Wednesday, April 20, 2011

Applying for PERA Duty Disability Benefits: Five Easy Mistakes to Avoid

We represent many, many police officers and firefighters covered under the Public Employees Retirement Association (PERA) Police and Fire Plan, for workers’ compensation claims, personal injury claims, and PERA disability claims.

If you are a Minnesota police officer or firefighter, and if you have a disability that is expected to prevent you from performing your normal duties as a police officer or firefighter for a period of at least a year, and if your disability “is the direct result of an injury incurred during, or a disease arising out of, the performance of normal duties or the actual performance of less frequent duties, either of which are specific to protecting the property and personal safety of others and that present inherent dangers that are specific to the positions covered by the public employees police and fire plan,” Minn. Stat. §353.01, Subd. 45 (2009), you may be eligible for PERA duty disability benefits.

PERA duty disability benefits start at a minimum of 60% of your average salary over your five highest-paid consecutive years of service. This is the equivalent to a retirement benefit based on 20 years of service. If you have in excess of 20 years of service, you will receive an additional 3% of your salary for every year beyond 20 years of service.

PERA regular disability benefits start at 45% of your salary, or the equivalent of 15 years of service. Police and Fire Plan members who have an illness or injury expected to prevent them from performing the normal duties of their position for a period of a year, but the injury or illness was not-work related, or does otherwise meet the definition of “Duty disability,” may be eligible for Regular Disability Benefits.

In addition PERA Police and Fire Plan members may also be eligible for continuation of health care coverage under Minn. Stat. §299A.465, if they also qualify for duty disability benefits. That means the Employer must continue to pay your health insurance premiums until age 65.

These benefits can be worth thousands and thousands of dollars! Meuser & Associate regularly represents PERA Police and Fire Plan Members, PERA Corrections Plan Members, MSRS State Corrections Plan Members, and State Troopers covered under MSRS, for duty disability applications and appeals, healthcare continuation under Minn. Stat. §299A.465 applications and appeals, and regular disability applications and appeals.

Unfortunately, we see a lot of folks make mistakes when they’re applying for these benefits, and then they have to retain us to appeal an adverse decision. Most often, people applying for PERA benefits get denied, or don’t get awarded the benefit they’re applying for because they made mistakes on the initial application. It’s easier (and cheaper) to get it right the first time you apply, than it is to appeal and try to fix some easily avoided mistakes you made on your initial application.

  1. Schedule a time to meet with a PERA or MSRS retirement counselor before you start completing your application. They will explain the various types of disability benefits that are available to you, and explain the application process. Many times, they are also kind enough to point out potential issues they might spot with your claim.
  2. You are generally required to submit reports from two doctors indicating that you are disabled from performing the duties of a firefighter or police officer for a period of at least a year. Bring a copy of your job duties to your appointment, and explain to your doctor exactly what they need to fill out. If your doctors don’t indicate on the forms that you can’t perform the duties of a police officer or firefighter for a period of at least one year, you will not be considered to be disabled. This seems self-explanatory, but submitting forms that indicate you're not disabled will not help you get approved. Unfortunately, I've seen people do this in at least three separate cases.
  3. The PERA disability application form gives space for about one paragraph to explain how your injuries occurred, and another paragraph to summarize your medical treatment. Don’t be afraid to attach additional pages to explain precisely how your injury occurred, and the medical treatment you’ve received. The PERA application form doesn’t really indicate the statutory requirements to qualify for duty disability, i.e., that your injuries or illness was incurred while performing duties that are specific to protecting property or safety, and that present inherent dangers specific to police officers or firefighters. If you don't do an adequate job of explaining how your injury fits into this definition, you may be denied duty disability benefits.
  4. If your injury occurred more than 2 years before your disability began, special rules apply, or at least that’s how PERA is interpreting the law. For example, if you had a back injury, tried conservative therapy, underwent surgery, then tried to return to full duty, only to realize a couple years later that it just isn’t going to work, you will need to show that your disability prevents you from performing your duties in the 90 days prior to your application. PERA has interpreted this to mean that if your injury was over 2 years prior to your application, and you pushed papers on light duty in the 90 days before you apply, you must show that your disability prevents you from doing those light duty assignments. In many cases, you may be better off waiting until 90 days after your light duty ends to apply for PERA benefits. This is a very case specific situation, but you certainly don’t want to get denied for either regular disability or duty disability benefits based on what, in our opinion, is poor wording in the language of the statute.
  5. If your claim is denied by PERA, or if you get awarded regular disability benefits when you think you qualify for duty disability benefits, don’t blow the appeal deadline! Depending on the basis for the denial, if you do not appeal PERA's decision, you may be barred from applying again based on the same injury or condition. If you do appeal, you will have adequate time to put together the materials you need to dispute the determination. And don’t wait until the day your appeal is due to consult with an attorney! Don’t assume that PERA’s right if you are denied. We can advise you if you have a basis for an appeal.
We’ve represented many Minnesota police officers and firefighters in applying for PERA benefits, and in appealing adverse determinations. Here’s some examples of a few of our more recent successes:

