Obtain the Disability Retirement Application, a multi- page form , by contacting ACERA by mail at 475 14th Street, Suite 1000, Oakland, CA 94612, ATTN: Disability Unit, or by phone at 1.800.838.1932.
Step 2: Complete the Application
ACERA serves as the administrator of your Application process and of the disability retirement allowance, should it be granted. The ACERA Disability Unit (D.U.) is within our Benefits Department and employs Retirement Specialists, who will facilitate your Application process by providing you with the Application, conducting an intake counseling session, following up with the Medical Advisor (M.A.), the Employer, and the Board, and ensuring the administrative process moves in accordance with applicable law, ACERA D.U. policy, and the ACERA Disability Retirement Procedures.
To achieve the goal of submitting a Completed Application, you must carefully read and respond to all questions in the Disability Application. Full instructions are in the Application. Listed below are the areas of information needed for the completion of your Application.
General Information. We need your contact information and social security number. Please, fill it out thoroughly. This enables us to communicate with you regarding your case. If you change your address and or phone number, please contact us with your new information.
Application Type. Indicate whether your Application is SCD or NSCD. Under the SCD section, you may indicate if you want to be considered for an NSCD, in the event your disability is found not service connected. You must have five years of credited service to be eligible for an NSCD.
Reciprocity. As indicated in this section of the Application, if you are a deferred member and have filed a disability Application with your current Employer’s retirement system, you only need provide verification that your disability has been approved, whether it’s SCD or NSCD, the Effective Date, your final average salary, and benefit amount from the reciprocal agency granting the benefit.
Each system is required to pay its proportional share of the benefit based on the total amount that would have been paid had all service been in one agency. If you are receiving a disability benefit with PERS (Public Employees’ Retirement System), speak to a Retirement Specialist about your ACERA benefit prior to applying.
Current Status and Expedited Process. Let us know if you are already retired or if your current state of health will require an expedited process.
Effective Date. This will be the date you filed your Application and it is accepted by ACERA or your last day of compensation, whichever is later. If you file your Application later than your last day of compensation, you may request that an Earlier Effective Date be considered. You must provide medical documentation, with your submitted Application, supporting your request. It must state that your disability has been continuous since you left service. You may also request an Earlier Effective Date, if you believe there was an administrative oversight.
Buy Back Option. If you are applying for an NSCD, you must have five (5) years of credited service with ACERA. If you do not have five (5) years, and you have eligible service available to purchase that will provide a total of five (5) years, the purchase of that service must be complete prior to filing your Application. A Retirement Specialist can assist you in determining whether or not you have eligible service credit to purchase.
Notice of Right to Legal Representation. You are not required to have an attorney, but you are entitled to legal representation at your own expense. If you are represented by legal counsel, please provide your legal counsel’s name and contact information in this section of your Application.
Current Employment. Your Employer will be notified when your Application is submitted. Please provide the current employment information requested in this section of the Application.
Current Work Status with an ACERA Participating Employer. Please provide accurate information regarding your pay status, if you are still employed. This information is important because it will assist in determining your Effective Date and allow us to counsel you on benefit coverage.
Current Non-ACERA Employment. Provide all information regarding current employment in the event we must contact you regarding your current Duties, if you are working for a non-ACERA Employer.
Injury/Illness. Tell us about your disability. The more complete this information is, the better the Medical Advisor (M.A.) can make a recommendation on your disability status. If you have more than one illness/injury, you may provide information and file the Application for both conditions. However, you must provide independent supporting documentation for each. You may not add an additional illness or injury later into the process without filing a new Application.
Permanent Incapacity from Performing Job Duties. State the usual Duties you were actually performing at the time you became disabled and those you were required to perform. What Duties can you presently not perform as a result of your injury/ illness? Is your injury/illness permanent? How has your department accommodated you?
Safety Members’ Injury/Illness. Safety Members with at least five years of credited service and whose disability is based on heart trouble, cancer, blood borne disease, or exposure to a biochemical substance may automatically be presumed to have a Service Connected Disability. Please complete this section, if it applies to you
All Medical Treatment within the Past Five (5) Years. State your health plan providers and history during the last five (5) years, as well as symptoms/conditions.
