New York City teachers applying for ordinary or accident disability retirement need their physician to complete this one-page report for the TRS Medical Board. It certifies how long the applicant has been under the physician's care, their subjective and objective symptoms, diagnosis, treatment and prognosis, and states that the applicant is physically or mentally incapacitated for the performance of duty.
The applicant signs the authorization at the top, addressed to the physician. The applicant's physician completes the rest of the report and signs as an M.D.
Download the current version from the source each time; forms change without notice.
Report of Applicant's Physician
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No. TRS's application instructions state that the Report of Applicant's Physician may not be amended after it is filed, even though other application details can be changed until shortly before the effective retirement date.
TRS includes DI32 inside each disability retirement application document, such as the Tier IV Ordinary Disability Retirement Application (OD4) and the accident disability applications. The member gives it to the physician, who completes it and forwards it to the TRS Medical Board.
The TRS Medical Board. Once all components are received, TRS schedules an interview and examination by the Medical Board's doctors, who determine eligibility. For Tier IV ordinary disability, the member also needs at least 10 years of total service credit.