Unfortunately, PERS often denies claims of deserving members. There are many reasons that a disability retirement application may be denied, however, the most common reasons include:

• Insufficient medical documentation

• Application and/or corresponding documents are improperly filled out or incomplete

• Application steps are missed

• CalPERS’ independent medical expert has determined you are not incapacitated from performing your duties

Receiving a denial is devastating, but it’s not the end of the road. With a skilled advocate in your corner, you have the best chance at securing benefits and reclaiming your life.

Once you receive your determination letter from CalPERS, you must provide a written request of appeal, usually within 30 days from the date of the determination letter. Your request must explain the factual and legal basis for your appeal.

If you include additional medical information to be considered, this information will be forwarded to CalPERS’ IME doctor for consideration. The doctor will provide a report of his or her findings based on the information submitted. Depending on the doctor’s conclusion, CalPERS will either change its decision and grant your disability application or stay its original decision and send your appeal request to its Legal Office. The Legal Office will then decide whether your case is appropriate for an administrative hearing.

If an administrative hearing is scheduled, then your case will be heard by an administrative law judge. At the hearing, you will be allowed to take the stand and testify on your own behalf, as well as ask questions of the CalPERS IME doctor. At the conclusion of the hearing, the judge will inform you of her opinion via a written decision.

Keep in mind that there are many factors that go into what your specific appeals journey looks like. This is only a brief summary of a typical case.

Since the determination of whether you are disabled is a medical determination, your physician must be able and willing to testify that you are no longer able to work at your current job.

You must notify CalPERS of your intent to appeal as soon as possible, but no later than the deadline stated in your denial letter (usually 30 days from the date of the determination letter).

You should contact me as soon as you receive your denial letter so I can determine whether we should move forward with an appeal.

How much your case will cost is dependent on many factors. However, these are the most common causes of a higher bill:

• Your case involves a complex question of law

• Filing pre-hearing and post-hearing briefs

• Lengthy medical records

• Multiple witnesses

• Copious emails and phone calls

Because of the nature of litigation, I am unable to bill on a flat fee basis. This means that you will pay by the hour. My current hourly rate is $300/hour.

When you sign the fee agreement, you will be required to furnish a retainer amount and continue to replenish that amount if/when your retainer gets below a certain amount. I will keep you informed as to what the balance of your retainer is, and notify you when it starts to get low.

Your retirement benefit is determined by a formula using the following three factors: (1) service credit, (2) benefit factor, and (3) final monthly compensation.

Further explanation can be found on CalPERS’ website: https://www.calpers.ca.gov/page/active-members/retirement-benefits/service-disability-retirement#:~:text=Retirement%20Calculation%20Formula,compensation%20equals%20your%20unmodified%20allowance.