5505-3-03 Review of eligibility to continue disability retirement benefits.

(A) For the purpose of this rule:

(1) "Medical advisor" and "examining physician" have the same meaning as rule 5505-3-02 of the Administrative Code.

(2) "Benefit recipient" means any person who is receiving disability retirement benefits pursuant to section 5505.18 of the Revised Code.

(B) Every benefit recipient under the age of sixty annually shall be subject to a medical examination by HPRS' examining physician, unless the board's medical advisor certifies that a benefit recipient's disability is ongoing and the board waives the requirement that the benefit recipient undergo an annual medical examination.

(C) Every person under the age of sixty who is receiving disability benefits pursuant to section 5505.18 of the Revised Code shall annually submit a statement of earnings, an attending physician's report, and any other medical or employment information as deemed necessary by the executive director or medical advisor to determine whether the benefit recipient is still disabled as defined by section 5505.18 of the Revised Code. The board may waive the requirement to submit an annual statement of earnings or attending physician's report if the board's medical advisor certifies that a disability benefit recipient's disability is ongoing.

(1) The information required pursuant to paragraph (C) of this rule shall be submitted at a time designated by the executive director, and shall be reported on forms provided by HPRS.

(2) The information required pursuant to paragraph (C) of this rule shall be reviewed by the medical advisor. If the medical advisor determines the benefit recipient may no longer be disabled, HPRS shall:

(a) Schedule a medical examination with an examining physician recommended by the medical advisor.

(b) Provide the benefit recipient with at least fourteen days prior written notice of the time and place of the scheduled examination.

(c) If the examining physician certifies the benefit recipient no longer meets the disability standards set forth in section 5505.18 of the Revised Code, HPRS staff and medical advisor shall present the benefit recipient's file to the board at the next available meeting.

(3) The board shall review the examining physician's report and if it concurs with the examining physician's certification that the benefit recipient no longer meets the disability standards set forth in section 5505.18 of the Revised Code, the disability benefits shall terminate thirty days after the board concurs with the examining physician's certification or upon employment in a position as described in paragraphs (G) and (H) of this rule.

(D) The member will be notified of the board's action no more than ten days after the board meets and such notice will be sent by certified mail or another method that is acknowledged in writing by the member. The benefit recipient will also be notified of the date his or her benefits will terminate, if applicable, and his or her right to appeal.

(E) Within ten days of receiving notification of the board's decision, the benefit recipient may file a written notice of appeal. The notice of appeal shall reference the decision being appealed and shall include the reason(s) why the decision is being appealed. If the benefit recipient does not file a notice of appeal as described in this division, the board's determination made under paragraph (C) of this rule is final.

(1) The notice of appeal will be considered at the next regularly scheduled meeting of the board. Except as provided in this rule, benefits shall not be terminated while an appeal is pending.

(2) Within forty days of receiving the notification of the board's decision, the member must file any evidence he or she would like considered by the board. New disabling conditions and the related medical evidence will not be considered. Extensions will only be granted if the benefit recipient can show, and the board chair concurs, that additional time is needed to obtain relevant new medical evidence that is already in progress. HPRS shall void the notice of appeal if new evidence is not received by HPRS in the time described in this paragraph.

(3) Copies of the reports of the examining physician and medical advisor will be sent to the member and the member's agent upon written authorization of the member, unless the release of such reports is otherwise prohibited by law. However, the medical advisor's recommendation will not be released until the board has made an initial decision regarding the member's disability benefits.

(4) The applicant has the right to appear at the hearing, with or without counsel, to present new testimony.

(5) Evidence, information, or other documentation not already submitted in accordance with this rule will not be permitted.

(6) The board's decision is final.

(F) Nothing in this rule or any waiver granted by the board shall waive any rights of HPRS to request the benefit recipient to undergo a medical examination if information is received at any time which indicates the benefit recipient may no longer be eligible for disability benefits.

(G) Unless competent and credible evidence is submitted to HPRS, a benefit recipient is presumed to be no longer eligible for disability benefits if employed as a law enforcement officer or "member of a fire department" as defined by section 742.01 of the Revised Code and the associated Administrative Rules. Any benefit recipient that is employed as such shall immediately be subject to the termination procedures detailed in paragraph (C) of this rule.

(H) For the purpose of this rule, law enforcement officer includes any "member of a police department" as defined by section 742.01 of the Revised Code and the associated administrative rules and any person that is appointed, commissioned, compensated, designated, employed, engaged, volunteering, or otherwise serving as one of the following:

(1) A sheriff, marshal, deputy marshal, member of the organized police department of a township or municipal corporation, member of a township police district or joint township police district police force, member of a metropolitan housing authority police force established under division (D) of section 3735.31 of the Revised Code, or township constable or a similar job position outside the state of Ohio;

(2) A railroad company police officer governed by sections 4973.17 to 4973.22 of the Revised Code or a similar job position outside the state of Ohio;

(3) A person engaged in the enforcement of Chapter 5743. of the Revised Code on behalf of the department of taxation and designated by the tax commissioner for peace officer training for purposes of the delegation of investigation powers under section 5743.45 of the Revised Code or a similar job position outside the state of Ohio;

(4) An undercover drug agent or a similar job position outside the state of Ohio;

(5) A department of public safety enforcement agent governed by section 5502.14 of the Revised Code or a similar job position outside the state of Ohio;

