Approximately 60 to 90 days before the conclusion of the short-term disability period or after salary continuation payments cease, whichever is later, an employee whose disability is likely to be total and permanent is eligible to apply for long-term disability benefits, provided he or she meets the following requirements:

• The employee must have at least five years of contributing membership service in TSERS earned within 96 calendar months immediately prior to the date of disability or the date of completion of continuous salary continuation payments, whichever is later. (The minimum periods of membership service required before a participant becomes eligible for disability benefits include membership service in LRS or CJRS added to membership service in TSERS.)
   
• The application for long-term disability benefits must be submitted within 180 days after the conclusion of the short-term disability period, or after salary continuation payments cease, or after monthly payments for Workers’ Compensation cease, whichever is later. Failure to do so will result in the denial of long-term disability benefits. The Board of Trustees may extend this 180-day filing requirement upon receipt of clear and convincing evidence that the application was delayed through no fault of the disabled employee and was delayed due to the employer’s miscalculation of the end of the 180-day filing period. However, in no instance shall the filing period be extended beyond an additional 180 days.
   
• The employee is not entitled to long-term disability benefits if he or she is already eligible for an unreduced service retirement benefit from TSERS. Employees enrolled in the Optional Retirement Program are not eligible if they meet the age and service requirements for an unreduced service retirement benefit under TSERS.
   
• The employee must terminate employment as a permanent full-time TSERS employee before long-term disability benefits can be paid.

The determination of disability and eligibility for long-term benefits is made by the DIPNC Medical Review Board. The DIPNC Medical Review Board must be able to determine from the medical information furnished that the employee is mentally or physically disabled for the further performance of his or her usual occupation, and that the disability has been continuous, is likely to be permanent, and was incurred at the time of active employment.

Regardless of the requirement that the incapacity was incurred at the time of active employment, any employee who becomes disabled while on an employer-approved leave of absence and who is eligible for and in receipt of temporary total benefits under the North Carolina Workers’ Compensation Act, may be eligible for long-term disability benefits. An employee who is in receipt of any other disability payments due to the same disability that existed upon entrance into membership in TSERS is not eligible for long-term disability benefits. For example, an employee in receipt of a disability benefit from another retirement plan at the time of covered employment, but who is otherwise able to perform the duties as required, is not eligible to receive benefits from DIPNC as a result of the condition as it existed at the time of employment.

The first step in applying for long-term disability benefits is the completion of Form 704 (Requesting Additional Benefits Through the Disability Income Plan of North Carolina). Please discuss Guides C through F regarding long-term disability benefits with the employee. Form 704 should be completed and signed by the employee or his or her legal representative and forwarded to the Retirement Systems Division approximately 90 days prior to the conclusion of the short-term disability period.
 

If the DIPNC Medical Review Board requests additional medical information, the employee will be notified of the information required. A copy of the letter will be sent to you.

In the event the application for long-term disability benefits is denied by the DIPNC Medical Review Board, the employee will be advised of the denial and his or her right to furnish additional information within 90 days from the date of the letter advising him or her of the DIPNC Medical Review Board’s decision. A copy of this letter will be sent to you.

If the application for long-term disability benefits has been approved and all of the required information has been received by the Retirement Systems Division, the payment amount will be determined. The employee will be mailed a Report of Disability Benefits just prior to the date his or her first disability payment is mailed. This statement provides all pertinent information relative to the long-term benefit.

Long-term disability benefits are generally paid on the 25th day of each month. 

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NOTE: A North Carolina Supreme Court ruling rendered under the Faulkenbury Class Action Lawsuit affects the calculation of disability benefits for some TSERS members. Under the provisions of the Supreme Court decision, a member who was vested in TSERS prior to January 1, 1988 must have an opportunity of choosing to receive benefits as provided under the Disability Income Plan in the form of short-term and long-term disability payments, or a disability retirement benefit calculated on the basis of a statutory formula with service projected to age 65 or to the earliest unreduced retirement date depending on the date the member became vested, with no offset for Social Security benefits. In order to comply with the requirements of the Supreme Court decision, the Retirement Systems Division provides appropriate information to each employee approved for long-term benefits who is eligible under the provisions of the lawsuit prior to payment of the long-term disability benefits.