Fillable City Statement For Occupational Disability (Page 2 of 2) in pdf

NOTES TO CITY CORRESPONDENT

If a member of TMRS becomes disabled, he or she may be entitled to regular disability or occupational disability –

depending upon the benefit plan adopted by the employing city.

The test for occupational disability is a finding by the TMRS Medical Board that

•

The member is physically or mentally disabled for further performance of the duties of his/her occupation;

•

The disability is likely to be permanent; and

•

The member should be retired.

The City Statement for Occupational Disability form must be completed by the member’s employing city and should be

attached to a photocopy of the member’s job description.

A photocopy of the completed City Statement for Occupational Disability form must be attached to both the Member’s

Statement for Occupational Disability form and the Physician’s Statement for Occupational Disability form.

THE APPLICATION PROCESS

The retirement date must be the last day of the calendar month, cannot precede the date the member terminates

employment and cannot be before the date the member files this application. Normally a member must apply for retirement

not less than 30 days nor more than 90 days before the retirement date. By signing the application, the member agrees to

waive any requirement to file the application at least thirty days before the effective date of retirement.

The following forms must be completed prior to the application being sent to the TMRS Medical Board for consideration:

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Application for Occupational Disability Retirement – to be completed by the member and certified by the

member’s employing city

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City Statement for Occupational Disability – to be completed by the member’s employing city

–

Member’s Statement for Occupational Disability – to be completed by the member

–

Physician’s Statement for Occupational Disability – to be completed by the member’s attending physician

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A photocopy of the member’s official job description

The following forms must also be submitted to TMRS prior to the mailing of the first payment:

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Selection of Retirement Plan

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The member’s proof of birth (photocopy)

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Proof of birth for the designated beneficiary only if a Retiree Lifetime with Survivor Benefits option is selected.

NOTE: If the birth name on the proof of birth is different from the names provided on the application (for the

member or the beneficiary), a Name Certification must be completed.

–

Electronic Direct Deposit Authorization- Retiring members must have their monthly annuity payments

electronically deposited to their financial institutions.

IF THE MEMBER IS ELIGIBLE FOR SERVICE RETIREMENT

It is recommended that members who are eligible for service retirement apply for Service Retirement benefits rather than

Occupational Disability Retirement benefits – the benefits are equal and there are no restrictions placed on the member’s

earning capacity. An exception to this might be if the disability retirement would cause the member to be eligible for

early Medicare or similar benefits. You should contact TMRS for further information.

Members who are eligible for service retirement are also entitled to receive a Partial Lump-Sum Distribution. If a member

elects to receive the partial lump-sum distribution, the Selection of Partial Lump Sum Distribution form will also need to

be completed and submitted to TMRS prior to the mailing of the first payment.

RETURNING TO WORK

An Occupational Disability retiree may return to work either for the city or some other employer. However, the monthly benefit

will be reduced if the retiree is less than age 60 and if the earnings of the retiree plus the disability retirement benefit exceed

the member’s compensation at the time of retirement. The monthly benefit will not be reduced below the amount of annuity

that the member’s own contributions would provide. Occupational Disability retirees may be required to submit yearly proof

of any amount received as salary, wages or other earnings along with federal tax form(s) W-2 or 1099.

IMPORTANT NOTE: If the retiree returns to work in a position that is the same type of position when he or she retired, the

monthly annuity would be discontinued and the account reinstated (example: a retired patrol officer cannot go back to work

as a patrol officer).

WHEN TO EXPECT PAYMENT

Retirement payments will begin the last day of the month following the effective date of retirement, if the TMRS Medical

Board approves the application.

Note: The retiree’s first monthly payment will be mailed to the address provided on the retirement application. Thereafter,

monthly payments will be electronically deposited to their financial institution.

TMRS WILL NOT ACCEPT

Illegible forms

Alterations without initials

Incomplete forms or any attempt to change its provisions

City Statement For Occupational Disability Page 2

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