Get A Guide To Completing Your Calpers Disability Retirement Election Application. A Guide To

This guide provides comprehensive, step-by-step instructions for completing your CalPERS Disability Retirement Election Application. It aims to assist you in navigating the various sections of the application efficiently and accurately, ensuring that you meet all necessary requirements.

Follow the steps to complete your application successfully.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill in your personal details in Section 1, including your full name as it appears on your Social Security card, Social Security number or CalPERS ID, mailing address, birth date, gender, and contact numbers.
3. In Section 2, provide retirement details, including your last day on payroll and desired retirement effective date. If applicable, mention any employment with other California public retirement systems.
4. Complete Section 3, which requires detailed information about your disability, including how it occurred, your limitations, and if a third party caused your injury.
5. In Section 4, enter your treating physician's details and their specialty. Ensure to include their address and contact number.
6. Select your retirement payment option in Section 5. Review the various payment choices and decide who you want to designate as your beneficiary.
7. Section 6 pertains to the Retired Death Benefit, providing details about who will receive this benefit upon your death.
8. Provide information regarding potential survivors in Section 7, including details about your spouse or domestic partner and any dependent children.
9. If applicable, complete Section 8 for workers' compensation details, including your claim information and carrier details.
10. Fill out Section 9 to indicate your preferences for tax withholding, both for federal and California state taxes.
11. In Section 10, indicate whether you wish to continue your CalPERS health coverage into retirement, selecting the appropriate option.
12. In Section 11, you and your spouse or domestic partner must sign and have the signatures notarized or witnessed.
13. Finally, review all sections and ensure that all necessary documentation is included. Save your changes, download, print, or share the form.

Start completing your Disability Retirement Election Application online today to ensure a smooth transition into retirement.