Previous Claims Filed. Provide information on workers’ compensation, state disability, social security, or other benefits you have applied for.
Additional Information. Add anything that might help the Board decide your case
Declaration. Your signature indicates you have reviewed the above with a Retirement Specialist
Your Application is considered complete when you also include the following documents:
Essential Functions Job Analysis (EFJA) requested from your Employer; this is a summary of the usual Duties of your job. If you need assistance in obtaining an EFJA, please contact your Retirement Specialist.
All medical documents supporting your Application, including your Medical Provider Statement(s). Give this form to your treating physician for their use in providing a medical report supporting your claim.
Authorization to Obtain and Release Records: permission to release relevant records and information to ACERA for a full evaluation of your Application.
Attention to detail and thoroughness with your document submissions are of high importance. An incomplete or altered Application will not be accepted and will be returned to you in its entirety. This can result in a delay in processing your Application.
Step 3: Schedule Intake Counseling
Contact ACERA to schedule an intake counseling appointment. Bring your Completed Application to the session. All Applicants are counseled in-person by a Disability Unit Retirement Specialist who assists you throughout the Application process.
Phone intake counseling is available if you are physically unable to come to the office.
During counseling, the following critical topics will be reviewed:
Eligibility Requirements: Service Connected or Non-Service Connected
Service Retirement Eligibility and Benefits
Effective Date of Disability Benefits
Retirement Allowance Estimates
Tax Withholding/Reporting 1099®
Final Retirement Allowance/Option Contract and Timeline
Current Pay Status/Accruals
Safety Member Presumption of Disability
Documentation Needed to Process Benefits
Health, Dental, and Vision Plan Coverage
Current Beneficiary Designation and Death Benefits
D.U. staff will review your Application for completeness and send a Confirming Letter stating the acceptance of your Application or
requesting further documentation, as needed. When complete, staff will prepare your Disability Packet and send it to your Employer for review and Comment Paper submission. You will receive the same Packet and opportunity to comment. See Step 4.
Information will be sought from your Employer about your job Duties, injury/illness, and other pertinent data. We may need a
Pre-Employment Examination Report, Agency/Department Statement Form, Occupational Injury/Illness reports, and Medical records. Your Employer must submit the Statement to us within thirty (30) days of receiving the request.
Step 4: Employer and Applicant Review of your Disability Packet
Your Employer’s Role
Your ACERA benefits are sponsored by your Employer. Therefore, your Employer is a Party to your case and has an interest in whether or not your disability benefit is granted.
Disability Packet and Employer Notification of Application
The Disability Packet contains the Completed Application, supporting documentation, and related information, as well as a calculation of your qualifying years of service. It is sent to you and to your Employer for review.
Comment Papers (30 days)
Once the Disability Packet is received by you and your Employer, a Comment Paper may be submitted to the D.U. outlining your respective positions on the Completed Application. Possible Comment Paper topics from your Employer may include their assessment of your incapacity, a request for more information, or that the M.A. examine certain documents more closely. Possible Comment Paper topics from you may include a letter expressing your views on the Disability Packet or your current health status.
Comment Papers must be submitted within thirty (30) days of receipt of the Disability Packet. They will be marked and become a part of the Disability Packet. Please notify the D.U. in writing or by email, if you decide not to submit a Comment Paper.
First Possible I.M.E. Referral
During your Employer review period, your Employer may refer you for an Independent Medical Evaluation (I.M.E.). The Employer may also choose the health care professional who conducts the I.M.E. It is at no cost to you.
Step 5: Medical Advisor (M.a.) Evaluation And Recommendation
Next, the D.U sends the Disability Packet, any Comment Papers, and any I.M.E. reports to the Medical Advisor (M.A.) for analysis and recommendation. The M.A. is an unbiased independent consultant, who reviews the file and provides a written Report and Recommendation to ACERA’s Board of Retirement to grant or deny the Application within 45 business days of receiving the file.
