This simple answer reflects three important realities:
STRS only reviews disability claims when members do not have eligibility under any other pension plan or government program. This means that more widely used safety nets like the Ohio Public Employee Retirement System, workers’ compensation, and Social Security are unavailable. Accepting a STRS denial of disability benefits could leave you without income.
Many teachers face that frightening possibility each year. Statistics published in the 2014 annual report for STRS show that fewer than half of the 5,825 participants receiving disability benefits were younger than 60. In other words, the group most prone to suffering debilitating work-related injuries and illnesses also make up the population least likely to have applications for disability benefits approved.
Which points directly to the third reason that appealing a disability benefits denial almost always makes sense. If you could work free of pain and without physical, mental, or emotional limitations, you would. That holds whether you have reached retirement age or remain in the largest group of STRS participants who run into roadblocks when applying for disability benefits. You need the disability income because you have lost the ability to earn it other ways, and you will use the benefits to pay your mortgage, buy groceries and cover medical expenses.
After receiving all the forms, medical reports, and employer affidavits it requires from an applicant for disability benefits, the STRS retirement board can take as long as six months to reach a decision. At least a week before that happens, the program mails a notice of its likely ruling to the applicant. When that letter hints at a no—which it likely will—the clock has started for preparing and filing an appeal.
This is the time to secure representation from an Ohio disability lawyer who has experience handling STRS cases. You can get help from an attorney even before you begin filling out the original application form, but having a skilled and dedicated legal advocate during your appeal is essential.
STRS largely bases its decisions regarding disability benefits awards on the findings of doctors and other health care providers it requires applicants to see. Even though each applicant’s own physicians and medical team know more about the person’s health history, current condition, and ability to do his or her job, the board generally puts more stock in the practitioners it pays to try to identify grounds for disqualifying disability claims.
In a detailed set of rules for considering appeals of denials, the STRS board specifies that “the purpose of the appeal hearing shall be for the applicant or recipient to present information to the retirement board … based on additional medical evidence not previously considered.” It further notes that unless specifically approved by the board, “‘additional medical evidence’ means current physician examinations, hospital discharge summaries, and diagnostic testing completed up to twelve months preceding the written notice of appeal.”
Finding such evidence quickly makes a great deal of difference. A notice of intent to appeal must reach the STRS board within 15 days. Understanding what counts as unique and convincing medical proof requires expertise you probably do not possess but an Ohio retirement attorney and his or her team will.
STRS generally refuses requests to appeal a disability denial more than once. Applicants can sue the retirement system when a case can be made that a physician paid by STRS acted unprofessionally or unethically, or if the rules for hearing an appeal were not followed. Succeeding in court is a longshot, however. The best chance to receive disability benefits is to put together a strong appeal.
Let the STRS specialists with Agee Clymer Mitchell & Portman help you do that. We have law offices staffed with experienced attorneys in nine locations across Ohio, and we can put you in touch with physicians and therapists who can provide much-need health care services. Call or contact us online today. You do not have time to waste when appealing a STRS disability benefits denial.