SF 2546

as introduced - 92nd Legislature (2021 - 2022) Posted on 06/03/2022 08:30am

A bill for an act
relating to retirement; Minnesota State Retirement System, Public Employees
Retirement Association, Teachers Retirement Association, and St. Paul Teachers
Retirement Fund Association; authorizing advanced practice registered nurses
(APRNs) to provide disability assessments; amending Minnesota Statutes 2020,
sections 352.01, by adding a subdivision; 352.03, subdivisions 8, 9; 352.113,
subdivision 4; 352.95, subdivision 4; 352B.011, by adding a subdivision; 352B.10,
subdivision 4; 353.01, by adding a subdivision; 353.03, subdivision 3; 353.031,
subdivisions 3, 8; 354.05, by adding a subdivision; 354.07, subdivision 2; 354.48,
subdivisions 4, 6, 6a; 354A.011, by adding a subdivision; 354A.36, subdivisions
4, 6.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2020, section 352.01, is amended by adding a subdivision
to read:

new text begin Subd. 27. new text end

new text begin APRN. new text end

new text begin "APRN" means advanced practice registered nurse as defined in
section 148.171, subdivision 3.
new text end

Sec. 2.

Minnesota Statutes 2020, section 352.03, subdivision 8, is amended to read:

Subd. 8.

Medical adviser.

The executive director may contract with an accredited
independent organization specializing in disability determinations, licensed physicians new text begin or
APRNs new text end , or physicians new text begin or APRNs new text end on the staff of the commissioner of health as designated
by the commissioner, to be the medical adviser to the system.

Sec. 3.

Minnesota Statutes 2020, section 352.03, subdivision 9, is amended to read:

Subd. 9.

Duties of the medical adviser.

The medical adviser shall designate licensed
physicians new text begin or APRNs new text end to examine applicants for disability benefits. The medical adviser
shall pass upon medical reports based upon examinations required to determine whether a
state employee is totally and permanently disabled as defined in section 352.01, subdivision
17, shall investigate health and medical statements and certificates by or on behalf of a state
employee in connection with a disability benefit, and shall report in writing to the director
conclusions and recommendations on matters referred for advice.

Sec. 4.

Minnesota Statutes 2020, section 352.113, subdivision 4, is amended to read:

Subd. 4.

Medical or psychological examinations; authorization for payment of
benefit.

(a) Any physician, psychologist, chiropractor, physician assistant, podiatrist, or
deleted text begin nurse practitioner deleted text end new text begin APRN new text end providing any service specified in this section must be licensed.

(b) An applicant shall provide a detailed report signed by a physician, and at least one
additional report signed by a physician, psychologist, chiropractor, physician assistant,
podiatrist, or deleted text begin nurse practitioner deleted text end new text begin APRN new text end with evidence to support an application for total and
permanent disability. The reports must include an expert opinion regarding whether the
employee is permanently and totally disabled within the meaning of section 352.01,
subdivision 17, and that the disability arose before the employee was placed on any paid or
unpaid leave of absence or terminated public service.

(c) If there is medical evidence that supports the expectation that at some point the person
applying for the disability benefit will no longer be disabled, the decision granting the
disability benefit may provide for a termination date upon which the total and permanent
disability can be expected to no longer exist. When a termination date is part of the decision
granting benefits, prior to the benefit termination the executive director shall review any
evidence provided by the disabled employee to show that the disabling condition for which
benefits were initially granted continues. If the benefits cease, the disabled employee may
follow the appeal procedures described in section 356.96 or may reapply for disability
benefits using the process described in this subdivision.

(d) Any claim to disability must be supported by a report from the employer indicating
that there is no available work that the employee can perform with the disabling condition
and that all reasonable accommodations have been considered. Upon request of the executive
director, an employer shall provide evidence of the steps the employer has taken to attempt
to provide reasonable accommodations and continued employment to the claimant.

(e) The director shall also obtain written certification from the employer stating whether
the employment has ceased or whether the employee is on sick leave of absence because
of a disability that will prevent further service to the employer and that the employee is not
entitled to compensation from the employer.

