Disability Retirement

What is the MainePERS Disability retirement program?

A: The disability benefit MainePERS administers is a form of retirement. In general terms, it exists to address situations where a member’s medical and employment records show they are unable to perform the duties of their job and it is more likely than not that inability is expected to be permanent.  As a form of retirement, it is a unique benefit that has different requirements than other government-run disability programs, like what may be available through Social Security or to veterans through the V.A.  It is also different than private insurance that may be purchased to provide some income during a short-term or long-term illness that prevents someone from working.

Is MainePERS disability retirement program available to me?

A: If you are a MainePERS member, disability retirement is one of your employment benefits. Members are public sector employees who make contributions to MainePERS through their employment, including: State of Maine employees, public school teachers and administrators, and many local government employees, known as Participating Local Districts (PLD).  Note that some PLD employees have optional membership or may be in employment positions that are not eligible for membership.

If I am a member, am I eligible to apply for disability retirement?

A: Maybe. You must not have received a refund of your retirement contributions to MainePERS.

I left my position but was a member. Can I still apply for disability retirement?

A: Yes. A member who has left the job they were contributing to MainePERS from may still apply for disability retirement as long as they have not received a refund of their retirement contributions.

My employer terminated my employment. Can I still apply for disability retirement?

A: Yes. Whether you make the decision to leave or were terminated by your employer, a member may still apply for disability as long as they have not received a refund of their retirement contributions.

Is there a time limit on when I need to apply for disability retirement?

A: No. However, you must show that you met the criteria to be eligible for disability retirement as of your last date in service (date last worked or used member’s own accrued time) when making contributions to MainePERS.

If I apply long after leaving my job, is there anything unique I should be aware of?

A: If it has been two years or more since you performed the full duties of your job, you must show that, in addition to being unable perform in that position, you also do not have the ability to perform other employment that is consistent with your education, experience and transferable skills that will allow you to earn a salary that is within 80% of your average final compensation.

When is the right time to apply for a disability retirement?

A: Pursuing disability retirement is a personal decision that, whether approved or denied, will have a number of effects on your life. Thinking through all the potential effects on your life should happen.  In addition, to be approved you must meet eligibility requirements that include documenting you have a medical condition that has functional limitations associated with it that make it impossible for you for perform your job and that the limitations are permanent.  Consulting with your doctor may help determine if it is the right time to apply for this benefit.  (See Qualifying for disability retirement)

Does the amount of time I’ve spent in my job matter?

A: A member with fewer than five years of continuous creditable service is typically not eligible for disability retirement benefits if the condition existed prior to membership with MainePERS. Continuous service means that service credit has accrued without any terminations or time off payroll.  You must have a period of five years at some time during your membership where you have had no time off payroll, no terminations and have been on payroll either working or receiving your own accruals of sick or vacation time for all of the time you are expected to be at work.

Are there different disability retirement plans, and how do I know which applies to me?

A: If you became a member of MainePERS either as your first date of membership or were rehired after a termination on or after October 15, 1992, you are covered by a plan that has no age restriction and provides a benefit of 59% of your average final compensation. If you became a member before that date and have maintained continuous employment since that date you may be covered by an older plan. Please contact MainePERS for more information about the plan you are covered by.

Should I apply for Social Security disability benefits?

A: Maybe. If you make contributions to both Social Security and MainePERS for the same job, Maine law requires that you apply for Social Security disability before an application for MainePERS disability retirement can be accepted. You do not have to receive a decision from Social Security before your MainePERS application can be accepted but you must provide proof that you have applied for that benefit.

If I’m approved for MainePERS disability will I be able to keep my health insurance?

A: Maybe. MainePERS does not provide any health insurance benefits that may be available in retirement, those benefits transition through your employer. If you qualify to continue to receive your health insurance, it is because you have met your employer’s requirements to do so. Please contact your employer’s human resources department for more information.

How do I apply for disability retirement?

A: The two steps you must take to apply are: participating in an intake interview and then submitting certain forms. To begin the intake process, contact a MainePERS representative at 1-800-451-9800 or 207-512-3170.

What is an intake interview?

A: MainePERS provides an intake to members who are considering disability retirement in order to help them understand the process, legal requirements, and jumpstart the completion of their application.  The intake interview is a simple conversation regarding these subjects.

Will someone from MainePERS help me fill out a disability retirement application form?

