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PDFWAC 415-104-480

Does my disability qualify me for a LEOFF Plan 2 catastrophic duty disability benefit?

(1) If the department determines you are disabled and you became disabled in the line of duty, you qualify for a catastrophic duty disability if:
(a) The disability or disabilities that qualified you for a LEOFF Plan 2 duty disability benefit are so severe that considering your age, education, work experience, and transferable skills, you cannot engage in any other kind of substantial gainful activity in the labor market; and
(b) Your disability or disabilities have lasted or are expected to last at least twelve months, or are expected to result in your death.
(2) A person with multiple injuries/conditions, some duty-related and some not, could qualify for a catastrophic duty disability but only if the duty injury or injuries, standing on their own, are catastrophically disabling.
Examples:
• Totally disabled, but not from duty injury – Not eligible for catastrophic disability benefit.
A LEOFF Plan 2 member suffers a knee injury on duty, leaving them disabled from LEOFF employment. The knee injury, standing alone, is not totally disabling. The member also suffers from amyotrophic lateral sclerosis (ALS) or Lou Gehrig's disease, a progressive neurodegenerative disease that ultimately leaves the member totally disabled. Pursuant to the ALS diagnosis the member is granted a full disability from the Social Security Administration. In this case the member would qualify for a duty disability, but not for a catastrophic disability since the fully disabling condition, ALS, is not duty related.
• Totally disabled, duty injury totally disabling – Eligible for catastrophic disability benefits.
A LEOFF Plan 2 member suffers a knee injury while fishing. The knee injury, standing alone, is neither duty related nor catastrophically disabling. The member also suffers severe burns while fighting a fire, leaving him/her fully disabled. The Social Security Administration grants the member a full disability based on his/her total condition. The member qualifies for a LEOFF plan 2 catastrophic disability benefit because the burn injuries, standing alone, render him/her totally disabled.
(3) Medical insurance premium reimbursement is an additional benefit for a member who is catastrophically disabled in the line of duty (RCW 41.26.470). However, if you choose to withdraw one hundred fifty percent of your accumulated contributions pursuant to RCW 41.26.470(6) you are not entitled to the medical insurance premium reimbursement.
(4) Definitions. As used in this section:
(a) Catastrophically disabled means the same as "totally disabled" as defined under RCW 41.26.470(9).
(b) Earnings are any income or wages received, which are reportable as wages or self-employment income to the IRS.
(c) Labor market is the geographic area within reasonable commuting distance of where you were last gainfully employed or where you currently live, whichever provides the greatest opportunity for gainful employment.
(d) Substantial gainful activity describes a level of work activity and earnings. Substantial gainful activity is work activity that is both substantial and gainful. Earnings as defined in this section includes compensated work that meets or exceeds the defined income threshold:
(i) Work activity is substantial if it involves doing significant physical or mental activities. Your work may be substantial even if it is done on a part-time basis or if you do less, or get paid less, or have less responsibility than when you worked in your LEOFF position.
(ii) Work activity is gainful if it is work activity that you do for pay or profit. Work activity is gainful if it is the kind of work usually done for pay or profit, whether or not a profit is realized.
(iii) Generally, activities like taking care of yourself, household tasks, profits from rental income, hobbies, therapy, school attendance, club activities, or social programs are not substantial gainful activity.
(e) Defined income threshold means any substantial gainful activity that produces average earnings, as defined in (a) of this subsection, in excess of the federal Social Security disability standards, adjusted annually for inflation. Wages count toward earnings when they are earned, not when you receive them. Self-employment income counts when you receive it, not when you earn it.
(f) Transferable skills are any combination of learned or demonstrated behavior, education, training, work traits, and skills that you can readily apply. They are skills that are interchangeable among different jobs and workplaces.
[Statutory Authority: RCW 41.50.050. WSR 18-13-078, § 415-104-480, filed 6/15/18, effective 7/16/18. Statutory Authority: RCW 41.50.050(5). WSR 13-18-034, § 415-104-480, filed 8/28/13, effective 10/1/13. Statutory Authority: RCW 41.50.050(5) and 41.26.470 (6) and (7). WSR 06-18-007, § 415-104-480, filed 8/24/06, effective 9/24/06. Statutory Authority: RCW 41.50.050(5) and 41.26.470. WSR 04-22-074, § 415-104-480, filed 11/1/04, effective 12/2/04.]
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