State Codes and Statutes

State Codes and Statutes

Statutes > North-carolina > Chapter_135 > GS_135-106

§ 135‑106.  Long‑termdisability benefits.

(a)        Upon theapplication of a beneficiary or participant or of his legal representative orany person deemed by the Board of Trustees to represent the participant orbeneficiary, any beneficiary or participant who has had five or more years ofmembership service may receive long‑term disability benefits from thePlan upon approval by the Board of Trustees, commencing on the first daysucceeding the conclusion of the short‑term disability period providedfor in G.S. 135‑105, provided the beneficiary or participant makesapplication for such benefit within 180 days after the short‑termdisability period ceases, after salary continuation payments cease, or aftermonthly payments for Workers' Compensation cease, whichever is later; Provided,that the beneficiary or participant withdraws from active service byterminating employment as a teacher or State employee; Provided, that theMedical Board shall certify that such beneficiary or participant is mentally orphysically incapacitated for the further performance of duty, that suchincapacity was incurred at the time of active employment and has beencontinuous thereafter, and that such incapacity is likely to be permanent;Provided further that the Medical Board shall not certify any beneficiary orparticipant as disabled who is in receipt of any payments on account of thesame incapacity which existed when the beneficiary first established membershipin the Retirement System. The Board of Trustees may extend this 180‑day filingrequirement upon receipt of clear and convincing evidence that application wasdelayed through no fault of the disabled beneficiary or participant and wasdelayed due to the employers' miscalculation of the end of the 180‑dayfiling period. However, in no instance shall the filing period be extendedbeyond an additional 180 days.

The Board of Trustees mayrequire each beneficiary who becomes eligible to receive a long‑termdisability benefit to have an annual medical review or examination for the firstfive years and thereafter once every three years after the commencement ofbenefits under this section. However, the Board of Trustees may require morefrequent examinations and upon the advice of the Medical Board shall determinewhich cases require such examination. Should any beneficiary refuse to submitto any examination required by this subsection or by the Medical Board, hislong‑term disability benefit shall be suspended until he submits to anexamination, and should his refusal last for one year, his benefit may beterminated by the Board of Trustees. If the Medical Board finds that abeneficiary is no longer mentally or physically incapacitated for the furtherperformance of duty, the Medical Board shall so certify this finding to theBoard of Trustees, and the Board of Trustees may terminate the beneficiary'slong‑term disability benefits effective on the last day of the month inwhich the Medical Board certifies that the beneficiary is no longer disabled.

As to the requirement of fiveyears of membership service, any participant or beneficiary who does not havefive years of membership service within the 96 calendar months prior toconclusion of the short‑term disability period or cessation of salarycontinuation payments, whichever is later, shall not be eligible for long‑termdisability benefits.

Notwithstanding therequirement that the incapacity was incurred at the time of active employment,any participant who becomes disabled while on an employer approved leave ofabsence and who is eligible for and in receipt of temporary total benefitsunder The North Carolina Workers' Compensation Act, Article 1 of Chapter 97 ofthe General Statutes, will be eligible for all benefits provided under thisArticle.

(b)        After thecommencement of benefits under this section, the benefits payable under theterms of this section during the first 36 months of the long‑termdisability period shall be equal to sixty‑five percent (65%) of 1/12th ofthe annual base rate of compensation last payable to the participant orbeneficiary prior to the beginning of the short‑term disability period asmay be adjusted for percentage increases as provided under G.S. 135‑108,plus sixty‑five percent (65%) of 1/12th of the annual longevity paymentto which the participant or beneficiary would be eligible, to a maximum ofthree thousand nine hundred dollars ($3,900) per month reduced by any primarySocial Security disability benefits and by monthly payments for Workers'Compensation to which the participant or beneficiary may be entitled. Themonthly benefit shall be further reduced by the amount of any monthly paymentsfrom the federal Department of Veterans Affairs, any other federal agency orany payments made under the provisions of G.S. 127A‑108, to which theparticipant or beneficiary may be entitled on account of the same disability.Provided, in any event, the benefit payable shall be no less than ten dollars($10.00) a month. However, a disabled participant may elect to receive anysalary continuation as provided in G.S. 135‑104 in lieu of long‑termdisability benefits; provided such election shall not extend the first 36consecutive calendar months of the long‑term disability period. Anelection to receive any salary continuation for any part of any given day shallbe in lieu of any long‑term benefit payable for that day, providedfurther, any lump‑sum payout for vacation leave shall be treated as ifthe beneficiary or participant had exhausted the leave and shall be in lieu ofany long‑term benefit otherwise payable. Provided that, in any event, abeneficiary's benefit shall be reduced during the first 36 months of the long‑termdisability period by an amount, as determined by the Board of Trustees, equalto a primary Social Security retirement benefit to which the beneficiary mightbe entitled.

After 36 months of long‑termdisability, no further benefits are payable under the terms of this sectionunless the member has been approved and is in receipt of primary SocialSecurity disability benefits. In that case the benefits payable shall be equalto sixty‑five percent (65%) of 1/12th of the annual base rate ofcompensation last payable to the participant or beneficiary prior to thebeginning of the short‑term disability period as may be adjusted forpercentage increases as provided under G.S. 135‑108, plus sixty‑fivepercent (65%) of 1/12th of the annual longevity payment to which theparticipant or beneficiary would be eligible, to a maximum of three thousandnine hundred dollars ($3,900) per month reduced by the primary Social Securitydisability benefits and by monthly payments for Workers' Compensation to whichthe participant or beneficiary may be entitled. The monthly benefit shall befurther reduced by the amount of any monthly payments from the federalDepartment of Veterans Affairs, for payments from any other federal agency, orfor any payments made under the provisions of G.S. 127A‑108, to which theparticipant or beneficiary may be entitled on account of the same disability.Provided, in any event, the benefit payable shall be no less than ten dollars($10.00) a month.