The M.A. Report and Recommendation addresses whether you are
Physically or mentally capable of substantially performing the usual Duties of your job
Incapacitated and the source is Service Connected or Non-Service Connected
Physically or mentally capable of substantially performing the usual Duties of your job from the date you discontinued service and have been continuously disabled since that time
Capable of performing another position based on the treating physician’s restrictions
If you are recommended for disability, the M.A. Report also addresses whether you will be required to undergo annual medical
Second Possible I.M.E. Referral
The M.A. may request additional documents/information from the D.U and make referrals for your examination by an I.M.E. An extension of time for the M.A. Report and Recommendation is triggered by a consultation referral or requests for information.
Step 6: Notice of M.A. Recommendation
Within ten (10) days of receipt of the M.A. written Report and Recommendation (Report), the D.U. will send a copy of the M.A. Report to all Parties, along with a Request for Hearing Form.
The case can go in one of two directions at this point in your Application process as stated below:
The M.A. will recommend you for a disability retirement and if there is no objection from any Party, the case will go before the Retirement Board. If this occurs, proceed to Step 8; or
The M.A. does not recommend you for disability retirement or your case in contested by a Party, proceed to Step 7.
Step 7: Legal Hearing
If your case is contested or the M.A. does not recommend a disability benefit, you may choose to have your case heard before a Hearing Officer. Your Employer may request a Hearing, as well, if they do not agree with the M.A. recommendation.
If any Party desires that their case be heard before a Hearing Officer they must request it within fourteen (14) days of service of the
M.A. Report and Recommendation. If you or another Party desires a Hearing, fill out the Request for Hearing Form. The request must be signed by the Party requesting the Hearing.
Role of the Hearing Officer
The H.O. conducts a Hearing when the M.A. Recommendation on an Application is disputed and a Hearing is requested. Hearing Officers are obtained from a panel of an independent arbitration system, such as the American Arbitration Association. The H.O. must be a current member of the State Bar of California whose name is contained on ACERA’s approved Hearing Officer panel.
Notice of Proposed Hearing Officer
This Notice is sent by the D.U. and identifies the next assigned Hearing Officer in rotation. Parties have ten (10) days, from service of the Notice, to challenge the named Hearing Officer in writing. If a Party exercises a challenge, the next Hearing Officer in the rotation shall be assigned the case. The other Party will have ten (10) days from the service of the Notice to challenge the H.O. in writing.
Withdrawing with and without Prejudice
You may withdraw your Application at any time. However, if you do so after you are assigned a Hearing Officer, you withdraw with Prejudice. This precludes you from filing a future Application based on the same injury/illness.
Withdrawal without Prejudice
You may withdraw your Application without prejudice prior to an H.O. assignment. An Application withdrawn without prejudice is treated as though it was never submitted. A subsequent Application, including resubmission of the withdrawn Application, is considered a new Application and must meet all requirements, including timely filing requirements.
Notice of Original Hearing Date
Once selection of a Hearing Officer is final, the ACERA Office of Chief Counsel offers all Parties the option of three Hearing dates
within ninety (90) days. Once selected, the Hearing date is dubbed the “Original Hearing Date.” The ACERA Chief Counsel issues a Notice of Original Hearing Date to the Parties and the Hearing Officer stating the time and place of the Hearing. ACERA arranges for a stenographic reporter and interpreter, if needed, and use of a Hearing room.
Hearings are held at ACERA’s offices. The Hearing Officer must hold a Hearing within ninety (90) days from the date of their final selection, except when the ACERA Office of Chief Counsel authorizes a delayed Hearing date. Without this authorization, the appointment of the Hearing Officer is vacated and a new Hearing Officer is appointed.
The Hearing Officer has sixty (60) days from the Original Hearing Date to receive all of the evidence, both testimonial and documentary, to complete the Hearing (including any closing arguments and final briefing), and to close the record.
