TRS Georgia members applying for disability retirement on mental health grounds send DB-5 to each psychiatrist, psychologist or counselor who treated or diagnosed them in the last 12 months. The four-page report covers ability to perform the attached job description, present illness, past history, daily activities and a 13-item current mental status assessment.
The member completes the identification section and signs a release of medical and psychiatric records. The treating source completes all four pages; if a licensed social worker or psychologist completes it, the referring medical doctor must also sign.
Download the current version from the source each time; forms change without notice.
Psychiatrist's, Psychologist's or Counselor's Report
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The treating psychiatrist, psychologist or counselor completes and signs it, and the form has separate signature lines for a physician and a mental health professional. If a licensed social worker or psychologist completes the report, the medical doctor who referred the member must sign it as well.
The member. TRS asks the treating source to bill the person named on the report for any charges, and tells members that charges for medical information are at their expense. If TRS requires an independent evaluation by a provider it chooses, TRS covers only that cost.