  • A young police officer sustained a shoulder injury several years ago while performing defensive tactics training. He had four surgeries to correct the problem with his shoulder, but kept going back to work. Last year, he seriously re-injured his shoulder while performing CPR, and underwent two more shoulder surgeries. Six shoulder surgeries later, and looking at a total shoulder replacement before age 40, his doctors finally convinced him that he can no longer perform the duties of a police officer. We completed his application for PERA duty disability benefits, which was approved within a matter of weeks, and he was also awarded healthcare continuation coverage under §299A.465.
  • A firefighter was at the scene of a major traffic accident on a Minnesota interstate. He parked a firetruck to block traffic because of the extremely icy conditions. As he was getting out of the rig, he slipped on the icy running board, and got hung up on the door handle, jerking his shoulder. After numerous conservative treatments failed, his doctors ultimately told him he could not continue working as a firefighter. This firefighter was over the age of 55, and had more than 20 years of service, so he was not eligible for duty disability benefits. He was, however, eligible for healthcare continuation under §299A.465, which we applied for and secured on his behalf.
  • A firefighter sustained a low back injury while performing CPR on a patient for an extended period of time. while his doctors determined that he was not a candidate for surgery, they ultimately concluded that he could not continue to safely perform the duties of a firefighter. We completed his application for PERA duty disability benefits, for which he was approved, and we also secured healthcare continuation benefits on his behalf.
  • A young firefighter injured her back while carrying a piece of equipment about four years ago, and suffered a severe flare up about a year and a half ago. She was placed under restrictions and was forced to resign when the fire department had no light duty available. She applied for disability benefits, but was denied because all three doctors reports she submitted indicated that she would NOT be disabled as a firefighter for a period of at least a year. We appealed because it was clear that her doctors didn’t fully understand the forms they completed for her. She underwent an FCE that showed that she was not physically capable of performing the duties of a firefighter, her doctors completed new forms indicating that she was disabled from performing the duties of a firefighter for a period of one year, and one of her doctors wrote a detailed expert opinion about the causes of her condition. We submitted this additional evidence and requested an administrative hearing, but PERA reversed its decision, awarding her PERA regular disability benefits, based on the additional evidence we secured and submitted on her behalf.
If you’re considering applying for PERA or MSRS disability benefits, it’s wise to consult with an attorney. For folks that find us on the internet, we offer a free, no-obligation consultation. Make sure you let us know you found us online. If we don’t think you have a claim, we’ll tell you. If we think you have a claim, but see some potential issues, we’ll tell you what they are. If you have a slam dunk case, we’ll tell you so, and you can decide whether or not you need our assistance in applying. If you don’t want to deal with the headache, or are concerned about putting together all of the information you need, we can complete your application for you. If you simply want to learn about disability benefits as a “back-up” plan, we’re happy to discuss your options with you.

Contact Jen Yackley or Ron Meuser at 877-746-5680 or click here to send us an email to schedule a free, no-obligation consultation.


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