later than 180 days after the Member leaves active service.

5. After the above information has been provided to the Member, the Retirement Counselor will request whether the Member wishes to proceed with an application for a disability pension. If the Member indicates a desire to continue the process, the Retirement Counselor will:

a. Assist the Member in filling out a "Disability Pension Application" (Exhibit "A" to this Procedure);

b. Advise the Member that an appointment must be scheduled for the Member with the Member’s attending Physician, the "Attending Physician") to evaluate the Member’s condition;

c. Provide the Member with an "Attending Physician’s Statement" form (Exhibit "B" to this Procedure). The System’s form must be properly and fully completed by the Member’s Attending Physician;

d. Provide the Member with a description of the current job duties for the Member’s rank (as is made available to the System) (Exhibit "C" to this Procedure), to be used by the Attending Physician in responding to questions contained in the Attending Physician’s Statement;

e. Provide the Member with a description of current sedentary duties available at the Member’s department (“Department”) (Exhibits “D” or “E”) to be supplied by the Member to the Attending Physician;

f. Provide the Member with a copy of this Procedure; and

g. Briefly explain the contents of the Attending Physician’s Statement form to the Member.

6. If the Member’s application is for a service-connected disability, the Pension Office will request that the Member execute a “Consent for Release of Medical Information” so that the Pension Office can request all injury reports (e.g. injury reports from the date on which the injury was first reported) from the Member’s Department and/or the City, as well as any other information from the Member’s Department and/or the City that relate to the circumstances under which the Member’s condition arose and the effect of such injury on the Member's service.

7. In order to confirm the Member’s compliance with the Ninety Day Rule, the Pension Office will request a copy of the Member’s time sheets for the previous months from the Member’s Department.

8. It is the responsibility of the Member to ensure that a fully and properly completed Attending Physician’s Statement along with any narrative and/or test results (e.g., CAT-scans, M.R.I.s, or psychological tests) be delivered to the Pension Office. A Member’s application for a disability pension will not proceed further until such time as the Pension Office receives a fully and properly completed Attending Physician’s Statement with all referenced attachments.

9. The Attending Physician’s Statement designated by the Member to be considered by the Board will determine the nature of the disability for which the Member seeks a disability pension. Both the selection of an independent physician (“Independent Physician”) by the Pension Office (if the Board or the Pension Office in their sole discretion deem necessary) and the review of the Member by the City Medical Officer will be based upon the nature of the Member’s claimed disability as described in Attending Physician’s Statement designated by the Member to be considered by the Board. There will be no determination by the Board of concurrent disability applications of a different nature for the same Member. If a Member desires to file a claim for a disability pension based on a disability of a different nature, the Member must separately follow the terms of this Procedure from the beginning.

10. Upon its receipt of the Attending Physician’s Statement and all attachments, the Pension Office may forward same to the City Medical Officer for purposes of selecting an appropriate Independent Physician to examine the Member. In certain cases, the City Medical Officer may be consulted in order to determine whether in his or her opinion it would be desirable to engage an Independent Physician to evaluate the condition of the Member.

The determination regarding whether further examination of the Member will not be required will be limited to those circumstances where the Member:

a. suffers from a terminal illness; or

b. has lost (or lost the complete use of) one or more hands or feet; or

c. is substantially and permanently impaired, by an illness or injury, from engaging in activities normally associated with persons of like age, education and experience.

11. If the System or the City Medical Officer determines that no Independent Physician is necessary, then the Pension Office will send the City Medical Officer: (i) a Medical Examination/Evaluation form (currently a form P-7A, Exhibit "F" to this Procedure); (ii) a description of the current job duties for the Member’s rank (Exhibit “C” to this Procedure); (iii) a description of current sedentary duties available at the Member’s Department (Exhibits “D” or “E” to this Procedure); (iv) medical information that the Member believes to be relevant to disability application; and (v) a copy of the Attending Physician’s Statement.

12. If the examination by an Independent Physician is not required by the System, then the Pension Office will inform the Member of the need to schedule an appointment with the City Medical Officer to examine and evaluate the Member’s condition. It is the responsibility of the Member to schedule and appear for this examination. The Pension Office will take no further action on the Member’s application for a disability pension until such time as the City Medical Officer examination and evaluation has been completed.

13. If the Member must be examined by an Independent Physician, the Pension Office will schedule the Member for an appointment. The Pension Office will inform the Member of the name of the Independent Physician and the date, time and location of the appointment. It is the responsibility of the Member to appear for this examination. The Member is responsible for bringing to the appointment any medical information the Member believes to be relevant for the Independent Physician’s examination. The Pension Office will take no further action on the Member’s application for a disability pension until such time as the Independent Physician’s examination has been completed. The information will also indicate that the Pension System will pay reasonable expenses for the examination.

