What Must My Virginia Retirement System (VRS) Disability Application Include?

The following forms are available at www.varetire.org and are required:

• Application for Disability Retirement (VRS-6). On the VRS-6, you provide basic information, including the benefit payout option you wish to elect. You complete Parts A through D and must include acceptable legible evidence of your date of birth, such as a birth certificate. If you are married or separated, your spouse must complete the spouse certification section and sign on or after the date you sign the application. If you are electing the Survivor Option, you also must include acceptable legible evidence of your survivor’s date of birth.After you complete your sections, submit your application to your employer to complete Part E-Employer Certification. Your employer must include a copy of your job description. Your Virginia Retirement System disability application will not be processed until your employer completes and signs this section.

• Explanation of Disability (VRS-6A). The VRS-6A allows you to provide additional information in support of your application and is required by the VRS Medical Board. The information on this form and supporting documentation include:
  • Job duties and other outside activities you no longer can perform because of your disability;
  • Whether you have been hospitalized or treated at a clinic for your condition;
  • Contact information for all doctors you are seeing for your disability;
  • If you are not eligible for a full Social Security benefit, documentation that you have applied for Social Security Disability Insurance (SSDI) benefits, such as a copy of the Application Summary, online filing confirmation, or Notice of Award or Notice of Disapproved Claim;
  • If you are applying for work-related disability retirement, copy of the letter from the Virginia Workers’ Compensation Commission approving your disability as compensable under the Virginia Workers’ Compensation Act or copy of your workers’ compensation award letter as well as an accident report, if applicable.
  • Physician’s Report (VRS-6B). Each doctor you list on the VRS-6A must complete this form and attach all relevant objective medical evidence. It is your doctor’s responsibility to fully document and supply objective medical evidence related to your condition so that the VRS Medical Board has a clear understanding of how your condition affects your performance of your job duties. A letter from your doctor is an opinion. Results of an examination, test results or x-rays are examples of objective medical evidence. If VRS does not receive this information in a timely manner, your application could be denied. If your doctor does not provide the required medical information, you can request a copy of your medical records and submit the information to VRS. You will be responsible for any costs associated with collecting this information from your doctor.
  • Employer Information for Disability Application (VRS-6D). In addition to your job description, your employer must submit this form to VRS providing additional job information regarding your required duties at the time of your disability. Your employer must explain any physical requirements such as walking, lifting, carrying or other job requirements that you cannot perform because of your disability. If your duties have been modified in any way, your employer must include this information as well.
  • Request for Income Tax Withholding (VRS-15). Submit this form if you are applying for non-work related disability retirement. If you are applying for work-related disability retirement, you will be asked to submit this form if you will be receiving the VRS formula amount. This form is not required if you will be receiving the work-related guaranteed benefit; as with workers’ compensation benefits, this benefit is tax exempt.
  • Authorization for Direct Deposit of Monthly Benefit (VRS-57). The VRS-57 authorizes VRS to deposit your monthly benefit electronically to the financial institution you designate on the form. Tape a voided check to this form before including it with your application.

  You should absolutely consult with a lawyer experienced in Virginia Retirement System disability benefits claims before you file a claim.