(f) The medical adviser shall consider the reports of the physician, psychologist,
chiropractor, physician assistant, podiatrist, or deleted text begin nurse practitioner deleted text end new text begin APRN new text end and any other
evidence supplied by the employee or other interested parties. If the medical adviser finds
the employee totally and permanently disabled, the adviser shall make appropriate
recommendation to the director in writing together with the date from which the employee
has been totally disabled. The director shall then determine if the disability occurred while
still in the employment of the state and constitutes a total and permanent disability as defined
in section 352.01, subdivision 17.

(g) A terminated employee may apply for a disability benefit within 18 months of
termination as long as the disability occurred while in the employment of the state. The fact
that an employee is placed on leave of absence without compensation because of disability
does not bar that employee from receiving a disability benefit.

(h) Upon appeal, the board of directors may extend the disability benefit application
deadline in paragraph (g) by an additional 18 months if the terminated employee is
determined by the board of directors to have a cognitive impairment that made it unlikely
that the terminated employee understood that there was an application deadline or that the
terminated employee was able to meet the application deadline.

(i) Unless the payment of a disability benefit has terminated because the employee is
no longer totally disabled, or because the employee has reached normal retirement age as
provided in this section, the disability benefit must cease with the last payment received by
the disabled employee or which had accrued during the lifetime of the employee unless
there is a spouse surviving. In that event, the surviving spouse is entitled to the disability
benefit for the calendar month in which the disabled employee died.

Sec. 5.

Minnesota Statutes 2020, section 352.95, subdivision 4, is amended to read:

Subd. 4.

Medical or psychological evidence.

(a) An applicant shall provide medical,
chiropractic, or psychological evidence to support an application for disability benefits. The
director shall have the employee examined by at least one additional licensed physician,
new text begin APRN, new text end chiropractor, or psychologist who is designated by the medical adviser. The
physicians, new text begin APRNs, new text end chiropractors, or psychologists with respect to a mental impairment,
shall make written reports to the director concerning the question of the employee's disability,
including their expert opinions as to whether the employee has an occupational disability
within the meaning of section 352.01, subdivision 17a, and whether the employee has a
duty disability, physical or psychological, under section 352.01, subdivision 17b, or has a
regular disability, physical or psychological, under section 352.01, subdivision 17c. The
director shall also obtain written certification from the employer stating whether or not the
employee is on sick leave of absence because of a disability that will prevent further service
to the employer performing normal duties as defined in section 352.01, subdivision 17d, or
performing less frequent duties as defined in section 352.01, subdivision 17e, and as a
consequence, the employee is not entitled to compensation from the employer.

(b) If, on considering the reports by the physicians, new text begin APRNs, new text end chiropractors, or
psychologists and any other evidence supplied by the employee or others, the medical
adviser finds that the employee has an occupational disability within the meaning of section
352.01, subdivision 17a, the deleted text begin advisor deleted text end new text begin adviser new text end shall make the appropriate recommendation
to the director, in writing, together with the date from which the employee has been disabled.
The director shall then determine the propriety of authorizing payment of a duty disability
benefit or a regular disability benefit as provided in this section.

(c) Unless the payment of a disability benefit has terminated because the employee no
longer has an occupational disability, or because the employee has reached either age 55
or the five-year anniversary of the effective date of the disability benefit, whichever is later,
the disability benefit must cease with the last payment which was received by the disabled
employee or which had accrued during the employee's lifetime. While disability benefits
are paid, the director has the right, at reasonable times, to require the disabled employee to
submit proof of the continuance of an occupational disability. If any examination indicates
to the medical adviser that the employee no longer has an occupational disability, the
disability payment must be discontinued upon the person's reinstatement to state service or
within 60 days of the finding, whichever is sooner.

Sec. 6.

