Guide The Comprehensive Medical Evaluation

After being approved for a disability retirement benefit, your case must be reviewed periodically by a Nurse Case Manager in PERAC's Disability Unit.

Table of Contents

Review of Medical Records

A PERAC Nurse Case Manager will examine PERAC's files and all updated information submitted by you or your retirement board to determine if there is a need for a CME. 

After reviewing your records, the Nurse Case Manager will determine that:

  • No exams needed
    • The catastrophic nature of the illness or injury is such that you do not need to be scheduled for any further exams in the future.
  • No exam now, but maybe in the future
    • You are currently unable to perform the essential duties of your former position or a similar job. You will not be scheduled for an exam but your records may be reviewed in the future. 
  • You must be evaluated
    • An exam must be scheduled in order to assess your current ability to perform the essential duties of the position you retired from, with or without rehabilitation.

Frequency of the Comprehensive Medical Exam

  • You may be required to be evaluated once a year for the first two years after retirement, and then once every three years. 
  • You may also submit a written request for a Comprehensive Medical Evaluation. 
  • You will not be evaluated more than once in a twelve-month period. 

The Comprehensive Medical Evaluation Appointment

The CME may include:

  • Mental or physical examinations,
  • vocational testing,
  • meetings and consultations with medical professionals, including a retiree’s treating physician and
  • vocational rehabilitation counselors.

The goal is to provide objective data regarding:

  • your ability to safely perform the essential duties of your former or similar job and
  • whether or not participation in a rehabilitation program will help you return to work

Coordinating Physician

  • The physician who coordinates this evaluation process will have copies of all of the available medical information, a copy of the current job description associated with the position you held at the time of retirement.
  • If you are a retired police officer or firefighter, a copy of the Medical Standards established by the Commonwealth’s Human Resources Division for those positions will also be given to the physician.
  • The physician will submit a written report to PERAC’s Disability Unit. If the physician has concluded that you may benefit from rehabilitation, the doctor will include a rehabilitation plan with the report.

After your CME is completed

You return to work

  • You are found able to perform the essential duties of the job you retired from or a similar position in the same department.

You return to work after rehabilitation

  • You are found able to perform the essential duties of the job from which you retired from or a similar position, with rehabilitation.
    • The physician who conducted the CME will recommend a rehabilitation program so you can return to work.
    • The plan must be reasonable, cost-effective, and approved by PERAC’s Disability Unit

You cannot return to work

  • You are found unable to perform the essential duties of the position you retired from or a similar position, with or without rehabilitation.
    • You will be re-evaluated by a PERAC Nurse Case Manager in the future.

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Image credits:  natacha dunker
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