Disability Retirement Benefits - PSERs

Physician’s Medical Report(s)
(PSRS-1237). Your physician(s)
complete this form.
Your physician should provide an
evaluation of your medical history as it
affects your ability to perform assigned
duties. This information should refl ect
your physical and/or mental condition as
of your last day of paid service as well
as your current condition. If the medical
information submitted is insuffi cient
to make a determination, the PSERS
medical examiners will request that you
provide additional information from your
physician(s).
If you are applying prior to your termination
or unpaid leave start date, your
employer must electronically submit
to PSERS an unpaid leave status or
a termination date within 30 days of
the date your application is received
by PSERS. The effective date of your
unpaid leave status or termination must
be within 30 days of your application.
Any missing and/or insufficient required
medical information will delay
the processing of your application.
Who is responsible for
charges incurred to provide
the medical information?
You are responsible for any cost to
obtain the medical information needed
to determine your disability status.
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