Minnesota Statutes 2020, section 352B.011, is amended by adding a subdivision
to read:

new text begin Subd. 3a. new text end

new text begin APRN. new text end

new text begin "APRN" means advanced practice registered nurse as defined in section
148.171, subdivision 3.
new text end

Sec. 7.

Minnesota Statutes 2020, section 352B.10, subdivision 4, is amended to read:

Subd. 4.

Proof of disability.

(a) No disability benefits may be paid unless new text begin the member
provides new text end adequate proof deleted text begin is furnished deleted text end to the executive director of the existence of the
disability.

(b) Adequate proof of a disability must include a written expert report by a licensed
physician, deleted text begin by a deleted text end new text begin APRN, or new text end licensed chiropractor, or with respect to a mental impairment, by
a licensed psychologist.

(c) Following the commencement of benefit payments, the executive director has the
right, at reasonable times, to require the deleted text begin disabilitant deleted text end new text begin disability benefit recipient new text end to submit
proof of the continuance of the disability claimed.

Sec. 8.

Minnesota Statutes 2020, section 353.01, is amended by adding a subdivision to
read:

new text begin Subd. 50. new text end

new text begin APRN. new text end

new text begin "APRN" means advanced practice registered nurse as defined in
section 148.171, subdivision 3.
new text end

Sec. 9.

Minnesota Statutes 2020, section 353.03, subdivision 3, is amended to read:

Subd. 3.

Duties and powers.

(a) The board shall:

(1) elect a president and vice-president;

(2) approve the staffing complement, as recommended by the executive director,
necessary to administer the fund;

(3) adopt bylaws for its own government and for the management of the fund consistent
with the laws of the state and may modify them at pleasure;

(4) adopt, alter, and enforce reasonable rules consistent with the laws of the state and
the terms of the applicable benefit plans for the administration and management of the fund,
for the payment and collection of payments from members and for the payment of
withdrawals and benefits, and that are necessary in order to comply with the applicable
federal Internal Revenue Service and Department of Labor requirements;

(5) pass upon and allow or disallow all applications for membership in the fund and
allow or disallow claims for withdrawals, pensions, or benefits payable from the fund;

(6) adopt an appropriate mortality table based on experience of the fund as recommended
by the association actuary and approved under section 356.215, subdivision 18, with interest
set at the rate specified in section 356.215, subdivision 8;

(7) provide for the payment out of the fund of the cost of administering this chapter, of
all necessary expenses for the administration of the fund and of all claims for withdrawals,
pensions, or benefits allowed;

(8) approve or disapprove all recommendations and actions of the executive director
made subject to its approval or disapproval by subdivision 3a; and

(9) approve early retirement and optional annuity factors, subject to review by the actuary
retained by the Legislative Commission on Pensions and Retirement; establish the schedule
for implementation of the approved factors; and notify the Legislative Commission on
Pensions and Retirement of the implementation schedule.

(b) In passing upon all applications and claims, the board may summon, swear, hear,
and examine witnesses and, in the case of claims for disability benefits, may require the
claimant to submit to a medical examination by a physician new text begin or APRN new text end of the board's choice,
at the expense of the fund, as a condition precedent to the passing on the claim, and, in the
case of all applications and claims, may conduct investigations necessary to determine their
validity and merit.

(c) The board may continue to authorize the sale of life insurance to members under the
insurance program in effect on January 1, 1985, but must not change that program without
the approval of the commissioner of management and budget. The association shall not
receive any financial benefit from the life insurance program beyond the amount necessary
to reimburse the association for costs incurred in administering the program. The association
shall not engage directly or indirectly in any other activity involving the sale or promotion
of goods or services, or both, whether to members or nonmembers.

(d) The board shall establish procedures governing reimbursement of expenses to board
members. These procedures must define the types of activities and expenses that qualify
for reimbursement, must provide that all out-of-state travel be authorized by the board, and
must provide for the independent verification of claims for expense reimbursement. The
procedures must comply with the applicable rules and policies of the Department of
Management and Budget and the Department of Administration.

