Fort Walton Beach Ordinance — 801 Restate General Emp Plan — reading text

construed to include regular annual leave, holidays or other paid leave while regularly employed by the -ci ty. If the trustees determine that the proximal of the cause disability occurred during employment by the city and the physician retained by the employee and the physician retained by the employer concur in their findings of disability, the trustees shall then determine if the disability was caused by sickness or a7cident and if the disability was job related and grant disability benefits according to the provisions of this article. If the trustees determine that the proximal cause of the disability occurred during employment by the city but that the employee' s physician and the physician retained by the employer do not concur in findings of total disability, th~y shall appoint a third physician who will independently examine the employee applying'-for disabili ty benefits. He shall review all information and test results from previous treatment and examinations and furnish a statement in writing on a form provided by the city as to whether or not the employee is totally and permanently disabled under the definition of this article. The third physician shall also support his opinion with a report detailing the basis of his conclusions. If it is the opinion of the third physician that the employee is not totally disabled, disability retirement shall be denied by the board of trustees. If the third physician reports a finding of total and permanent disability and the trustees have determined the absence of fraud and that the proximal cause of the disability occurred while the claimant was employed, disability benefits shall be granted by the trustees. Furthermore, total and permanent disability retirement shall be granted upon the loss of : both hands or arms, both feet or legs, both eyes or any combination of two such members or organs. In order to receive consideration for the application of disability be~ efits, an employee must cooperate fully in facilitating the medical examinations required. Pa~ e 44  If the participant disagrees with the decision of the truste~s, he shall, within thirty- five ( 35) days after the date the plan administrator mails the trustee' s decision to him in writing, advise the plan administrator in writing of his intention to appeal the decision of the trustees. Upon receipt of such notice, the plan administrator shall convene the appeal review board on a date which will provide adequate time for all parties to prepare presentations to the board. The claimant may represent himself or be represented by another party and present information and furnish expert witnesses to support his claim. The information on which the trustees based its decision shall be presented to the board by a representative of the ci ty other than a board member. Th'e hearing shall be conducted according to the provisions of the Florida Administrative Code and the retirement system administration manual. These documents shall be available for the participant and all members of the board. The board may require additional information or professional assistance to resolve each claim. A decision by the board shall be final and subject to, no further administrative review procedures. In order that disability benefits may continue to be paid to each il1dividual initially approved for same, it is required that an annual statement of disability be filed with the board of trustees. Such statement, on an approved form provided by the city, shall contain: a) A signed statement by the retiree affirming continued disabili ty as defined in this article. b) A signed statement by the retiree' s physician that said retiree is totally and permanently disabled and continues to be disabled as defined in this article. c) A signed statement of income earned in any occupation during the year ending September 30 for the just preceding year. The annual statement of disability shall be filed by all persons receIvIng disability benefits under this section no later than thirty ( 30) days following September 30th of each year regardless of the date of disability or the date benefits actually began. Members who qualified for and are receiving disability benefits by virtue of the loss of members as previously stated in this section shall only be required to furnish annual statements detailing their earned income. If the annual statement of disability reports earned income in the twelve ( 12) month period ending on September 30 greater than fifty percent ( 50%) of the current monthly disability benefit or if this information is developed indepe~ dently Pa~ e 45 and verified, ther~ shall be a reduction of the retiree' s benefits according to the following formula. Beginning on January 1 of the following year" each dollar of monthly disabili ty benefit during the next twelve ( 12) months in excess of fifty percent ( 50%) of the benefit shall be reduced by fifty cen,ts ($ 0. 50) for each dollar of income earned during the previous year. The reduction will be recalculated each year, based on earned income for the twelve months ending September 30. At the normal retirement date, the reductions for earned income shall cease and the benefi t shall revert to the accrued normal retirement benefit herein described. The board of trustees, upon discovery of intentional misrepresentation of condition or earned income by the employee filing this statement of disabili ty and/ or anyone filing same in his behalf, shall cause to terminate all benefits under this section. The board of trustees may, at its discretion, require a complete medical evaluation at the expense of this fund, to determine continued eligibility to receive disabili ty benefi ts. Any such benefits shall cooperate in this person receiving requirement and failure to do so will result in a termination of benefits. If the trustees or the plan administrator develop factual information that any person receiving disability benefits is no longer totally and permanently disabled under the definitions of this article, the plan administrator shall so advise that person in writing of a hearing to be held to consider the termination of disabili ty benefits and shall fully advise him of the facts in support of terminati,on. Any person receiving such written notice shall have a period of thirty- five ( 35) days from the date of mailing of the notice to prepare material in support of his continued disability. He shall advise the plan administrator in writing if he plans to appeal the termination and appear at a hearing before the review board. If the participant does not appeal the termination of disability benefits, the plan administrator shaH cause the same to be terminated beginning with the first of the month following the end of the thirty- five ( 35) day period. If the participant provides notice to the plan administrator that he will appeal the termination, the review board shall be convened as previously described in this section. The hearing shall be conducted according to the provisions of the Florida Administrative Code and the retirement system administration manual and copies of both documents shall be made available to all parties. The board may require medical tests and an examination of the participant by a physician practicing in the special ty area of the disabili ty and the participant shall cooperate in k~ eping Pa~ e 46 medical appointments, submit to necessary tests and provide such information as might be required by the board to resolve the issue. In such case, the city shall bear the expense of the examination. A decision by the board shall be final. A hearing may be requested by either the plan administrator or the participant in the future, however, if information is developed which is material and might reasonably be expected to change the outcome of the previous hearing. If an employee is determined to be totally and permanently disabled under the definitions of this article and commences to receive disability benefits but, at any time, is found to be no longer totally and permanently disabled or returns to work either as a city fireman or other employee or with any other private or public employer including self- employment or any kind, his interest in the pension fund of the City of Fort Walton Beach shall be limited as follows: a) With respect to employee' s contributions 1) For any employee to work or determine to be no longer disabled