Hearing Officer’s Decision
The Hearing Officer will send a written report to the D.U. summarizing the evidence, findings of fact, and making a recommendation to the Board within forty-five (45) days after the Hearing is concluded and the record is closed. The document is called the Proposed Findings of Fact and Recommended Decisions and complies with the legal requirements of a civil administrative decision. The D.U. provides all Parties with a copy, once received at ACERA.
Objection to the Hearing Officer’s Decision
Any Party objecting to a Hearing Officer’s recommendation has ten (10) days after service of the Proposed Findings of Fact and Recommended Decisions to submit written objections to the D.U. The D.U. will send any objections to all Parties and provide a courtesy copy to the Hearing Officer. All Parties have five (5) days to respond, in writing, to objections, which will be incorporated into the record for consideration by the Board.
ACERA’s Chief Counsel has sole discretion to return the matter back to the Hearing Officer for consideration of the objections and modification to the Proposed Findings and of Fact and Recommended Decisions prior to the Board Consideration Date.
I Do Not Want a Hearing
If you do not submit your request for Hearing to the D.U. within the 14-day limit, the D.U. will place the matter on the calendar for the next available Board meeting, with at least fifteen (15) days notice to all Parties of the Board Consideration Date. The Disability Packet and all subsequent documentation will be submitted to the Board for consideration, along with an Administrative Report.
Step 8: Disability Unit Board Preparation
Before your Completed Application, including a copy of all the M.A. Recommendations and any Hearing Officer Proposed Findings of Fact and Recommended Decisions, is sent to the Board for a decision, the D.U. reviews the file and prepares a written report to the Board addressing the following matters:
Permanent Disability whether the M.A. Recommendation and the H.O. Findings support a Board decision determining permanent incapacity from performing your usual Duties
Service Connected Disability whether the M.A. Recommendation and the H.O. Findings substantiate the incapacity results from injury/illness or disease arising out of and in the course of employment
Non-Service Connected Disability summary of the M.A. Recommendation(s), and any H.O. Proposed Findings of Fact and Recommended Decisions regarding the disability not being service connected. This summary also includes a discussion about the disability being attributed to intemperate use of alcoholic liquor or drugs, willful misconduct or violation of law. If you joined ACERA on or after January 1, 1988, the summary also addresses whether the disability is due to conviction of a felony or criminal activity.
Return to Work whether the opportunity for accommodation or returning to work is supported by the applicable legal standard
Annual Examinations if you are under age 55, whether the M.A. Recommendation and the H.O. Findings determine that annual medical exams should be required following disability retirement
Effective Date of Disability recommendation of the date your disability retirement begins, which is one of three possibilities:
the date your Application is deemed complete by the D.U.; or
the date after the last date you received regular compensation, whichever date is later; or
if an Earlier Effective Date is requested.
Step 9: Board Action
Consent Calendar Cases
If all Parties are in agreement with the M.A. Recommendation for granting your disability retirement, your case will be included on the Board Agenda as a consent item. Consent items are normal business items that are grouped together and approved as one, including service retirements and death benefit payments. They are not addressed individually during the Board meeting. However, if a Board member or the Employer chooses to address your case, it will be postponed to the following month so it can be added as a regular agenda item.
Board Consideration Date: Hearing Cases
All Parties receive notice for the Board Consideration Date, regardless of a Hearing. ACERA presents your Disability Packet to the Board on the date noticed to all Parties. The Board may immediately vote and take action or request that any Party, ACERA staff, and/or the M.A. respond to questions.
Any Party or their counsel may ask to orally present to the Board on this date and the Board has sole discretion to grant this request. Oral presentations are limited to ten (10) minutes and any other Party can immediately orally respond, but must do so within a five (5) minute time limit. Additional time for oral presentation or response is also in the Board’s discretion. New evidence or witness testimony will not be heard or received by the Board on this date.
Each decision is based on all admissible evidence presented to the Board, including but not limited to the M.A. Recommendation and Hearing Officer Proposed Findings of Fact and Recommended Decisions. The D.U.’s written administrative report alone is not deemed evidence by the Board.
