FROM: Barbara Hannah, Chief Counsel
SUBJECT: Procedures for Disability Retirement and Formal Hearings
RECOMMENDATION:
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Approve and adopt updates to the Procedures for Disability Retirement and Formal Hearings.
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BACKGROUND:
The SBCERA Board adopted the Procedures for Disability Retirement Application and Formal Hearings (“Procedures”) to govern the disability retirement process. On December 7, 2023, the Board approved changes to the Procedures. Subsequent to that approval, the Board requested that staff review and propose changes to time limits that will assist Applicants who need additional time to complete the Disability Retirement Application. Staff reviewed the Procedures and made changes to time limits for curing defects in applications and amendments. Staff also made suggested changes to allow delegation of some matters to the Chief Executive Officer (CEO).
Attached as Exhibit A is a redlined version of the Rules which incorporates the following proposed changes:
1. Rule 4 (a) (3) - Disability Retirement Application - Authorization for Release of Records Forms.
Removed language stating failure by the Applicant to contact SBCERA or complete the disability checklist within 30 days may result in dismissal of the Application.
2. Rule 4 (b) - Independent Medical Examinations.
Added language to provide more flexibility for submitting records prior to the IME examination. Previously, records had to be submitted to SBCERA no less than five business days prior to the examination. New language allows records to be submitted to SBCERA the day before the examination.
3. Rule 5 (a) - Timely Applications - Complete and Timely.
Changed the time for an Applicant to cure an incomplete Application from 30 days to 90 days to preserve the initial Application filing date. New language provides a longer period to cure any defects in the Application.
4. Rule 5 (b) - Untimely Application.
Allows the Applicant to submit a statement from a treating or examining physician that the Applicant has been continuously incapacitated from the last day of regular compensation without having to submit all medical records relied upon by the treating or examining physician. This statement is already on the Physician’s Report form used by SBCERA. If the Application is submitted 18 months or more after the last day of regular compensation, the Applicant will still have to produce medical records relied upon by the treating or examining physician that support the statement the Applicant has been continuously incapacitated.
5. Rule 5 (d) - Amending an Application.
Expands the Application amendment period from 60 days to 90 days to allow more flexibility to amend Applications. Changed appeal to the Board to appeal to the CEO when the amendment is received more than 90 days after acceptance of the original Application.
6. Rule 7B.1 - Chronic or Fatal Injury / Disease.
Allows for record review by the Medical Advisor when the Applicant has a fatal or chronic injury or disease rather than subjecting the Applicant to an IME examination. If the Medical Advisor is not able to make a determination regarding permanent incapacity, service connection, or gainful employment, the matter will be referred to an IME for examination.
7. Rule 11 (c) - Formal Hearings
Added language authorizes the CEO to extend the Hearing Officer’s jurisdiction.
8. Rule 11A (b) - Expedited Administrative Review.
Added language authorizes the CEO to extend the Hearing Officer’s jurisdiction.
9. Rule 13B - Formal Hearing - Allegation of New Injury or Disease.
Changes the time for an Applicant to file an amendment to the initial Application from 60 days to 90 days when the Applicant alleges a new injury or disease during the Formal Hearing.
10. Rule 33 (j) - Dismissal for Lack of Prosecution - Untimely or Incomplete Application.
Changes the time to submit documents to complete an Application from 90 to 180 days before the CEO may dismiss the Application for failure to prosecute. Submission of documents after 90 days does not preserve the original application date. Changes the requirement for submission of a Physician’s Report for amendments under Rule 13B from 60 days to 90 days.
COMMITTEE REVIEW:
This item was reviewed by the Administrative Committee at its meeting on March 20, 2025, and recommends Board approval with a 4-0 vote.
BUDGET IMPACT:
None.
STRATEGIC PLANNING GOAL/OBJECTIVE:
Superior Service Experience
STAFF CONTACT:
Barbara Hannah
David Lantzer
ATTACHMENTS:
Exhibit A: Proposed Redlined Procedures for Disability Applications and Formal Hearings