Your local disability board administers the medical services provisions of the plan. The disability board decides whether medical services are necessary, determines “reasonable” cost, and has authority to designate the provider of the services. The disability board can deny medical benefits if it finds that the medical services are unnecessary or if it determines your illness or disability was brought on by dissipation or abuse.
Your employer is required to pay for your necessary medical services whether you are an active member, on disability leave or retired for service or disability. Payments by your employer will be reduced by any amounts you receive or are eligible to receive under Workers’ Compensation, Medicare, insurance provided by your LEOFF employer or another employer, other pension plan or any other similar source.
The amount of your service credit does not affect your eligibility for medical benefits if:
If you are not eligible to retire when you leave LEOFF employment but you have at least 20 years of service credit and you have applied for optional vesting, you will be eligible for medical benefits when you begin receiving your LEOFF retirement benefit at age 50.
If you end your employment prior to age 50 and you have fewer than 20 years of service credit, you will not be eligible for medical benefits.
The disability board has authority to have you examined by a doctor it selects in order to determine the nature and extent of your illness or disability. If you refuse to be examined, you may lose your rights to medical benefits. For more information on your medical benefits, contact your local disability board or your employer.