Memorandum  PERAC Memo #12: Violent Act Injury Disability – Updated Forms

Date:	03/10/2026
Referenced Sources:	PERAC Website

PERAC Memo #12 2026

To All Retirement Boards:

TO: All Retirement Boards

FROM: Bill Keefe, Executive Director

RE: Violent Act Injury Disability – Updated Forms

DATE: March 10, 2026

As noted in PERAC Memo #33 of 2025, Governor Healey recently signed Chapter 73 of the Acts of 2025, which in Section 21 changed the definition of “Violent Act Injury” in Section 1 of G.L. c. 32 and, in Sections 22 and 23, made State Police Officers eligible for this benefit by amending Section 26 of G.L. c. 32. 

Due to these changes, G.L. c. 32, § 1 now reads:

“Violent Act Injury,” a catastrophic or life-threatening and permanent bodily injury sustained as a direct and proximate result of a violent attack upon a person by means of a dangerous weapon, which is used in a manner intended to cause serious injury or death, including, but not limited to, a firearm, knife, automobile or explosive device.

Given these changes, PERAC had to amend several of its forms to comply with the new language in the definition.  The below listed forms link to the PERAC website and should be used by retirement boards going forward.  Although this memorandum supersedes Memo #15 of 2025, the underlying instruction and guidance in that Memo, as well as Memo #28 of 2024 and Memo # 33 of 2025, has not changed. 

The newly amended forms related to the Violent Act Injury provision include:

1. Member’s Application for Disability Retirement
2. Physician’s Statement
3. Employer’s Statement Pertaining to an Application for Disability Retirement
4. Regional Medical Panel Certificates

We trust the foregoing will be of assistance.  If you have any questions, please feel free to contact Deputy Executive Director Ken Hill at 617-591-8945 or at [e-mail]. Thank you.