Sec. 22.06.03.01. Disability Unit’s Review

A. Disability Forms Review.

(1) On receipt of a Statement of Disability and Preliminary Application for Disability Retirement, the Disability Unit will conduct a disability forms review to determine whether:

(a) The appropriate disability forms have been properly completed and include the required information and documentation;

(b) Except as permitted under COMAR 22.06.02.04, the disability forms were submitted to the Retirement Agency before the date membership ended; and

(c) If the applicant has filed a claim for ordinary disability retirement only, the applicant has at least 5 years of eligibility service.

(2) If the Disability Unit determines that the applicant has not satisfied the requirement set forth in §A(1)(a) of this regulation, the Disability Unit shall:

(a) Reject the disability forms;

(b) Return the disability forms to the applicant;

(c) Notify the applicant that the applicant may refile for disability retirement if the applicant properly completes and timely submits a new Statement of Disability and Preliminary Application for Disability Retirement; and

(d) Close the applicant’s file in accordance with COMAR 22.06.01.05B.

(3) Denial of Disability Claim.

(a) If the Disability Unit determines that the applicant has not satisfied the requirement set forth in §A(1)(b) or (c) of this regulation:

(i) The Retirement Agency shall deny the disability claim; and

(ii) The Disability Unit shall provide the applicant written notice of the denial of the disability claim and the applicant’s appeal rights under §A(3)(b) and (c) of this regulation and in accordance with COMAR 22.06.05.05.

(b) The applicant may appeal the denial of the disability claim by submitting a written request for a hearing in the format required under COMAR 22.03.04.07B to the Executive Director within 30 days of the date of the Disability Unit’s notice of the denial of the disability claim.

(c) If the applicant does not submit a written request for a hearing to the Executive Director within 30 days of the date of the Disability Unit’s notice, the applicant shall not have any further right to appeal the denial of the disability claim.

B. Review of Claim by Applicant with Fewer than 5 Years of Eligibility Service.

(1) An applicant who has fewer than 5 years of eligibility service is not eligible for ordinary disability retirement.

(2) If the applicant has filed a claim for accidental disability retirement, the Disability Unit and medical board may review the applicant’s claim for eligibility for accidental disability retirement only.

C. The Disability Unit may request an applicant or an applicant’s employer to submit additional information, including but not limited to:

(1) Records of proceedings before, or any decisions issued by the Workers’ Compensation Commission or Social Security Administration;

(2) The applicant’s personnel records; and

(3) Any other information the Disability Unit considers relevant to the determination of the disability claim.

D. Review of Claims for Accidental Disability Retirement.

(1) Except as provided in §D(2) of this regulation, the Disability Unit shall review an applicant’s claim for accidental disability retirement to determine whether the event claimed to be the natural and proximate cause of the applicant’s disability was an accident that occurred in the actual performance of duty at a definite time and place without willful negligence by the applicant.

(2) If the applicant is in the State Police Retirement System or Law Enforcement Officers’ Pension System:

(a) Subject to §D(2)(b) of this regulation, the Disability Unit shall review the applicant’s claim for accidental disability retirement to determine whether the occurrence or condition claimed to be the cause of the applicant’s disability arose out of and in the course of the actual performance of duty without willful negligence by the applicant.

(b) If the applicant is a member of the Deferred Retirement Option Program who commenced participation on or after July 1, 2008, the Disability Unit shall also review the applicant’s claim to determine whether the occurrence claimed to be the cause of the applicant’s disability arose out of and in the course of the actual performance of duty during the member’s participation in the Deferred Retirement Option Program, without willful negligence by the applicant.

(3) Except if the applicant is in the State Police Retirement System, Law Enforcement Officers’ Pension System, or Correctional Officers’ Retirement System, the Disability Unit may not consider an accident that took place more than 5 years before the date that the Statement of Disability and Preliminary Application for Disability Retirement was submitted to the Retirement Agency.