3307:1-7-01 Disability benefits - definitions.

 

 

 

3307:1-7-01                 Disability benefits - definitions.

 

 

Chapter 3307:1-7 of the Administrative Code is adopted to establish the definitions, procedures and guidelines needed to fulfill the requirements of sections 3307.48, 3307.62, 3307.63, and 3307.631 of the Revised Code and to assure fair and impartial evaluation of all applications for disability benefits.

 

As used in Chapter 3307:1-7 of the Administrative Code:

 

(A)  "Applicant" shall mean the member for whom an application has been completed and received by the retirement system.

 

(B)   "Application" includes all of the following: an application for disability benefits; an attending physician's report based on an examination that was completed within the

last  sixty  daystwo  months  and  includes

supporting  diagnostic  testing;medical

evidence, an employer report;, and, a job description provided by the last employer. The application for disability benefits, attending physician's report and employer report shall be made on forms provided by the retirement system. The requirement to submit a job description may be waived by the chair of the medical review board.

(C)     "Attending physician" shall mean an applicant's physician of choice, who has established a therapeutic relationship with the applicant and has completed a report and certified on forms provided by the retirement system that in the attending physician's opinion an applicant is incapacitated for the performance of duty by a disabling condition that is presumed to be permanent. The attending physician shall provide standard objective and pertinent medical evidence supporting the opinion.

(D)"Board," shall mean the state teachers retirement board.

(E)(D) For purposes of section 3307.48 of the Revised Code, to "perform any teaching service" whether or not such services or positions are performed full-time or part-time, in a public or private employment school or non-school setting, on a volunteer basis or for compensation, in or outside the state of Ohio shall be defined to include any of the following:

(1)   All employment, contracted services or volunteer work that if performed in an Ohio public school would be considered employment covered by the state teachers retirement system as defined in section 3307.01 of the Revised Code.

(2)      All teachers, tutors, substitute teachers, electronic classroom instructors, daycare teachers, community school instructors and private-lesson providers whether the service was performed through employment, contracted services, or volunteer work.

(3)   All employment contracted services, or volunteer work that relates to the work of educators, such as, but not limited to, writing curriculum, leading workshops, providing training, instructing students of any age, or directing teachers, student teachers or students.

(4)   Any other service determined by the retirement board to be performing teaching services.

(F)(E) For purposes of division (B)(2) of section 3307.62 of the Revised Code, "The date on which the member's most recent application for a disability benefit was received by the board" shall occur when an application as defined in this rule is received by the retirement system. In all cases of dispute, the retirement system shall determine when an application is received and its decision shall be final.

(F) For purposes of division (C) of section 3307.62 of the Revised Code, "condition" shall mean a medically determinable physical or mental impairment that results from anatomical, physiological, or psychological abnormalities, which can be shown by standard objective and pertinent medical evidence as defined in this rule. A physical or mental impairment must be established by medical evidence, not only by the applicant's statement of symptoms, but also by symptoms, signs and laboratory findings reported by a physician.

(G)   "Independent medical examiner" shall mean a competent physician neither involved in a treatment relationship with an applicant or recipient nor otherwise employed by the retirement system, who shall be designated by the chair of the medical review board to conduct an impartial examination.

(H) "Medical evidence" means current physician examinations, clinical findings, laboratory findings, diagnosis, treatment prescribed with response and prognosis, hospital discharge summaries and diagnostic testing relevant to the applicant's claimed disabling condition.

(H)(I) "Medical review board" shall mean the group of independent physicians designated by the retirement board under the direction of a chair appointed by the retirement board to assist in the evaluation of medical examinations and information. The members of the medical review board may be asked in panels of three or more to review any application and provide their conclusions as to whether an applicant will be mentally or physically incapacitated from the performance of duty for at least twelve months.

(I)(J) A disabling condition shall be "presumed to be permanent," if it physically or mentally incapacitates an applicant from the performance of regular duty for a period of at least twelve months from the date of the retirement system's receipt of

the completed application.

(J)(K)  "Recipient"  shall  mean  a  member  granted  disability  benefits  under  sections 3307.48, 3307.57, 3307.62, 3307.63, and 3307.631 of the Revised Code.

Effective:                                                             06/10/2016

Five Year Review (FYR) Dates:                         03/23/2016 and 06/10/2021

CERTIFIED ELECTRONICALLY

Certification

05/31/2016

Date

Promulgated Under:                           111.15

Statutory Authority:                           3307.04

Rule Amplifies:                                  3307.48, 3307.57, 3307.62, 3307.63, 3307.631

Prior Effective Dates:                         12/23/76, 12/26/77, 2/26/81, 7/3/91, 10/29/98 (Emer.),

1/17/99, 7/1/01 (Emer.), 9/17/01, 9/17/02, 7/1/06,

6/6/11, 9/4/11, 1/7/13 (Emer.), 3/24/13, 1/1/14 (Emer.), 2/10/14, 6/5/15