Get Article 15 Disability Retirement

Filling out the Article 15 Disability Retirement application online can be a straightforward process with the right guidance. This comprehensive guide is designed to help users navigate each section of the form, ensuring that all necessary information is provided clearly and accurately.

Follow the steps to successfully complete the Article 15 Disability Retirement application online.

1. Press the ‘Get Form’ button to access the Article 15 Disability Retirement form online. This allows you to open and begin editing the document right away.
2. Begin by entering your personal information in the 'Information About You' section. This includes your full name, social security number, date of birth, address, and contact numbers. Ensure that all information is accurate and clearly printed or typed.
3. Indicate your payroll status by answering whether you are on payroll and receiving a salary. If not, provide a brief explanation in the space provided.
4. If applicable, state whether you are a member of both the New York State Employees’ Retirement System and the New York State Police and Fire Retirement System. Mark 'Yes' or 'No' as appropriate.
5. Detail the medical conditions that have led to your permanent disability in the designated section. Be thorough, and use additional sheets if necessary.
6. List all doctors who have treated you for the conditions mentioned. Provide their names, medical specialties, and contact information.
7. Document any hospitalizations by filling in the names and addresses of the hospitals along with the dates of admission.
8. Answer the questions regarding whether you are incapacitated due to an accident related to your duties. If yes, provide details about the accidents, including dates and descriptions.
9. List the names and addresses of any witnesses to the accidents, along with the dates they witnessed the events.
10. Provide information about your intended beneficiary, including their name, relationship to you, address, date of birth, and sex.
11. Sign the form on the designated line and ensure your name is printed clearly above the signature. Confirm that all information provided is true and complete.
12. Once you have filled out all sections, review your document for accuracy and completeness. You can then save the changes, download the form, print it, or share it as needed.

Complete your Article 15 Disability Retirement application online today for a smooth and efficient process.