PURPOSE: This rule clarifies when an employee is eligible for work-related disability benefits under section 104.110.2., RSMo.

1. (1) For the first twelve (12) full months after the effective date of benefits, an employee will be considered disabled and eligible for work-related disability benefits provided the following conditions are met:

   1. (A) The employee is disabled as a result of injuries incurred during the performance of his/her duties; and
   2. (B) As a result of the injury incurred during the performance of duties, the employee is unable to perform the essential duties of his/her normal occupation. Normal occupation is the occupation, job or work performed by the employee on the date preceding the date of disability; and
   3. (C) The employee has not retained or regained his/her earning capacity. For purposes of this paragraph, earning capacity means the employee’s ability to perform the essential duties of any occupation commensurate with the employee’s education, training, or experience; and
   4. (D) Upon written request, the board may at its discretion grant an extension of up to an additional twelve (12) months of eligibility under this section provided that all of the conditions in this section are met and information acceptable to the board has been provided to show that the individual is participating in an ongoing educational, vocational, rehabilitative or retraining program.
2. (2) Unless granted an extension under subsection (1)(D), after monthly work-related disability benefits have been effective for twelve (12) full months, a member will be considered disabled and continue to be eligible for work-related disability benefits provided the member has not regained his/her earning capacity. For purposes of this paragraph, earning capacity means the member’s ability to perform any occupation for which the member is or may reasonably become qualified for by training, education, or experience, including a rehabilitative program, to the extent that the member can earn at least 16 CSR 40-3

fifty percent (50%) of his/her current annualized rate of pay for the position held by the member on the date preceding the date of the member’s disability.

1. (3) An injury as used in this rule means an injury which the board determines was incurred during the performance of duties and with respect to which the injury arose out of and in the course of the employment, and that work was the substantial factor causing the resulting disability.

AUTHORITY: sections 104.110, RSMo (Supp. 1995) and 104.210.2., and 536.023.3., RSMo (1994).* Emergency rule filed Aug. 18, 1995, effective Aug. 28, 1995, expired Feb. 23, 1996. Original rule filed Aug. 18, 1995, effective Feb. 25, 1996. *Original authority 104.110, RSMo (1955), amended 1961, 1969, 1972, 1976, 1979, 1984, 1986, 1988; 104.210, RSMo (1955), amended 1983, 1988; and 536.023, RSMo (1975), amended 1976.