14. The Pension Office will send an "Independent Physician’s Statement" form (Exhibit "G" to this Procedure) to the Independent Physician prior to the scheduled appointment with the Member along with the following: (i) a description of the current job duties for the Member’s rank (Exhibit "C" to this Procedure); and (ii) a description of current sedentary duties available at the Member’s Department (Exhibits “D” or “E” to this Procedure), (iii) medical information that the Member believes to be relevant to the disability application; and (iv) a copy of the Attending Physician’s Statement.

15. When the Independent Physician’s Statement and any attachments are received by the Pension Office, the Pension Office will send the City Medical Officer: (i) a Medical Examination/Evaluation form (Exhibit "F" to this Procedure); (ii) a description of the current job duties for the Member’s rank (Exhibit "C" to this Procedure); (iii) a description of current sedentary duties available at the Member’s Department (Exhibit “D” or “E” to this Procedure); (iv) medical information that the Member believes to be relevant to the disability application; (v) a copy of the Attending Physician’s Statement; and (vi) a copy of the Independent Physician’s Statement.

16. The Pension Office will inform the Member of the need to schedule an appointment with the City Medical Officer to examine and evaluate the Member’s condition. It is the responsibility of the Member to schedule and appear for this examination. The Pension Office will take no further action on the Member’s application for a disability pension until such time as the City Medical Officer examination and evaluation has been completed.

17. If two of the examining physician’s (one of which is either the City Medical Officer or the Independent Physician) concur that the Member cannot perform the current job duties for the Member’s rank (Exhibit "C" to this Procedure) and those same physicians concur that the Member can perform the sedentary duties set forth in Exhibit “D” or “E” to this Procedure, then Paragraphs a-g must be followed, if not, proceed to paragraph 18:

a. The Pension Office will forward the examining Physician’s reports and any attachments to the Member’s Chief to determine whether sedentary duties can be found for the Member.

b. If there are no sedentary duties available within the Member’s Department as described by the Chief (or the Chief’s designee), the application for disability pension will be presented to the Board at its next scheduled regular meeting.

c. If sedentary duties are available within the Member’s department, the Chief of the Department (or the Chief’s designee) will state the specific duties that are available, as well as any specific accommodations that can be made for the Member.

d. The Chief’s (or the Chief’s designee’s) statement concerning available sedentary duties and accommodations will be sent by the Pension Office to the Attending Physician, the City Medical Officer, and, if necessary, the Independent Physician for their review.

e. The examining physicians who review the Chief’s statement concerning available sedentary duties and accommodations will report to the Pension Office what duties, if any, each believes the Member is capable of performing.

f. The Pension Office will forward the reports of the examining physicians to the Chief of the Member’s Department (or the Chief’s designee) for additional review and comment.

g. The Pension Office will present the physician’s statements and all other relevant information from the Member’s department to the Board for its next scheduled regular board meeting.

To the extent possible, the Pension Office will provide the Member with a copy of all of the above correspondence prior to the Board meeting in which the Member’s disability pension application will be considered. The correspondence will be provided to the Member not later than one week after the Board meeting.

18. a. If two or three of the examining physicians concur that the Member cannot perform the current job duties for the Member’s rank but at least two of them do not concur that the Member can perform the sedentary duties set forth in Exhibit “D” or “E” to this Procedure, then the Pension Office will determine whether the Member has satisfied the Ninety Day Rule.

b. If the Member has satisfied the Ninety Day Rule, the Pension Office will present the Member’s application for a disability pension along with all of the physician’s statements and any attachments to the Board for its determination at its next scheduled regular meeting.

c. If the Ninety Day Rule has not been satisfied, then the Pension Office will inform the Member by letter that the application process cannot proceed further until satisfaction of the Ninety Day Rule.

19. a. If two of the examining physicians (one of which is either the City Medical Officer or the Independent Physician) do not concur that the Member cannot perform the current job duties for his rank, the Pension Office will write to the Member and ask whether the Member wishes to proceed with the application process.

b. If the Member decides not to proceed with the disability pension application the process ends and the Member may:

i. return to work;

ii. terminate employment with the City of Dallas and, if eligible, apply to the System for a retirement pension; or

iii. terminate employment with the City of Dallas and, if eligible, apply to the System for a retirement pension at some later date.

c. If the Member decides to proceed with the disability pension application, the Pension Office will review the Member’s application to determine whether the Member has satisfied the Ninety Day Rule.

d. If the Ninety Day Rule has been satisfied, the Member’s application will be presented to the Board at its next scheduled regular meeting.

e. If the Ninety Day Rule has not been satisfied, then the Pension Office will inform the Member by letter that the application process cannot proceed until satisfaction of the Ninety Day Rule.

III. The Board Meeting

1. The Board will render its determination concerning the Member’s disability application in open session; however, any testimony or discussion regarding the Member's medical information will be held in closed session. The medical records related to the Member's application will be kept confidential and any extra copies will be destroyed by the Pension Office.

