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Get DR - 1 Feb 2011:SR- 1 (t)April.04.qxd.qxd - OPERS - Opers

Irety. Failure to complete this form in its entirety could result in a delay in processing. Managed Medical Review Organization (MMro), OPERS third party administrator, may be contacting you regarding your application for disability benefits. This Application must be completed by the member or, if the member is unable to apply due to being physically or mentally incapacitated, by the member s legal guardian or attorney in fact. If a legal guardian or attorney in fact is making application.

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