A: Yes.  Part of a completed intake is providing you with information about the process as well as a partially pre-populated application form using your information.  If you require additional assistance, we welcome the chance to schedule an in-person appointment at our offices in Augusta or assist you over the phone.

Before I call MainePERS, are there other things I should consider when looking into disability retirement?

A: Yes.

• The impact to other benefits offered through your employer such as the continuation of health and life insurance.
  
  If you end your employment while going through the disability process, your ability to maintain your health insurance and life insurance may be affected.   As stated above, please consult your employer about health insurance questions.  Contact MainePERS Survivor Services about Life Insurance questions.

• Terminating employment
  
  The decision to leave your employment as a result of a physical or psychological medical condition will have significant effects on your life, including the loss of income you are receiving from that job.  Although a member can apply for disability retirement whether they are still in their position or not, approval is not guaranteed and the process to the point of getting a decision will take time.

• Service Retirement – do I qualify now?
  
  The two types of retirement benefit programs administered by MainePERS are known as “service” and “disability” – each of which have unique qualification requirement.  You need to choose one or the other.  Whether you qualify for service retirement can be answered by calling 1-800-451-9800 and having a conversation with one of MainePERS’  retirement specialists.

• The impact to other benefits offered through your employer such as the continuation of health and life insurance.
  
  If you end your employment while going through the disability process, your ability to maintain your health insurance and life insurance may be affected.   As stated above, please consult your employer about health insurance questions.  Contact MainePERS Survivor Services about Life Insurance questions.

• Terminating employment
  
  The decision to leave your employment as a result of a physical or psychological medical condition will have significant effects on your life, including the loss of income you are receiving from that job.  Although a member can apply for disability retirement whether they are still in their position or not, approval is not guaranteed and the process to the point of getting a decision will take time.

• Service Retirement – do I qualify now?
  
  The two types of retirement benefit programs administered by MainePERS are known as “service” and “disability” – each of which have unique qualification requirement.  You need to choose one or the other.  Whether you qualify for service retirement can be answered by calling 1-800-451-9800 and having a conversation with one of MainePERS’  retirement specialists.

• Workers’ Compensation and Social Security Benefits
  
  You may receive Workers’ Compensation or Social Security disability benefits concurrently with disability retirement.  However, your MainePERS payment will be reduced (i.e. offset) by the amounts received from other sources if they are being paid for the same incapacitating condition.
• Effect of other income, earned or received otherwise
  
  There is a maximum amount of payment you may receive from MainePERS if you qualify for disability retirement.  Please consult a MainePERS Disability Specialist about the effects of other income on a MainePERS disability benefit payment. 

Am I required to send my medical records to MainePERS when I apply for disability?

A: No. An essential part of MainePERS processing your application is an independent request for your medical information directly from your doctor or medical provider. Although not essential for filing, you are free to supply copies of medical records you have on hand at the time you file an application.  A benefit to you supplying or at least reviewing information you have in your possession is it reduces the likelihood that a medical provider’s name will be forgotten when MainePERS asks for the releases we need to independently collect records from your doctors. You may also submit a Healthcare Provider Assessment Form completed by your treating clinician. This is a form MainePERS can make available to you, if you choose to use it, that allows a healthcare provider to offer opinions about your medical diagnoses and the impact on your ability to do your job.

What happens after I send in my application?

A: A Disability Specialist will be assigned to your application and she or he will contact you to go over what you submitted. They will also have a conversation with you about your situation.

We will then begin collecting whatever objective information is available.  This includes getting medical releases from you so we can gather medical records from your doctors and hospitals.

MainePERS will also request information from your employer in order to gather records regarding your job duties as well as current employment status and functioning.  We will inquire about available job modifications to your position or if there is another job available of equal pay and similar stature or class that your employer can offer you. The items we request from your employer are:  job description, copy of your most recent performance evaluation, first report of injury, report of last 12 months’ vacation and sick leave usage, any records of disciplinary action, family medical leave paperwork and any medical or job modification records in their possession.

Once all of the medical and employer information is received, the Disability Specialist will contact you to discuss what has been received and whether or not all of the information that is received is up to date.  If it is, then you will decide together whether or not your case is ready to go to the next step in the process, which is submission for an evaluation of the medical information in your file. Just as you rely on doctors for medical advice, MainePERS receives advice from a resource of contracted doctors to benefit from their knowledge regarding your medical condition(s) and limitations. If there is more up to date information to obtain, then the Specialist will request it from the doctors that you specify. It is also possible that MainePERS will ask you to attend an Independent Medical Examination with a mutually agreed upon doctor you have not treated with previously.