(e) The board may purchase fiduciary liability insurance and official bonds for the
officers and members of the board of trustees and employees of the association and may
purchase property insurance or may establish a self-insurance risk reserve including, but
not limited to, data processing insurance and "extra-expense" coverage.

Sec. 10.

Minnesota Statutes 2020, section 353.031, subdivision 3, is amended to read:

Subd. 3.

Procedure to determine eligibility; generally.

(a) Every claim for a disability
benefit must be initiated in writing on an application form and in the manner prescribed by
the executive director and filed with the executive director. An application for disability
benefits must be made within 18 months following termination of public service as defined
under section 353.01, subdivision 11a.

(b) All medical reports must support a finding that the disability arose before the employee
was placed on any paid or unpaid leave of absence or terminated public service, as defined
under section 353.01, subdivision 11a.

(c) An applicant for disability shall provide a detailed report signed by a licensed medical
doctor and at least one additional report signed by a medical doctor, psychologist, new text begin APRN,
new text end or chiropractor. The applicant shall authorize the release of all medical and health care
evidence, including all medical records and relevant information from any source, to support
the application for initial, or the continuing payment of, disability benefits.

(d) All reports must contain an opinion regarding the claimant's prognosis, the duration
of the disability, and the expectations for improvement. Any report that does not contain
and support a finding that the disability will last for at least one year may not be relied upon
to support eligibility for benefits.

(e) Where the medical evidence supports the expectation that at some point in time the
claimant will no longer be disabled, any decision granting disability may provide for a
termination date upon which disability can be expected to no longer exist. In the event a
termination date is made part of the decision granting benefits, prior to the actual termination
of benefits, the claimant shall have the opportunity to show that the disabling condition for
which benefits were initially granted continues. In the event the benefits terminate in
accordance with the original decision, the claimant may petition for a review by the board
of trustees under section 353.03, subdivision 3, or may reapply for disability in accordance
with these procedures and section 353.33, 353.656, or 353E.06, as applicable.

(f) Any claim to disability must be supported by a report from the employer indicating
that there is no available work that the employee can perform in the employee's disabled
condition and that all reasonable accommodations have been considered. Upon request of
the executive director, an employer shall provide evidence of the steps the employer has
taken to attempt to provide reasonable accommodations and continued employment to the
claimant. The employer shall also provide a certification of the member's past public service;
the dates of any paid sick leave, vacation, or any other employer-paid salary continuation
plan beyond the last working day; and whether or not any sick or annual leave has been
allowed.

(g) An employee who is placed on leave of absence without compensation because of
a disability is not barred from receiving a disability benefit.

(h) An applicant for disability benefits may file a retirement annuity application under
section 353.29, subdivision 4, simultaneously with an application for disability benefits. If
the application for disability benefits is approved, the retirement annuity application is
canceled. If disability benefits are denied, the retirement annuity application must be
processed upon the request of the applicant. No member of the public employees general
plan, the public employees police and fire plan, or the local government correctional service
retirement plan may receive a disability benefit and a retirement annuity simultaneously
from the same plan.

Sec. 11.

Minnesota Statutes 2020, section 353.031, subdivision 8, is amended to read:

Subd. 8.

Proof of continuing disability.

(a) A disability benefit payment must not be
made except upon adequate proof furnished to the executive director of the association that
the person remains disabled.

(b) During the time when disability benefits are being paid, the executive director of the
association has the right, at reasonable times, to require the disabled member to submit
proof of the continuance of the disability claimed.

(c) Adequate proof of a disability must include a written expert report by a licensed
physician, deleted text begin a deleted text end new text begin APRN, or new text end licensed chiropractor, or, with respect to a mental impairment, a
licensed psychologist.

Sec. 12.

Minnesota Statutes 2020, section 354.05, is amended by adding a subdivision to
read:

new text begin Subd. 43. new text end

new text begin APRN. new text end

new text begin "APRN" means advanced practice registered nurse as defined in
section 148.171, subdivision 3.
new text end

Sec. 13.

