FROM: Barbara Hannah, Chief Counsel
SUBJECT: Disability Retirement Application of Ron Chalfant
RECOMMENDATION:
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Review and determine the Service-Connected Disability Retirement with Supplemental Retirement Allowance of Ron Chalfant - County of San Bernardino - Public Works.
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Requested Benefit:
1. Service-Connected Disability Retirement with Supplemental Retirement Allowance
Staff Recommendation:
1. Ron Chalfant is permanently incapacitated for the performance of duties and a disability retirement should be granted.
2. Ron Chalfant’s disability is service-connected based on the claimed injury(ies)/disease as listed in Exhibit A; therefore, grant a service-connected disability benefit.
3. Ron Chalfant is capable of gainful employment; therefore, deny the supplemental disability retirement allowance.
4. Staff shall initiate disability benefit payments with an effective date of the day after the last day of regular compensation as determined by staff.
BACKGROUND:
Medical Advisor - Joseph Dotan, M.D.
Attorney - None
STAFF CONTACT:
David Lantzer
ATTACHMENTS:
Exhibit A: Claimed Injury or Disease
Exhibit B: Demographic Information
Exhibit C: Medical Advisor’s Report
Exhibit D: Independent Medical Examiner’s Report
Exhibit E: Applicant’s Statement of Facts and Physician’s Report
Exhibit F: Department Statement of Facts
Exhibit G: Job Description, Physical Requirements