How long will it take to get a decision?

A: The processing of your application has several pieces. The amount of time it takes depends on several factors such as how long it takes for your medical providers and your employer to respond and the information we receive and how much your records are supplemented while your application is pending. Once assembled, the evaluation of your information that MainePERS performs in order to make determinations and issue a decision is done as quickly as possible.

How are MainePERS disability retirement benefit payment amounts calculated?

A: The payment amount varies depending on what plan the member falls under. For example, the Age-Limited Plan (members who were hired before October 16, 1992 and who have continued to be employed and did not elect the No-Age plan):  MainePERS will calculate the member’s highest three years of earnings to determine their average final compensation, then multiple that by 66 2/3% which will result in their annual disability retirement benefit amount.  Lastly the annual disability retirement amount will then be divided by twelve to generate the member’s monthly payment. This monthly amount is subject to change due to any Worker’s Compensation, Social Security Disability, or other legally required offsets. Federal and State taxes are withheld from disability benefits.

Members who fall under the No-Age Limit Plan (members who were hired after October 16, 1992 or elected coverage under the No-Age Limit disability provisions): MainePERS will calculate the member’s highest three years of earnings to determine their average final compensation, then multiple that by 59 % which will result in their annual disability retirement benefit amount. Lastly, the annual disability retirement amount will then be divided by twelve to generate the member’s monthly payment. This monthly amount is subject to change due to any Worker’s Compensation, Social Security Disability, or other legally required offsets. Federal and State taxes are withheld from disability benefits.

When can I expect my first payment?

A: If your application for disability retirement is approved, to begin receiving a disability retirement benefit, you must terminate your employment position.  Next, MainePERS will also need several forms from your employer, along with a direct deposit form and W4 from the member. Once all forms have been received, then MainePERS can usually process your payment on the next possible payroll.

How will benefits be paid to me?

A: MainePERS will deposit your monthly disability retirement payment directly to your financial institution, by Electronic Direct Deposit, into either your savings or checking account.

How long will I receive disability retirement benefits?

A: Under the Article 3-A Age-Limited Plan, as long as you remain disabled in accordance with the standards in Maine law you will receive a disability retirement benefit until 10 years past normal retirement age, or when service retirement benefits equals disability retirement benefits, whichever occurs first.

Under the Article 3-A No-Age Limit Plan, as long as you remain disabled in accordance with statute, you will continue to receive benefits until the amount of your service retirement benefits equal your disability retirement benefits.

Will my case be reviewed for continued disability benefits?

A: As a Disability retirement recipient, you will be periodically scheduled for a review to determine your continuing eligibility for these benefits. Although, MainePERS may conduct a review at any time, the general practice is to review each member once every two years.

Will I be notified that my case is being reviewed?

A: Yes. You will receive a review for continuing eligibility packet in the mail that contains four (4) forms that you will complete on your own or with the help of your doctor(s).

Will the review process affect the monthly disability payment I receive?

A: No. You will continue to receive your benefit throughout the review process.

If I am denied disability retirement, how will I be notified?

A: Maine law requires MainePERS to contact you prior to issuing a written denial. The Disability Specialist that you are assigned to will call you to discuss a denial and a letter will be subsequently mailed to you, explaining the decision.

Is there an appeal process?

A: Yes. You have the right to have an appeal heard by an independent hearing officer. Your decision letter will explain how to start an appeal. For additional information, see the Guide to the Administrative Appeals Process.

Should I hire an attorney?

A: Maybe. Appealing a decision is a legal process that may benefit from having a lawyer involved on your behalf. However, you are not required to have an attorney represent you.

What is vocational rehabilitation?

A: State law allows MainePERS to provide vocational rehabilitation services that are aimed at assisting disability retirees with transitioning back into the workforce.  Generally, an eligibility determination is based upon your inability to perform the duties of your employment position as defined by statute. The vocational rehabilitation focus is on providing services that when combined with your training, education, and experience, would allow you to engage in employment to the level of substantial gainful activity.

Can I refuse to participate in the rehabilitation program?

A: Yes. Vocational rehabilitation is voluntary for disability recipients.