Disability Retirement Applications and Other Relief

PURPOSE: This rule sets forth the procedures to be followed by members filing applications for disability retirement benefits or other types of relief. (1) A member seeking disability retirement shall apply for such benefits with LAGERS by submitting forms provided by LAGERS for that purpose and medical documentation to establish the nature and extent of the claimed disability. (A) Such application for disability retirement shall specify the nature of the condition the member believes entitles them to disability retirement. (B) A member requesting disability retirement must acknowledge that the information they provide to LAGERS may be supplied to third parties including but not limited to their employer and physicians selected to be on the medical committee. (2) The following procedure will be used in issuing determinations with respect to applications for disability: (A) Consistent with section 70.680, RSMo, LAGERS shall establish a medical committee consisting of a physician selected by the member, a physician selected by the board of trustees, and a third physician to be agreed to between the first two (2) physicians named; (B) Each member of the medical committee shall document their belief as to the nature of the claimed disability in a format provided by LAGERS; (C) In the event that a member applies for duty-related disability, and it is the conclusion of a physician on the medical committee that the member is totally and permanently disabled, such physician shall state if the member’s disability is the natural and proximate result of the course and actual performance of their employment; (D) Consistent with section 70.680, RSMo, the medical committee shall report its conclusions in writing to the board of trustees; (E) LAGERS shall issue a preliminary decision consistent with the majority of the medical committee’s conclusions. LAGERS shall inform the member and employer of such decision by certified mail; (F) A member, employer, or LAGERS may request a hearing pursuant to 16 CSR 20-3 if any party disagrees with the preliminary decision; (G) If a hearing is requested, LAGERS, at the discretion of the executive director, may request an independent medical examination. 1. Such independent medical examination shall be at the expense of LAGERS and by a physician selected by LAGERS. 2. The examination results may be used or presented by any party at the hearing. 3. LAGERS shall transmit the results of the independent medical examination to the medical committee for reconsideration of its original conclusions. 4. If the conclusions of the medical committee change such that, pursuant to this rule, the board of trustees would have issued a different preliminary decision, the board of trustees shall issue a supplemental decision and inform the member and employer of such decision. 5. If LAGERS elects not to hire an independent medical examiner or the conclusions of the medical committee as a result of the independent medical examination have not changed such that the board would have issued a different preliminary opinion under this rule, a hearing officer shall be appointed in accordance with applicable rules and a hearing shall proceed; (H) Should a request for hearing not be received within twenty-one (21) days from the date notice of the preliminary or supplemental decision is received by all parties or upon receipt of waivers, in writing, by all parties of a hearing, the parties will be deemed to have waived any right to a hearing on this matter and the preliminary or supplemental decision shall be automatically adopted as a final order of the board without the need for any further action of the board; (I) The rules applicable to an administrative hearing pursuant to this rule shall be the same as those for other administrative hearings before the board of trustees as prescribed in 16 CSR 20-3 except— 1. An employer wishing to contest the preliminary or supplemental decision of the board must, in their initial pleading, unless granted leave by the hearing officer for good cause shown, allege sufficient facts to establish why the employee is not disabled or that such disability is not duty related and to establish that the employer has standing in this matter; 2. A member wishing to provide additional medical evidence shall do so within thirty (30) days of their initial pleading or as otherwise approved by the hearing officer upon a showing of good cause. Failing to submit any medical documentation within this time period will create a presumption that such evidence is inadmissible; 3. Any medical information presented in accordance with the preceding paragraph shall be transmitted to the medical committee with a request that they reconsider their previous position considering this information. LAGERS shall be granted an automatic continuance of any proceeding during the pendency of this review. Should the opinions of the medical committee change in such a way that the board, pursuant to this rule, would have issued a different preliminary decision, the hearing officer shall entertain a motion for summary judgment related thereto; and (J) The executive director, in their sole discretion, may accept additional medical information and transmit the same to the medical committee up until the point that a hearing is requested or twenty-one (21) days have passed since the transmission of the preliminary decision. In the event that a preliminary decision has already been issued when medical information is received, such decision may be rescinded by LAGERS for the consideration of any additional medical information. (3) A member who makes a written application for disability retirement benefits pursuant to section 70.680, RSMo, or for other relief pursuant to section 70.605.16, RSMo, shall file EMPLOYEES’ RETIREMENT SYSTEM (LAGERS) the application within two (2) years from the date of alleged disability or within two (2) years of the date of the event from which relief is sought under section 70.605.16, RSMo. (4) Notwithstanding other provisions of this rule to the contrary, the board of trustees, in its sole discretion, may allow the filing of an application for disability retirement benefits by a member without regard to the time frames specified in section (3) in those instances where the member submits competent medical evidence that the member sustained a work-related injury or illness which, due to the latent, chronic, progressive, or debilitating nature of the injury/illness, did not result in the member’s permanent disability for an extended period of time, such that the member would otherwise be precluded from filing an application for disability retirement benefits. Such determination shall be taken up with the remainder of the disability case as an additional claim which the applicant must prove. (5) A recipient of disability allowance may make a written request to the board of trustees to return, on a trial basis, to full-time or part-time employment in a position the same or substantially similar to the position the recipient was previously determined to be unable to perform. The written request shall include the proposed employer, a job description for the position which the recipient intends to perform, and the proposed start date of employment. The written request shall then either be approved or denied by the board of trustees. If the request is approved, the recipient’s disability allowance shall be placed on hold by the board of trustees for the duration of the trial period, which is not to exceed six (6) calendar months. If the recipient is unable to complete his or her trial basis employment period, the recipient must provide written documentation to the board of trustees stating that he or she is physically or mentally totally incapacitated for the further performance of the job duties. Prior to restoring retirement disability status, the board of trustees may require the recipient to submit a Restatement of Disability by attending physician stating that the recipient is physically or mentally totally incapacitated for the further performance of the job duties. If determined to be physically or mentally totally incapacitated for the further performance of the job duties, the recipient shall again be considered a disability retiree and receive a disability retirement allowance restarting the first month following termination of employment, without resubmitting a Retirement Application seeking disability retirement; any contributions paid to the retirement system by the recipient and his or her employer during the incomplete trial basis employment period will be refunded to the employer, which shall then refund its employee for any employee-paid contributions. The recipient shall receive no additional service credit for the incomplete trial basis employment period. If the recipient does successfully complete his or her trial basis employment, his or her disability retirement will be revoked and his or her membership status as of the date of the member’s disability retirement shall be restored; any contributions paid by the recipient and his or her employer to the retirement system by the recipient and his or her employer during the trial basis employment period will be retained by the retirement system, and the recipient will be granted service credit for the trial basis employment period. In no event shall the recipient receive a disability allowance in the same calendar month in which the recipient either works for his or her trial basis employer or receives service credit except that if the recipient was in receipt of a duty disability allowance provided for in subsection 3 of section 70.680, RSMo, the recipient shall be given service credit for the period he or she was in receipt of the duty disability allowance. AUTHORITY: section 70.605, RSMo 2016, and section 70.680, RSMo Supp. 2025.* Original rule filed Feb. 16, 1999, effective July 30, 1999. Amended: Filed Sept. 26, 2011, effective March 30, 2012. Amended: Filed Nov. 4, 2020, effective May 30, 2021. Amended: Filed July 14, 2025, effective Feb. 28, 2026. *Original authority: 70.605, RSMo 1967, amended 1974, 1992, 2000, 2003, 2013, and 70.680, RSMo 1967, amended 1971, 1972, 1975, 1980, 1988, 1992, 2000, 2025.