61.665 Medical examiners -- Ruling on disability retirement -- Appeal.
2,200 words·~10 min read·
/ky/chapter-61/61-665A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
(1)The Authority shall employ or contract for the services of at least three
physicians, licensed in the state and not members of the system, upon terms and
conditions it prescribes to serve as medical examiners, whose duty it shall be to
pass upon all medical examinations required under KRS 61.510 to 61.705, 16.505
to 16.652, and 78.510 to 78.852, to investigate all health or medical statements and
certificates made by or in behalf of any person in connection with the payment of
money to the person under KRS 61.510 to 61.705, 16.505 to 16.652, and 78.510 to
78.852, and who shall report in writing to the system the conclusions and
recommendations upon all matters referred to them. The Authority may employ or
contract for the services of one
(1)or more licensed mental health professionals in
making recommendations regarding mental impairments.
(a)Each person requesting disability retirement shall file at the retirement office:
1. An application for disability retirement and supporting medical
information to report the person's physical and mental condition;
2. A complete description of the job and duties from which he or she
received his or her last pay, including information regarding whether the
person has made a request for reasonable accommodation pursuant to 42
U.S.C. sec. 12111(9) and 29 C.F.R. pt. 1630 or whether reasonable
accommodation as provided in 42 U.S.C. sec. 12111(9) and 29 C.F.R.
pt. 1630 has been offered to the person; and
3. A certification that the application for disability retirement and
supporting medical information are ready to be evaluated by the medical
examiners in accordance with subsection
(3)of this section.
(b)If, after good faith efforts, the person informs the Authority that he or she has
been unable to obtain the employment or medical information, the Authority
shall assist the person in obtaining the records and may use the authority
granted pursuant to KRS 61.685(1) to obtain the records. If the person fails to
file, at the retirement office within one hundred eighty
(180)days of the date
the person filed his or her notification of retirement, any of the forms,
certifications, or information required by this subsection, the person's
application for disability retirement shall be void. Any subsequent filing of an
application for disability retirement or supporting medical information shall
not be evaluated, except as provided in subsection (3)(g) of this section or
KRS 61.600(2), 78.5522, or 78.5524.
(c)The employer shall file at the retirement office a complete description of the
job and duties for which the person was last paid and shall submit a detailed
description of any reasonable accommodations attempted.
(d)The cost of medical examinations and the filing of the medical information,
reports, or data with the retirement office shall be paid by the person applying
for disability retirement.
(a)The Authority shall select one
(1)medical examiner to evaluate the medical
evidence submitted by the person. The medical examiner shall recommend
that disability retirement be approved or that disability retirement be denied. If
there is evidence of a mental impairment, the medical examiner may request
the Authority's licensed mental health professional to assist in determining the
level of the mental impairment.
(b)If the medical examiner selected under paragraph
(a)of this subsection
recommends that the person be approved for disability retirement, the system
shall make retirement payments in accordance with the retirement plan
selected by the person.
(c)If the medical examiner selected under paragraph
(a)of this subsection
recommends that the person be denied disability retirement, the Authority
shall select one
(1)medical examiner other than the medical examiner
selected under paragraph
(a)of this subsection to evaluate the medical
evidence submitted by the person. The second medical examiner selected
under this paragraph shall recommend that the disability retirement be
approved or that disability retirement be denied. If there is evidence of a
mental impairment, the second medical examiner may request the Authority's
licensed mental health professional to assist in determining the level of mental
impairment.
(d)If the second medical examiner selected under paragraph
(c)of this subsection
recommends that the person be denied disability retirement, the Authority
shall send notice of this recommendation by United States first-class mail to
the person's last address on file in the retirement office, by electronic mail to
the person's last electronic mail address on file in the retirement office, or by
other electronic means. The person shall have one hundred eighty
(180)days
from the day that the Authority sent the notice to file at the retirement office
additional supporting medical information and certify to the retirement office
that the application for disability retirement and supporting medical
information are ready to be evaluated under subsection
(4)of this section or to
appeal his or her denial of disability retirement by filing at the retirement
office a request for a formal hearing. Any subsequent filing of an application
for disability retirement or supporting medical information shall not be
evaluated, except as provided in KRS 61.600(2), 78.5522, or 78.5524.
(e)If the second medical examiner selected under paragraph
(c)of this subsection
recommends that the person be approved for disability retirement, the
Authority shall select one
(1)medical examiner other than the first and second
medical examiners selected under paragraphs
(a)and
(c)of this subsection to
evaluate the medical evidence submitted by the person. The third medical
examiner selected under this paragraph shall recommend that disability
retirement be approved or that disability retirement be denied. If there is
evidence of a mental impairment, the third medical examiner may request the
Authority's licensed mental health professional to assist in determining the
level of the mental impairment.
(f)If the third medical examiner selected under paragraph
(e)of this subsection
recommends that the person be approved for disability retirement, the system
shall make retirement payments in accordance with the retirement plan
selected by the person.
(g)If the third medical examiner selected under paragraph
(e)of this subsection
recommends that the person be denied disability retirement, the Authority
shall send notice of this recommendation by United States first-class mail to
the person's last address on file in the retirement office, by electronic mail to
the person's last electronic mail address on file in the retirement office, or by
other electronic means. The person shall have one hundred eighty
(180)days
from the day that the Authority sent the notice to file at the retirement office
additional supporting medical evidence and certify to the retirement office
that the application for disability retirement and additional supporting medical
evidence are ready to be evaluated under subsection
(4)of this section or to
appeal his or her denial of disability retirement by filing at the retirement
office a request for a formal hearing.
