Get Disability Retirement Application - Mass.gov - Mass

This guide provides detailed instructions on how to effectively complete the Disability Retirement Application for Massachusetts online. It aims to make the application process straightforward, ensuring that applicants can successfully navigate each section of the form.

Follow the steps to complete your application seamlessly.

1. Press the ‘Get Form’ button to access the Disability Retirement Application. This will open the form in your preferred online editing tool.
2. Begin filling out the applicant data section. This includes entering your name, social security number, and type of disability retirement you are applying for (either Accidental, Ordinary, or Both).
3. Complete the next section regarding your marital status and veteran status. Indicate your current marital status and if you are a veteran. Provide any relevant dates related to military service.
4. List your employment history. Start with your current position and include all previous employment in chronological order. Be sure to note your current employer's details, including the school district and contact information.
5. Identify your primary treating physician who will certify your disability. Include contact details and ensure to notify them that they will receive a request for medical information.
6. Provide information on your current disability, including the medical reasons for your application and essential duties required in your job that you are unable to perform due to your disability.
7. Document any recent physical activities and medical treatment you've received. This includes rehabilitation activities and daily activities affected by your disability.
8. Fill in the workers' compensation information, specifying if you have applied for benefits and the nature of those benefits.
9. Complete the salary data section, reporting your regular compensation over the required timeframe, and attach any necessary contract documents.
10. Complete the dependent child data if applicable, providing names, dates of birth, and social security numbers for your qualifying children.
11. If applying for accidental disability, detail the reasons for the disability, including descriptions of any incidents or hazards encountered.
12. Ensure you review all sections of the application for completeness. Gather required documents, make copies for your records, and prepare to send your application to the Disability Case Manager.
13. After completing your application and ensuring all necessary documents are attached, submit your materials to the appropriate address provided in the instructions.

Start filling out your Disability Retirement Application online today to secure your benefits.