2. The Member may appear in both the closed and open portion of the Board meeting in person on his or her own behalf or through or with a representative, who may be legal counsel.

3. The attendance at the Board meeting of the Chief of the Member’s Department or the Chief’s designee will be requested by the Pension Office.

4. Should the Member desire to address questions to persons who may not be in attendance at the Board meeting (such as the designee or the Chief of the Member’s Department or one of the examining physicians) the Board may attempt to contact such persons by telephone during the course of the meeting; however, if unable to do so, the Board will delay its determination regarding the Member’s application until its next scheduled regular meeting. The Member's questions must be submitted in writing to the Pension Office at least 5 working days prior to the Board’s next scheduled regular meeting. Receipt of the questions within less than a week of the Board’s meeting may require an additional postponement of the Board’s determination of the Member’s application.

IV. The Board’s Decision

1. When presented with the Member’s application for a disability pension, the Board will make its decision whether to grant or deny the application in accordance with the standards set forth in Section 6.03 of the Plan.

2. The Board’s written decision regarding the Member’s application for a disability pension will be provided to the Member within 10 working days of the meeting in which the decision was made.

V. Appeal of Board’s Decision

A Member may seek to appeal the decision of the Board in the Dallas County District Court in accordance with the provisions of Sections 6.18(b) and (c) of the Plan. (Exhibit "H" to this Procedure.)

VI. Reactivation of the Application for Disability Pension

1. The Board will consider reactivating the disability pension application of a Member if:

a. the Member provides the Board with additional medical evidence that directly relates to the disability application previously considered by the Board; and

b. the Member’s request for a reactivation of the disability application is received by the Pension Office within 90 days of the Board’s denial of the Member’s application.

2. A Member’s timely request for reactivation of a disability pension application will be presented to the Board at its next scheduled regular meeting.

3. A Member’s request for reactivation of a disability pension application after 90 days from the Board’s denial of the Member’s application will be treated as a request to once again apply for a disability pension and, therefore, will require following this Procedure from the beginning.

VII. Other Guidelines and Statements

1. It is the intent of the Board to process disability pension applications as quickly as possible; however, a minimum of 3 months can be expected.

2. If the Board is unable to complete its review of the Member’s application for a disability pension at the first meeting it is considered, and if the Member is eligible for a retirement pension, then the Member may request a retirement pension pending completion of the Board’s review. If the Member’s application for a disability pension is later granted by the Board, the Member’s pension status will be changed from Service Retirement to Disability Retirement.

3. Unless otherwise stated herein, once a Member goes on Service Retirement, the Member is no longer eligible to apply for a disability pension.

4. Once a Member becomes a participant in the System's DROP program, the Member is no longer eligible to apply for a disability pension.

5. The Ninety Day Rule applies unless upon the request of the Member or his agent, the Board waives the requirement. The Board will only waive the Ninety Day Rule if the Member’s request is supported by credible evidence acceptable to the Board that the Member’s disability is wholly and immediately incapacitating.

6. If the Board’s Chairman receives information that an applicant is engaging in activities that are inconsistent with the findings contained in the statements of the examining physicians, then upon notification of the Chairman the Administrator will be required to engage the services of an approved private investigative service generally within 5 working days of the receiving such information. The private investigative service shall be authorized to investigate the accuracy of the information received by the Board’s Chairman. All System action on the Member’s disability pension application or payment will be suspended pending reconsideration by the Board of the report of the private investigation service at a duly called Board meeting.

7. It is generally the position of the Board that unless credible evidence indicates that a Member’s disability is unlikely to be removed, future medical examinations and recalls will occur. However, the Board will not require more frequent medical examinations than once in every 6 months.

Once a disability application is granted, if the Board’s Chairman receives information that a disabled Pensioner is engaging in activities that are inconsistent with the findings contained in the statements of the examining physicians, then upon notice from the Chairman, the Administrator will be required to engage the services of an approved private investigative service generally within 5 working days of the receiving of such information.

The private investigative service shall be authorized to investigate the accuracy of the information received by the Board’s Chairman. The information will be considered by the Board at a duly called Board meeting. If the information is deemed to be meaningful by the Board, then the Board will notify the Pensioner of: (i) his or her immediate recall for medical reexamination; and (ii) the need to attend a meeting of the Board for the purpose of reconsidering the appropriateness of his or her continuing the receipt of the disability pension.

APPROVED on November 9, 2000 by the Board of Trustees of the Dallas Police and Fire Pension System.

Gerald Brown, Chairman

Attested: Richard L. Tettamant, Secretary

Exhibit “A”
Disability Pension Application

Exhibit “B”
Attending Physician’s Statement

Exhibit “C”
Current Job Duties for the Member’s Rank

Exhibit “D”
Current Sedentary Duties

Exhibit “E”
Current Sedentary Duties

Exhibit “F”

Exhibit “G”

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