OPERS Disability Benefits and Eligibility Requirements
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The Ohio Public Employees Retirement System (OPERS) was designed to make sure that both full- and part-time state, city, and county employees can get the benefits they deserve. That includes disability benefits. The program is designed to act as a safety net for public employees, but unfortunately, it doesn’t always work exactly as intended. Read on to find out the truth about OPERS disability benefits and eligibility requirements.
What Are OPERS Disability Benefits?
OPERS disability benefits are intended to provide a safety net for public employees in Ohio who are not eligible for other state or federal programs. However, the program is known for rejecting completely valid claims, creating financial hardship for public servants. When that happens, OPERS disability lawyers can help affected workers get the benefits they need to focus on their health instead of worrying constantly about finances.
Eligibility Standards
Unlike SSDI, OPERS disability benefits eligibility is determined not based on universal standards but on what’s called an “own occupation disability standard.” If an Ohio public servant becomes unable to perform their current or last employment position due to either mental or physical impairments expected to last for at least 12 months, that person meets the own occupation disability standard.
It’s worth noting here that there are different eligibility criteria for certain groups. Those groups include police officers injured while in the line of duty, state, city, or county employees who have retired before they turned 60, and beneficiaries who aren’t aware of their disabling injuries or illnesses until after retirement. In these cases, it’s best to speak with an OPERS attorney prior to filing a claim.
Claim-Filing Requirements
It takes a good deal of paperwork to apply for OPERS disability benefits. Applicants will first need to complete an official packet of forms and submit it along with a “Report of Physician.” If any of the requested paperwork is omitted or the forms are not filled out correctly, it could lead to the rejection of the application. Unfortunately, not all doctors are aware of the qualifications set forth by OPERS regarding disabling conditions, and something as minor as improper wording in the physician’s report can also lead to the rejection of otherwise valid applications.
Receiving Ongoing Benefits
Applicants need to undergo examinations and assessments by specialists before their claims can be approved and prove that they have complied with all orders from their healthcare providers. In many cases, injured workers must also participate in vocational rehabilitation programs to receive ongoing benefits.
After the first three years of annual assessments, the standards for claiming ongoing disability benefits change. Instead of an “own occupation disability standard,” benefit recipients will be evaluated based on a stricter “any occupation standard.”
How to Appeal a Denial
Most applicants who are denied OPERS disability benefits only fail to have their applications approved for technical reasons, and it’s a very common situation. Don’t give up on getting OPERS disability benefits as a result of receiving a rejection letter. Instead, contact an attorney immediately to get help with appealing the denial.
To appeal the denial, applicants may need to submit additional information, new evidence, or second opinions that could strengthen their cases. It can take multiple rounds of appeals before people receive the benefits to which they were entitled, to begin with. Don’t give up hope, and don’t be afraid to contact a lawyer at any point in the application for assistance or advice.