Minnesota Statutes 2020, section 354.07, subdivision 2, is amended to read:

Subd. 2.

Investigatory powers.

In passing upon all applications and claims, the board
may summon, swear, hear, and examine witnesses and, in the case of claims for disability
benefits, may require the claimant to submit to a medical examination by a physician new text begin or
APRN new text end of the board's choice, at the expense of the claimant, as a condition precedent to the
passing on the claim, and, in the case of all applications and claims, may conduct
investigations necessary to determine the validity and merit of the same.

Sec. 14.

Minnesota Statutes 2020, section 354.48, subdivision 4, is amended to read:

Subd. 4.

Determination by executive director.

(a) The executive director shall have
the member examined by at least two licensed physicians, licensed chiropractors, or licensed
psychologists.

(b) These physicians, chiropractors, new text begin APRNs, new text end or psychologists with respect to a mental
impairment, shall make written reports to the executive director concerning the member's
disability, including expert opinions as to whether or not the member is permanently and
totally disabled within the meaning of section 354.05, subdivision 14.

(c) The executive director shall also obtain written certification from the last employer
stating whether or not the member was separated from service because of a disability which
would reasonably prevent further service to the employer and as a consequence the member
is not entitled to compensation from the employer.

(d) If, upon the consideration of the reports of the physicians, chiropractors, new text begin APRNs, new text end or
psychologists and any other evidence presented by the member or by others interested
therein, the executive director finds that the member is totally and permanently disabled,
the executive director shall grant the member a disability benefit.

(e) An employee who is placed on leave of absence without compensation because of
disability is not barred from receiving a disability benefit.

Sec. 15.

Minnesota Statutes 2020, section 354.48, subdivision 6, is amended to read:

Subd. 6.

Regular physical examinations.

At least once each year during the first five
years following the allowance of a disability benefit to any member, and at least once in
every three-year period thereafter, the executive director may require the disability new text begin benefit
new text end recipient to undergo an expert examination by a physician or physicians, by a chiropractor
or chiropractors, new text begin by an APRN or APRNs, new text end or by one or more psychologists with respect to
a mental impairment, engaged by the executive director. If an examination indicates that
the member is no longer permanently and totally disabled or that the member is engaged
or is able to engage in a substantial gainful occupation, payments of the disability benefit
by the association must be discontinued. The payments must be discontinued as soon as the
member is reinstated to the payroll following sick leave, but payment may not be made for
more than 60 days after the physicians, deleted text begin the deleted text end chiropractors, new text begin APRNs, new text end or deleted text begin the deleted text end psychologists
engaged by the executive director find that the person is no longer permanently and totally
disabled.

Sec. 16.

Minnesota Statutes 2020, section 354.48, subdivision 6a, is amended to read:

Subd. 6a.

Medical adviser; duties.

The executive director may contract with an
accredited independent organization specializing in disability determinations, licensed
physicians, or physicians on the staff of the commissioner of health as designated by the
commissioner, to be the medical adviser to the executive director. The medical adviser shall
designate licensed physicians, licensed chiropractors, new text begin APRNs, new text end or licensed psychologists
with respect to a mental impairment, who shall examine applicants for disability benefits.
The medical adviser shall pass upon all expert reports based on any examinations performed
in order to determine whether a teacher is totally and permanently disabled as defined in
section 354.05, subdivision 14. The medical adviser shall also investigate all health and
medical statements and certificates by or on behalf of a teacher in connection with a disability
benefit, and shall report in writing to the director setting forth any conclusions and
recommendations on all matters referred to the medical adviser.

Sec. 17.

Minnesota Statutes 2020, section 354A.011, is amended by adding a subdivision
to read:

new text begin Subd. 6a. new text end

new text begin APRN. new text end

new text begin "APRN" means advanced practice registered nurse as defined in section
148.171, subdivision 3.
new text end

Sec. 18.

Minnesota Statutes 2020, section 354A.36, subdivision 4, is amended to read:

Subd. 4.

Determination of disability.

