<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".02" citation="COMAR 22.06.02.02" title_num="22" subtitle_num="06" chapter_num="02" heading="Statement of Disability.">
  <paragraph num="A.">
    <text>A Statement of Disability submitted to the Retirement Agency shall:</text>
    <paragraph num="(1)">
      <text>Identify the mental or physical condition that is claimed to have permanently incapacitated the applicant for the further performance of the normal duties of the applicant’s position;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Give the applicant’s consent to report for one or more independent medical evaluations at the request of the Retirement Agency; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Provide the information and documents requested by the Retirement Agency, including but not limited to:</text>
      <paragraph num="(a)">
        <text>A report completed by the applicant’s physician in the format required by the Retirement Agency;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>A written authorization for the release of medical records and personnel records to the Retirement Agency, medical board, and the physicians designated by the Retirement Agency;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>A copy of the applicant’s position description that is signed and dated by the applicant’s employer;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Any reports of injury filed with the applicant’s employer;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Any disability determinations rendered by the Social Security Administration;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>The applicant’s attendance record for the 12-month period preceding the submission of the Statement of Disability; and</text>
      </paragraph>
      <paragraph num="(g)">
        <text>The applicant’s most recent written employment performance evaluation, if any.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>In addition to the requirements set forth in §A of this regulation, if accidental disability retirement is requested, a Statement of Disability shall:</text>
    <paragraph num="(1)">
      <text>Identify:</text>
      <paragraph num="(a)">
        <text>Every work-related accident that is claimed to entitle the applicant to accidental disability retirement; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>If the applicant is in the State Police Retirement System or Law Enforcement Officers’ Pension System, every work-related accident or work-related condition that is claimed to entitle the applicant to accidental disability retirement; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Provide any workers’ compensation awards related to the claim for accidental disability retirement.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>An applicant who, at the time of submission of a Statement of Disability, fails to request accidental disability retirement or fails to identify a work-related accident in accordance with §B of this regulation may not later request accidental disability retirement or submit a new claim for accidental disability retirement based upon a work-related accident that took place before the date the applicant submitted the Statement of Disability.</text>
  </paragraph>
</regulation>