After presentations, including consent calendar cases, the Board may take any of the following actions on your Application:
Approve your Application
Deny your Application
Approve and adopt H.O. Proposed Findings of Fact and Recommended Decisions
Refer Back to H.O. for further proceedings
Refer to M.A. for additional advice or further information
Refer to D.U. with instructions, such as return the matter back with specific instructions to the presiding H.O.
Assign the next available H.O., if the matter has not already been heard before an H.O., with specific instructions to consider all or limited issues
Take any other action which may assist the Board in making a decision on the Completed Application.
Receive and review all evidence considered by the H.O. (including transcripts and affidavits, if any) and make a decision based on its own independent review of the testimony and evidence. In doing so, the Board may reject the decisions of the H.O. and make its own determinations.
Conduct a Board Hearing by setting the matter for a Hearing and deciding the matter as if it had not been referred to the H.O. If the Board holds the Hearing itself, the Board will render its decision by the second regular meeting after your case is submitted.
A tie vote results in a failure to find in your favor and constitutes a denial of the Complete Application or the portion of the Completed Application on which the vote is taken.
Notice of Board’s Action
The D.U. notifies the Parties and their representatives of the Board’s decision within ten (10) days of the Board Consideration Date. The Notice of Board Decision includes the decision, the date the decision was rendered, and notice of the right to judicial review. The Notice of Board Decision is sent by certified mail, return receipt requested.
Step 10: Disability Retirement Granted and Calculated
Your granted disability retirement can be Service Connected or Non- Service Connected and the calculations depend on the particulars of your case.
Service Connected Calculations
When you retire for Service Connected Disability, you will receive a lifetime retirement allowance payable in monthly installments, equal to one-half (50%) of your final average salary. Or, if qualified for a service retirement, you will receive your service retirement allowance, if it is greater. Your benefit amount will not exceed the limitation set forth by applicable law. Generally, each Reciprocal System calculates its respective obligations based upon your service with that entity and each adjusts its payment on a pro rata basis. No retirement system or political entity is liable for more than its just financial obligation. Your combined reciprocal benefit will not be higher than it would have been were all service credit earned in one system.
Non-Service Connected Calculations
An NSCD benefit is typically one-third (1/3) of your final average salary. However, this amount will depend on your age and service credit and is paid in monthly installments during your lifetime.
Cost of Living Adjustments (COLA)
COLA is equally applied to disability retirement grantees and regular service retirees.
Step 11: Appealing the Board’s Decision
Any Party may obtain review of the Board’s decision in a court of law by filing a Petition for Writ of Mandate (Petition) with the Superior Court of Alameda County (Superior Court) no later than the ninetieth (90th) day following the date the Board’s decision is finalized. An extension will be granted if you request the record within ten (10) days of the decision.
A copy of any Petition filed must be served on all Parties and the ACERA Office of Chief Counsel.
The process of seeking judicial review through a petition is a complex legal proceeding and it is beyond the scope of this website section or the Handbook. However, ACERA recommends that you seek the advice of an attorney. Please note that strict deadlines apply to petitions, so you must act promptly to avoid waiving valuable rights.
Non-Service Connected Disability Retirement Pending Review of Right to Service Connected Disability Benefits
If the Board determines you are entitled to a Non-Service Connected Disability retirement, you may accept a Non-Service Connected Disability retirement benefit while you are pursuing a rehearing or judicial review concerning your right to Service Connected Disability retirement. If later determined that you are entitled to a Service Connected Disability retirement, appropriate adjustments will be made to your retirement allowance retroactive to the Effective Date.
Step 12: Reexaminations
The Board may require you to undergo annual reviews and medical examinations, at ACERA’s expense, if you are under age 55 and granted a disability retirement. You will be required to complete a Continuing Disability Questionnaire Form, as part of this review. These examinations and records are reviewed by the M.A. who makes a recommendation to the Board regarding whether you remain permanently incapacitated for the performance of duty. The Board will determine if you are unable to perform the usual Duties of the position you held when your disability retirement was granted.
Your retirement allowance will be cancelled, if, over a period of one year, you refuse to submit to a medical examination, supply
requested information, or provide requested release forms.