Commonwealth of Massachusetts | Public Employee Retirement Administration Commission
Five Middlesex Avenue, Suite 304, Somerville, MA 02145
Ph 617 666 4446 | Fax 617 628 4002 | TTY 617 591 8917 | www.mass.gov/perac
Domenic J. F. Russo, Chairman | A. Joseph DeNucci, Vice Chairman
Mary Ann Bradley | Paul V. Doane | Kenneth J. Donnelly | James M. Machado | Donald R. Marquis
Joseph E. Connarton, Executive Director
M E M O R A N D U M
TO: All Retirement Boards
FROM: Joseph E. Connarton, Executive Director
RE: Clarification on Physician Statement and Related Medical Record Costs
DATE: September 18, 2008
The Public Employee Retirement Administration Commission (PERAC) received a few communications from retirement systems requesting clarification on issues relating to the Disability Presentation offered by PERAC this past August 18, 2008 at the “UMASS PERAC Public Pension Institute”.
It seems that the confusion relates to references appearing in the “Oliver Payne” case study and the discussions that followed. The intent of this Memo is to provide clarification on specific issues pertaining to costs incurred in obtaining medical records during the Disability Application process. I hope this memo addresses any confusion that may have occurred from responses offered to staff at the “UMASS PERAC Public Pension Institute”.
There are two specific provisions contained within the PERAC Regulations that govern the responsibilities of members and boards under the proceedings for Ordinary and Accidental Disability Retirement Applications. They are 840 CMR 10.6 (1) (b) as it relates to the member and 840 CMR10.6 (1)(g) (1), (2), and (3) as it relates to the Board.
Specifically, 840 CMR 10.6 (1) (b) states that the applicant must file “A certificate from a licensed medical doctor”. Therefore obtaining the document is the responsibility of the applicant and the cost of such is incurred by the applicant. If the applicant has difficulty obtaining the document, because of the costs, the applicant may seek the retirement board’s assistance. PERAC often advises retirement boards to have the applicant request copies of the treating physician current office notes and also attach injury reports to information sent to PERAC in an effort to address the three certificate questions. Some boards have procedures in place to offer financial assistance to applicants to assist them in obtaining the physician statement. However, the determination to provide financial assistance to the applicant is a determination made by the individual retirement board and not required by regulation.
Likewise, 840 CMR 10.6 (1) (g) (1), (2), (3) requires the retirement board to obtain authorizations as such, as may be required by a person, institution or other agency having custody of the member’s records, for release of medical or insurance records relating to the member: The retirement board has a fiduciary responsibility to obtain all records, stated in the regulation, so that the board may render the appropriate decisions to move forward with the application and ultimately the medical panel physicians have complete medical records to properly evaluate the applicant’s condition and render a fair and well considered determination. Financial costs may be incurred in obtaining these records for which the retirement board is responsible.
The Disability staff are in the process of again reviewing pages 61-65 of the new “Disability Retirement – PERAC’s Complete Guide to the Process”, which includes the “Introduction to the Physician’s Statement Pertaining to a Member’s Application for Disability Retirement”. Pages 61 – 65 reference the actual Physician Statement. We intend to revise and condense the actual Physician Statement, making it more appealing to the Physician while still providing the retirement board and PERAC with all necessary medical information. The new Physician Statement may be hand written by the physician at the time he/she conducts the member examination. Our goals are to expedite the Physician Statement process and reduce unnecessary costs to the member.
We do hope this memo is responsive to your questions. Should you have additional questions please contact Frank Valeri at 617-666-4446 extension 945 or our legal staff by calling extension 907.