(a) The board of the teachers retirement fund
association shall make the final determination of the existence of a permanent and total
disability. The board shall have the coordinated member examined by at least two licensed
physicians, licensed chiropractors, new text begin APRNs, new text end or licensed psychologists who are selected by
the board. After making any required examinations, each physician, chiropractor, new text begin APRN,
new text end or psychologist with respect to a mental impairment, shall make a written report to the board
concerning the coordinated member, which shall include a statement of the expert opinion
of the physician, chiropractor, new text begin APRN, new text end or psychologist as to whether or not the member is
permanently and totally disabled within the meaning of section 354A.011, subdivision 14.
The board shall also obtain a written statement from the employer as to whether or not the
coordinated member was terminated or separated from active employment due to a disability
which is deemed by the employer to reasonably prevent further service by the member to
the employer and which caused the coordinated member not to be entitled to further
compensation from the employer for services rendered by the member. If, after consideration
of the reports of the physicians, chiropractors, new text begin APRNs, new text end or psychologists with respect to a
mental impairment, and any evidence presented by the member or by any other interested
parties, the board determines that the coordinated member is totally and permanently disabled
within the meaning of section 354A.011, subdivision 14, it shall grant the coordinated
member a disability benefit. A member who is placed on a leave of absence without
compensation as a result of the disability is not barred from receiving a disability benefit
under this section.

(b) The executive director shall reject an application for disability benefits under section
354A.36 if the member is applying only because an employer-sponsored provider of private
disability insurance benefits requires the application and the member would not have applied
for disability benefits in the absence of the requirement. The member shall submit a copy
of the disability insurance policy that requires an application for disability benefits from
the plan if the member wishes to assert that the application is only being submitted because
of the disability insurance policy requirement.

Sec. 19.

Minnesota Statutes 2020, section 354A.36, subdivision 6, is amended to read:

Subd. 6.

Requirement for regular physical examinations.

At least once each year
during the first five years following the granting of a disability benefit to a coordinated
member by the board and at least once in every three-year period thereafter, the board may
require the disability benefit recipient to undergo an expert examination as a condition for
continued entitlement of the benefit recipient to receive a disability benefit. If the board
requires an examination, the expert examination must be made at the place of residence of
the disability benefit recipient or at any other place mutually agreeable to the disability
benefit recipient and the board. The expert examination must be made by a physician or
physicians, by a chiropractor or chiropractors, new text begin by an APRN or APRNs, new text end or by one or more
psychologists engaged by the board. The physician or physicians, the chiropractor or
chiropractors, new text begin APRN or APRNs, new text end or the psychologist or psychologists with respect to a
mental impairment, conducting the expert examination shall make a written report to the
board concerning the disability benefit recipient and the recipient's disability, including a
statement of the expert opinion of the physician, chiropractor, new text begin APRN, new text end or psychologist as to
whether or not the member remains permanently and totally disabled within the meaning
of section 354A.011, subdivision 14. If the board determines from consideration of the
written expert examination report of the physician, deleted text begin of the deleted text end chiropractor, new text begin APRN, new text end or deleted text begin of the deleted text end
psychologist deleted text begin , deleted text end with respect to a mental impairment, that the disability benefit recipient is no
longer permanently and totally disabled or if the board determines that the benefit recipient
is engaged or is able to engage in a gainful occupation, unless the disability benefit recipient
is partially employed under subdivision 7, then further disability benefit payments from the
fund must be discontinued. The discontinuation of disability benefits must occur immediately
if the disability recipient is reinstated to the district payroll following sick leave and within
60 days of the determination by the board following the expert examination and report of
the physician or physicians, chiropractor or chiropractors, new text begin APRN or APRNs, new text end or psychologist
or psychologists engaged by the board that the disability benefit recipient is no longer
permanently and totally disabled within the meaning of section 354A.011, subdivision 14.

Sec. 20. new text begin EFFECTIVE DATE.
new text end

new text begin Sections 1 to 19 are effective the day following final enactment.
new text end