Applying for Disability is a Two-Step Process
Step 1: File a disability claim
A member filing for ordinary or accidental/special disability benefits must properly complete and submit to the Maryland State Retirement Agency the forms and materials listed here.
- Sample Disability Form
- Form 20: Statement of Disability
- pertinent medical records
- current job description signed and dated by employer
- Form 129: Preliminary Application for Disability Retirement
- Application for an Estimate of Disability Retirement
Allowances
- Form 21A: Estimate for Disability Retirement Allowances
Employees. Teachers. Correctional Officers, Judges and Legislators - Form 22: Estimate for Disability Retirement Allowances
State Police - Form 100: Estimate for Disability Retirement Allowances
Law Enforcement Officers
- Form 21A: Estimate for Disability Retirement Allowances
- leave/attendance records for the last two years and
- performance evaluations for the last two years.
If, during the application process, your employer places you on a medical unpaid leave of absence, you also should file a Application to be Placed on a Qualifying Approved Leave of Absence. This form preserves your death benefit while on medical unpaid leave.
Members applying for accidental or special disability also must submit the following:
- employer’s first report of injury, forms submitted to Workers’ Compensation and copies of awards,
- medical evidence establishing the accident as the cause of the disability
- OR
- evidence that the disability arose out of, and in the course of, the performance of duty (Maryland State Police and LEOPS only).
Following a review by the System’s medical board, the System’s Board of Trustees takes final action on the claim and the applicant is notified. The filing process for ordinary disability can take up to six months. Accidental or special disability claims may take longer. Requests for reconsideration or the appeal process can extend the timeline by six to eight months or more.
NOTE: A disability claim can only be opened upon receipt of a properly completed Form 20: Statement of Disability and . If either of these documents is not received or is not properly completed, the claim will be rejected and all documents will be returned to the member. A disability application is considered submitted on the date it is received by the Maryland State Retirement Agency.
Step 2: If approved, apply to retire
If the claim is approved, the member will receive an estimate of his or her monthly disability retirement payment. To retire and begin collecting monthly benefits, the member must submit within 120 days the following:
- Application for Service or Disability Retirement
- Form 13-23: Application for Service or Disability Retirement
Employees, Teachers and Correctional Officers - From 14-24: Application for Service or Disability Retirement
State Police - Form 98-101: Application for Service or Disability Retirement
Law Enforcement Officers - Form 16: Application for Retirement
Judges - Form 15: Application for Retirement
Legislators
- Form 13-23: Application for Service or Disability Retirement
- Form 85: Electronic Fund Transfer—Direct Deposit Sign-Up
- IRS Form W-4P for Federal Tax Withholding
- Form 766.11: Maryland State Tax Withholding Request
If these forms are not submitted within 120 days of claim approval, the disability claim will be closed and you will not be entitled to disability benefits.
NOTE: State employees approved for disability retirement have 120 days to accept and file for retirement or will be considered resigned by their employer.