Notwithstanding the foregoing,the long‑term disability benefit is payable so long as the beneficiary isdisabled and is in receipt of a primary Social Security disability benefituntil the earliest date at which the beneficiary is eligible for an unreducedservice retirement allowance from the Retirement System, at which time thebeneficiary would receive a retirement allowance calculated on the basis of thebeneficiary's average final compensation at the time of disability as adjustedto reflect compensation increases subsequent to the time of disability and thecreditable service accumulated by the beneficiary, including creditable servicewhile in receipt of benefits under the Plan. In the event the beneficiary hasnot been approved and is not in receipt of a primary Social Security disabilitybenefit, the long‑term disability benefit shall cease after the first 36months of the long‑term disability period. However, a beneficiary shallbe entitled to a restoration of the long‑term disability benefit in theevent the Social Security Administration grants a retroactive approval forprimary Social Security disability benefits with a benefit effective datewithin the first 36 months of the long‑term disability period. In suchevent, the long‑term disability benefit shall be restored retroactivelyto the date of cessation.

(c)        Notwithstanding theforegoing, a beneficiary in receipt of long‑term disability benefits whohas earnings during the long‑term disability period shall have his long‑termdisability benefit reduced when the sum of the net long‑term disabilitybenefit and the earnings equals one hundred percent (100%) of monthlycompensation adjusted as provided under G.S. 135‑108. The net long‑termbenefit shall mean the long‑term benefit amount payable as calculatedunder (b) above, after the reduction for Social Security benefits and Workers'Compensation benefits to which the beneficiary might be entitled, and after thereduction for any monthly payments from the federal Department of VeteransAffairs, for payments from any other federal agency, or for any payments madeunder the provisions of G.S. 127A‑108, to which the participant orbeneficiary may be entitled on account of the same disability. The net long‑termdisability benefit shall be reduced dollar‑for‑dollar for theamount of earnings in excess of the one hundred percent (100%) monthly limit.Any beneficiary exceeding the earnings limitations shall notify the Plan by thefifth of the month succeeding the month in which the earnings were received ofthe amount of earnings in excess of the limitations herein provided. Failure toreport excess earnings may result in a suspension or termination of benefits asdetermined by the Board of Trustees.

(c1)      During the long‑termdisability period, a beneficiary may return to service for trial rehabilitationfor periods of not greater than 36 months of continuous service. Such returnwill not cause the beneficiary to become a participant and will not require anew waiting period or short‑term disability period to commence regardlessof whether the beneficiary is unable to continue in service due to the sameincapacity or a different incapacity.

A beneficiary who, during aperiod of trial rehabilitation, is unable to continue in service may beentitled to a restoration of the long‑term disability benefit providedthat the Medical Board certifies that the beneficiary is disabled in accordancewith the laws in effect at the time of the Board's original approval for long‑termdisability benefits, either due to the same or a different incapacity,notwithstanding the requirement the incapacity has been continuous. In theevent that the Medical Board determines that the long‑term disabilitybenefit should be restored, the restored benefit should be calculated inaccordance with G.S. 135‑106(b); should include any post‑disabilitybenefit adjustments as provided by G.S. 135‑108; and shall continue aslong as the beneficiary remains disabled until the beneficiary has received atotal of 36 long‑term disability payments. Continuation of long‑termdisability benefit payments beyond 36 total payments shall be dependent uponapproval for primary Social Security disability benefits as required by G.S.135‑106(b).

A beneficiary who returns toservice for a period of trial rehabilitation and who has continued in servicefor greater than 36 continuous months shall again become a participant, and anysubsequent incapacity shall be treated as a new incapacity causing a newwaiting period to begin. Such a beneficiary may be entitled to additional long‑termdisability benefits on account of the new incapacity provided the beneficiarymeets all other requirements notwithstanding the requirement of five years ofmembership service within the 96 calendar months prior to becoming disabled orthe cessation of continuous salary continuation payments.

(d)        Notwithstanding theforegoing, a participant or beneficiary who has applied for and been approvedby the Medical Board for long‑term disability benefits may make anirrevocable election, within 90 days from the date of notification of suchapproval, and prior to receipt of any long‑term disability benefitpayments, to forfeit all pending and accrued rights to the long‑termdisability benefit including any ancillary benefits and retire on an earlyservice retirement allowance or receive a return of accumulated contributionsfrom the Retirement System. (1987, c. 738, s. 29(q); 1989, c. 717, s. 11; 1989(Reg. Sess., 1990), c. 1032, s. 2; 1991 (Reg. Sess., 1992), c. 779, s. 4; 1993(Reg. Sess., 1994), c. 769, s. 7.30(u); 2003‑284, s. 30.20(l); 2004‑78,ss. 3, 4; 2005‑91, s. 6.1; 2005‑276, s. 29.30B(a), (b); 2006‑74,ss. 3, 4(a), (b); 2007‑325, s. 2.)