The Physician’s Statement

In order to receive an Accidental Disability Retirement in Massachusetts, the claimant must prove three things: disability, permanency, and causation. Those seeking Ordinary Disability Retirements must only provide disability and permanency.

The first step in the Accidental Disability Retirement Application Process is for the claimant to be declared permanently disabled from performing the essential tasks and functions of his or her position. This determination must be made by the claimant’s treating physician. In order for this determination to be valid, it must be made at the right time. The decision must be made when the person seeking the Accidental Disability Retirement has reached his or her “maximum medical improvement” or “end medical result.” Disability determinations made prior to the ADR applicant having reached an end medical result may be discredited as premature.

Once is clear that the Disability Retirement applicant’s medical condition is unlikely to improve, the time is right for the person’s treating physician to complete the “Treating Physician’s Statement Pertaining to a Member’s Application for Disability Retirement.” It is absolutely imperative that this form be completed accurately. Usually, the best person to complete the Physician’s Statement is not the claimant’s primary care physician. The Treating Physician’s Statement should be completed by the specialist who is treating the patient for the disabling injury or condition upon which the retirement is based.

In order to receive an Accidental Disability Retirement, the doctor completing the Physician’s Statement must certify that the applicant is no longer capable of performing his or her essential job functions and that the disabling condition is likely to be permanent, based on the established permanency standard. Finally, to address the question of causation, the physician must state that the “incapacity such as might be the natural and proximate result of the claimed personal injury sustained or hazard undergone in the performance of the applicant’s duties and on account of which this disability retirement is based.”

In Massachusetts, a public employee’s Accidental Disability Retirement application should not be filed unless and until the employee’s treating physician answers “yes” to all three questions. If the employee is permanently disabled because of a non-job related disability, an application for an Ordinary Disability Retirement can be filed and the amount of the retirement benefits are generally based on the employee’s age, years of credible service, and group classification. Accidental Disability Retirement benefits are approximately equal to 72% of the employee’s “regular compensation” regardless of age and years of service. ADR benefits are state and federal tax free.1