Mo. Code Regs. Ann. tit. 16, § 30-2.181
Application for Long- Term Disability Benefits
Effective Jun 30, 1997sections 104.010 and 104.500, RSMo (1994).* Original rule filed Nov. 25, 1992, effective June 7, 1993. Amended: Filed Dec. 6, 1996, effective June 30, 1997. *Original authority: 104.010, RSMo (1955), amended 1965, 1969, 1972, 1981, 1982, 1983, 1987, 1988, 1989, 1992, 1994 and 104.500, RSMo (1957), amended 1981, 1984, 1988Missouri State Employees' Retirement System
PURPOSE: This rule standardizes the information needed to make application for longterm disability benefits.
- (1) The application for long-term disability benefits shall consist of the following three
(3) forms, provided by the retirement system:
- (A) Statement of Claim for Long-Term Disability Insurance Benefits, application to be completed by employee;
- (B) Employing Department’s Statement of Disability, to be completed by the employer; and
- (C) Attending Physician’s Statement of Functional Capacity, to be completed by the employee’s physician.
- (2) Whenever used in this chapter, the term physician means a physician or surgeon licensed to practice under Chapter 334, RSMo, or who is licensed to practice medicine as a physician or surgeon under similar laws in which the person is located.
AUTHORITY: sections 104.010 and 104.500, RSMo (1994).* Original rule filed Nov. 25, 1992, effective June 7, 1993. Amended: Filed Dec. 6, 1996, effective June 30, 1997. *Original authority: 104.010, RSMo (1955), amended 1965, 1969, 1972, 1981, 1982, 1983, 1987, 1988, 1989, 1992, 1994 and 104.500, RSMo (1957), amended 1981, 1984, 1988.