(a) As to Benefits. The Board shall not decide applications for disability benefits provided by this Chapter. The Board shall have the power to prescribe rules and regulations for administration of this Chapter and to provide for enforcement of the same by forfeiture of any benefit payment or by denial of any claim, if such rules and regulations are not followed. The rules may provide for suspension or reduction of any disability benefit if the Member does not cooperate in treatment of the disability or in vocational rehabilitation or does not pursue other employment. The rules may provide for the designation of one or more licensed physicians or psychologists to act at any time with the physicians appointed by the City Personnel Director in the mental and physical examinations of applicants for membership in the Bureau of Fire or Bureau of Police. The rules may require applicants for benefits from the Fund and persons receiving benefits from the Fund to submit to and undergo mental and physical examinations by one or more licensed physicians or psychologists designated by the Fund Administrator for that purpose. The Board is hereby authorized and empowered to administer oaths, subpoena and examine witnesses, and to require the production and examination of papers and documents for the purpose of rulemaking.
(b) The Board shall retain one or more independent hearings officers who shall be members of the Oregon State Bar, have relevant disability training and experience, and who shall not be a Member or beneficiary of a Member. The Board shall establish rules of evidence and procedure for the conduct of hearings.
(c) The Board shall establish an independent panel to consider appeals from the hearings officer’s decisions. One panel member shall be appointed for an initial one year term and then every three years thereafter; the second panel member shall be appointed for an initial two year term and every three years thereafter and the third panel member shall be appointed for an initial three year term and every three years thereafter. Panel members shall be members of the Oregon State Bar, shall have relevant disability training and experience, and shall not be a Member or beneficiary of a Member. Panel members may be removed by the Board for cause.
(d) The Board shall pay from the Fund the expenses of vocational rehabilitation of disabled Members established in a vocational rehabilitation plan approved by the Fund Administrator to reduce disability benefits. The Board may, but has no obligation to, pay other financial incentives that demonstrate a reduction in disability costs.
(e) The Board may pay its administrative expenses from the Fund and may borrow from the General Fund. The Board may purchase bonds or insurance covering any act or failure to act.
(f) The Fund shall have a Fund Administrator. The Fund Administrator shall be appointed by the Mayor, approved by the Board and confirmed by the City Council. The Fund Administrator shall be a qualified disability expert. The Fund Administrator shall have the position of a bureau director and shall report to the Mayor and the Board. The Mayor may remove the Fund Administrator, for any reason, after seeking the advice of the Board. The Board and the Fund Administrator may appoint other agents or advisers to assist the Board or Fund Administrator, including actuaries and attorneys.
(g) The Fund Administrator shall have the authority to settle and discharge all or part of the Fund’s future obligations to any Member or Member’s eligible beneficiaries for disability, retirement or death benefits as to any and all claims or entitlements to disability, retirement or death benefits as part of a settlement. The Board shall adopt Administrative Rules regarding the maximum amount that the Fund Administrator may expend to discharge all or part of the Fund’s future obligations to any Member or Member’s eligible beneficiaries for disability, retirement or death benefits as to any and all claims or entitlements to disability, retirement or death benefits as part of a settlement without the approval of the Board of Trustees. Any amount exceeding the maximum amount set by Administrative Rule shall require approval of the Board.
(h) Disability Claims Processing.
1. Restoring injured workers physically and economically to a self-sufficient status in an expeditious manner and to the greatest extent practicable is an important aspect of any disability system.
2. All claims by FPDR Two and FPDR Three Members for service connected and occupational disability benefits under Sections 5-306 and 5-308, for nonservice connected disability benefits under Sections 5-307 and 5-309, benefits on service connected or occupational death before retirement under Section 5-308 and benefits for non service connected death before retirement under Section 5-309 shall be adjusted, administered and decided by the Fund Administrator. The decision of the Fund Administrator shall be made in accordance with this Charter and the rules and regulations adopted by the Board.
3. A FPDR Two or FPDR Three Member or a Surviving Spouse or Dependent Minor Child adversely affected by a determination of the Fund Administrator may appeal that decision to a hearings officer within 60 days of the date of the decision of the Fund Administrator. The hearings officer shall conduct an evidentiary hearing under the rules of procedure and evidence established by the Board. The hearings officer shall have the power to administer oaths, subpoena and examine witnesses, and require the production and examination of papers and documents. The decision of the hearings officer shall be in writing and shall be issued within 30 days after the close of the evidentiary record. The decision shall be based on the evidence presented at the hearing.
4. The decision of the hearings officer shall be final unless an appeal to the independent panel is filed by the Member, Surviving Spouse, Dependent Minor Child or the Fund Administrator with the Fund within 30 days of the hearings officer’s decision. The decision of the independent panel shall be de novo on the record and shall be the final decision of the Fund and may be appealed to the circuit court as provided by state law.
(i) Subrogation.
1. By filing a claim for disability benefits the Member or the beneficiary of a Member agrees to be bound by the subrogation provisions of this Chapter.
2. If injury, death or medical condition of a Member is due to the negligent, intentional or wrongful action of a third party or product manufactured by a third party, the Member or beneficiary of the Member shall bring a cause of action or other claim against that third party or assign the cause of action or claim to the Fund. As used in this Chapter, “third party” includes any provider of medical care or vocational assistance to the Member and does not include any City employee acting in the course and scope of their employment.
3. In the event a Member or the beneficiary of a Member collects damages from a third person for injury, death or medical condition inflicted on such Member for which benefits are paid or payable by the Fund, the Member or beneficiary shall pay to the Fund the money so collected or the total amount paid to such Member for any benefits paid or payable by the Fund that are authorized to be recovered by any law or this Chapter. The amount so collected by the injured Member shall be distributed as provided in the Oregon Workers’ Compensation statutes governing similar damage recoveries.
4. The Fund shall have a lien on any recovery equal to the value of all benefits paid or payable by the Fund, including but not limited to, disability payments, vocational rehabilitation expenses paid on behalf of a Member, and medical expenses for the injury or medical condition. The Fund lien shall include the present value of the Fund’s reasonably expected future benefit payments.
5. No compromise or settlement of a cause of action or claim described in this Subsection (i) by a Member or the beneficiary of a Member shall be valid without the approval of the Fund Administrator. In the event the Member, beneficiary or third party fails to obtain the approval of the Fund Administrator for the compromise or settlement, the Fund Administrator retains the right to pursue any causes of action against the third party.
6. The Fund Administrator shall have the right to offset disability payments in the amount that is the lesser of the Fund’s unsatisfied lien or the amount recovered by the Member or beneficiary of the Member from the third party.
7. The Fund Administrator shall have the authority to suspend, offset or reduce benefits if a Member or the beneficiary of a Member does not pursue or assign to the Fund the Member’s or beneficiary’s cause of action against a third party who causes the injury, death or medical condition of a Member for which the Fund pays or is obligated to pay benefits, or does not pay a Fund lien on recoveries from such third parties. Benefits so suspended or reduced shall not be payable to the Member or beneficiary at any time unless the Fund lien has been satisfied.
8. The Board’s right to bring a cause of action against a third party in the name of the Member or Member’s beneficiaries shall be separate and independent of any other cause of action the City or Board may have.
[Amended by Ordinance No. 190204, effective December 18, 2020.]