SECTION 395:10-1-13. Application for disability retirement requirements

(a)   A statement from the applicant for disability describing the event or events which caused the purported disability together with a specific description of the disability.

(b)   A specific declaration as to whether the disability claimed is non-service or service related.

(c)   If the claim is for a service related disability, a copy of the collision, accident or incident report must be provided.

(d)   A copy of all worker's compensation documents filed, including

all medical evaluations.

(e)   A copy of all medical records.

(f)   An executed authorization for release of medical information for all treating or evaluating physicians.

(g)   A executed authorization for release of employment records.

(h)   A letter from the Agency Head expressing the employers opinion as to whether the injury did or did not occur within the scope of the applicant's employment.

(i)   Complete the System's Application For Disability Retirement questionnaire under oath providing information concerning the claim of the applicant and the following information:

(1)   Name

(2)   Age

(3)   Social Security Number

(4)   Name of employer

(5)   Length of employment

(6)   Date of injury

(7)   Cause of injury

(8)   Nature of injury

(9)   Witnesses to injury

(10)   Name and address of all physicians who have treated or evaluated the applicant

(11)   Period of time(s) that you have been away from work as a result of the purported disability and the last date worked for your employer

(12)   Any additional information

(j)   No application for service related disability retirement shall be placed on the Board's agenda until all documents required under this section have been received by the System.

(k)   When an eligible member applies for retirement, the member may only apply for a single type of retirement, such as normal retirement, non-service disability retirement, or service related disability retirement. Once a member has been granted a specific retirement by the OLERS Board, the member may not apply or obtain a different type of retirement under the System.This rule is not intended to distinguish between temporary retirements which later become permanent retirements.

[Source: Added at 15 Ok Reg 40, eff 9-25-97 (emergency); Added at 15 Ok Reg 3265, eff 7-13-98; Amended at 18 Ok Reg 3084, eff 7-12-01; Amended at 20 Ok Reg 962, eff 5-12-03]