Ophthalmology experts are often called on to provide legal consultation and testimony for issues related to CalPers disability retirement.
CalPers normally provides eligible members a monthly retirement allowance that is based on a vesting formula. CalPers may substitute retirement disability when an individual qualifies for benefits. It is important to note that CalPers does not utilize the California Worker’s Compensation Appeals Board definition of injuries. Instead, CalPers uses a standard known as “substantial disability”. It is also important that CalPers grants a disability allowance only when an employee does not actively return to work while receiving a monthly retirement allowance.
Substantial disability means that an employee must be substantially incapacitated for the performance of his regular job duties. Individuals who qualify for disability retirement on the basis of impaired vision have a substantial incapacity or a medical condition that is permanent or extended. Disabilities that are anticipated but not evident do not qualify for disability retirement.
The law interprets mere difficulty in performing regular work-related tasks as insufficient to qualify for disability retirement. The inability to perform the essential functions of the actual and present job duties determines if a worker is substantially incapacitated. Furthermore, disability is not necessarily an inability to perform fully every function of a job. A CalPres worker must be unable to substantially perform the duties of his position to qualify for CalPers disability retirement.
Vision issues regarding California Highway Patrol officers are covered under California Code section 21428.1. This code states total loss of sight in one or both eyes is considered a serious bodily injury that qualifies for disability retirement. A serious physical injury to the eyes that results in the inability to perform substantial gainful employment may also qualify for disability retirement. However, cumulative events that result in vision impairment are not applied to disability requirements under CalPers.
CalPers workers who qualify for disability retirement receive an allowance for life or for the duration of the disability may that person is unable to perform his job duties.
CalPers may require an individual claiming s substantial vision injury to be examined by a qualified ophthalmologist. This type of examination is know as an IME or Independent Medical Examination. The ophthalmologist is asked if there are specific jib duties that the worker is unable to perform because of a vision condition. An opinion regarding whether a member is substantially incapacitated for the performance of the usual duties of his current position is usually required. If so, the examining ophthalmologist may be asked his opinion regarding the date of onset for a member’s impairment. The ophthalmologist may also be asked about expected duration, exaggeration, or work aggravation of the claimed vision impairment.
Sources of information that an ophthalmologist uses for his IME report includes history given by the patient, assessment of prior medical records, and examination. Ophthalmologists are ethically bound to provide an unbiased report that explains their findings and conclusions.
Following submission of an IME report, the ophthalmologist may be required to appear and testify at administrative hearings. The process to determine vision impairment under CalPers, and the qualifications for disability retirement benefits can be a long and arduous journey. However, the system is designed to provide assistance to those who truly qualify for legal benefits.