(6) A natural resources law enforcement staff officer in the department of natural resources governed by section 1501.013 , a park officer governed by section 1541.10 , a forest officer governed by section 1503.29 , a preserve officer governed by section 1517.10 , a wildlife officer governed by section 1531.13 , or a state watercraft officer governed by section 1547.521 of the Revised Code or a similar job position outside the state of Ohio;

(7) A park district law enforcement officer governed by section 511.232 or 1545.13 of the Revised Code or a similar job position outside the state of Ohio;

(8) A conservancy district police officer governed by section 6101.75 of the Revised Code or a similar job position outside the state of Ohio;

(9) A member of a hospital police or security department governed by sections 4973.17 to 4973.22 of the Revised Code or a similar job position outside the state of Ohio;

(10) A veterans home police officer established by section 5907.02 of the Revised Code or a similar job position outside the state of Ohio;

(11) A member of a qualified nonprofit corporation police department established by section 1702.80 of the Revised Code or a similar job position outside the state of Ohio;

(12) A state university law enforcement officer governed by section 3345.04 of the Revised Code or a person serving as a state university law enforcement officer on a permanent basis on June 19, 1978, who has been awarded a certificate by the executive director of the Ohio peace officer training commission attesting to the person's satisfactory completion of an approved state, county, municipal, or department of natural resources peace officer basic training program or a similar job position outside the state of Ohio;

(13) A special police officer in the department of mental health governed by section 5119.14 of the Revised Code or a similar job position outside the state of Ohio;

(14) A special police officer in the department of mental retardation and developmental disabilities governed by section 5123.13 of the Revised Code or a similar job position outside the state of Ohio;

(15) A member of a campus police department established under section 1713.50 of the Revised Code or a similar job position outside the state of Ohio;

(16) A regional transit authority police officer governed by division (Y) of section 306.35 of the Revised Code or a similar job position outside the state of Ohio;

(17) An investigator of the auditor of state governed by section 117.091 of the Revised Code who is engaged in the enforcement of Chapter 117 of the Revised Code or a similar job position outside the state of Ohio;

(18) A special police officer serving on state property pursuant to section 5503.09 of the Revised Code or a person who was serving as a special police officer pursuant to that section on a permanent basis on October 21, 1997, and who has been awarded a certificate by the executive director of the Ohio peace officer training commission attesting to the person's satisfactory completion of an approved state, county, municipal, or department of natural resources peace officer basic training program or a similar job position outside the state of Ohio;

(19) A port authority special police officer governed by section 4582.04 or 4582.28 of the Revised Code or a person serving as a port authority special police officer on a permanent basis on May 17, 2000, who has been awarded a certificate by the executive director of the Ohio peace officer training commission attesting to the person's satisfactory completion of an approved state, county, municipal, or department of natural resources peace officer basic training program or a similar job position outside the state of Ohio;

(20) A municipal corporation special police officer who has been awarded a certificate by the executive director of the Ohio peace officer training commission for satisfactory completion of an approved peace officer basic training program and who is serving at a municipal airport or other municipal air navigation facility that is governed by aviation security rules of the transportation security administration of the United States department of transportation and required by federal laws and regulations to be under a security program or a similar job position outside the state of Ohio;

(21) A PERS law enforcement officer, as defined in section 145.01 of the Revised Code or a similar job position outside the state of Ohio;

(22) A bailiff or deputy bailiff of a court of record in this state who has received a certificate attesting to the person's satisfactory completion of the peace officer training school as required by section 109.77 of the Revised Code or a similar job position outside the state of Ohio;

(23) A parole, corrections, or probation officer or a similar job position outside the state of Ohio;

(24) An employee of the department of youth services who is designated by the director of youth services pursuant to division (A)(1) of section 5139.53 of the Revised Code and who has received the training described in division (B)(1) of that section;

(25) A federal protective service officer or a federal marshal, including, but not limited to, a court security officer hired by the U.S. marshall service.

(I) Any benefit recipient who desires to be reexamined in conjunction with a request to return to active duty status shall first be required to submit a medical examination report from a physician of his or her choice, which certifies that the benefit recipient is no longer eligible for disability benefits. The benefit recipient shall then be subject to the process described in paragraph (C) of this rule.

(J) Failure to comply with the provisions identified in this rule may result in the suspension of disability and healthcare benefits.

(1) Unless for good cause shown, the disability benefit recipient shall be presumed to have refused to submit to the medical examination by an examining physician if HPRS has scheduled such examinations two times and such disability benefit recipient has canceled, rescheduled, or failed to submit to such scheduled medical examinations.

(2) The refusal of a benefit recipient to submit to a medical examination or submit employment information requested pursuant paragraphs (B) and (C) of this rule shall result in the suspension of disability benefits and health care or prescription benefits selected by the disability benefit recipient, if any, upon thirty days prior written notice to the benefit recipient and shall continue until compliance.

(a) The suspension of disability and health care or prescription drug benefits selected by the disability benefit recipient, if any, shall be effective on the first day of the month immediately following the expiration of the aforementioned thirty day notice period.

(b) In the event the benefit recipient submits to the required medical examination or information after the aforementioned thirty day notice period, HPRS will reinstate the benefit recipient's disability and health care or prescription drug benefits selected by the benefit recipient, if any, on the first day of the month immediately following the benefit recipient's compliance.

Replaces: 5505-3-03

Effective: 03/28/2013
R.C. 119.032 review dates: 03/28/2018
Promulgated Under: 111.15
Statutory Authority: 5505.04
Rule Amplifies: 5505.18
Prior Effective Dates: 2/15/81, 1/1/86, 11/2/89, 10/1/1996