(a)The Authority shall select one
(1)medical examiner to evaluate the additional
supporting medical evidence submitted by the person in accordance with
subsection (3)(d) and
(g)of this section. The medical examiner selected under
this paragraph shall recommend that disability retirement be approved or that
disability retirement be denied. If there is evidence of a mental impairment,
the medical examiner may request the Authority's licensed mental health
professional to assist in determining the level of the mental impairment.
(b)If the first medical examiner selected under paragraph
(a)of this subsection
recommends that the person be approved for disability retirement, the system
shall make retirement payments in accordance with the retirement plan
selected by the person.
(c)If the first medical examiner selected under paragraph
(a)of this subsection
recommends that the person be denied disability retirement, the Authority
shall select one
(1)medical examiner other than the medical examiner
selected under paragraph
(a)of this subsection to evaluate the additional
supporting medical evidence. The second medical examiner selected under
this paragraph shall recommend that disability retirement be approved or that
disability retirement be denied. If there is evidence of a mental impairment,
the second medical examiner may request the Authority's licensed mental
health professional to assist in determining the level of the mental impairment.
(d)If the second medical examiner selected under paragraph
(c)of this subsection
recommends that the person be denied disability retirement, the Authority
shall send notice of this recommendation by United States first-class mail to
the person's last address on file in the retirement office, by electronic mail to
the person's last electronic mail address on file in the retirement office, or by
other electronic means. The person shall have one hundred eighty
(180)days
from the day that the Authority sent the notice to appeal his or her denial of
disability retirement by filing at the retirement office a request for a formal
hearing.
(e)If the second medical examiner selected under paragraph
(c)of this subsection
recommends that the person be approved for disability retirement, the
Authority shall select one
(1)medical examiner other than the first and second
medical examiners selected under paragraphs
(a)and
(c)of this subsection to
evaluate the additional supporting medical evidence. The third medical
examiner selected under this paragraph shall recommend that disability
retirement be approved or that disability retirement be denied. If there is
evidence of a mental impairment, the third medical examiner may request the
Authority's licensed mental health professional to assist in determining the
level of the mental impairment.
(f)If the third medical examiner selected under paragraph
(e)of this subsection
recommends that the person be approved for disability retirement, the system
shall make retirement payments in accordance with the retirement plan
selected by the person.
(g)If the third medical examiner selected under paragraph
(e)of this subsection
recommends that the person be denied disability retirement, the Authority
shall send notice of this recommendation by United States first-class mail to
the person's last address on file in the retirement office, by electronic mail to
the person's last electronic mail address on file in the retirement office, or by
other electronic means. The person shall have one hundred eighty
(180)days
from the day that the Authority sent the notice to appeal his or her denial of
disability retirement by filing at the retirement office a request for a formal
hearing.
(5)The medical examiners shall be paid a reasonable amount by the retirement system
for each case evaluated.
(6)Notwithstanding the foregoing provisions of this section, the Authority may pay for
one
(1)or more medical examinations of the person requested by the medical
examiners for the purpose of providing medical information deemed necessary by
the medical examiners. The system may require the person to submit to one
(1)or
more medical examinations.
(a)Any person whose disability benefits have been reduced, discontinued, or
denied pursuant to subsection (3)(g) or (4)(g) of this section may file at the
retirement office a request for a formal hearing to be conducted in accordance
with KRS Chapter 13B. The right to demand a formal hearing shall be limited
to a period of one hundred eighty
(180)days after the person had notice of the
system's determination, as described in subsection (3)(g) or (4)(g) of this
section. The request for a formal hearing shall be filed with the executive
director, at the retirement office in Frankfort. The request for a formal hearing
shall include a short and plain statement of the reasons the denial of disability
retirement is being contested.
(b)Failure of the person to request a formal hearing within the period of time
specified shall preclude the person from proceeding any further with the
application for disability retirement, except as provided in KRS 61.600(2),
78.5522, or 78.5524. This paragraph shall not limit the person's right to appeal
to a court.
(c)The system may require the person requesting the formal hearing to submit to
one
(1)or more medical or psychological examinations. Notice of the time
and place of the examination shall be provided to the person or his or her legal
representative. The system shall be responsible for the cost of the
examination.
(d)A final order of the board shall be based on substantial evidence appearing in
the record as a whole and shall set forth the decision of the board and the facts
and law upon which the decision is based.
(e)All requests for a hearing pursuant to this section shall be made in writing.
(8)The boards of the Kentucky Retirement Systems and the County Employees
Retirement Systems may each establish an appeals committee whose members shall
be appointed by the chair and that shall have the authority to act upon the
recommendations and reports of the hearing officer pursuant to this section on
behalf of each respective board. The boards of the Kentucky Retirement Systems
and the County Employees Retirement System may establish a joint appeals
committee that shall be authorized to select a chair from among its committee
members and to act upon the recommendations and reports of the hearing officer
pursuant to this section on behalf of both boards.
(9)Any person aggrieved by a final order of the board may seek judicial review after
all administrative appeals have been exhausted by filing a petition for judicial
review in the Franklin Circuit Court in accordance with KRS Chapter 13B.