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CalSTRS DSCB1528: Cash Balance Physician Certification

CalSTRS uses DSCB1528 when a Cash Balance Benefit Program participant applies for a disability benefit. The attending physician or therapist states whether the impairment is total and permanent, meaning expected to prevent creditable service for at least one year, whether it is physical or mental, its etiology and its anticipated duration. The form travels with the participant's Cash Balance disability application.

Who completes it

The participant completes Section 1, Member Information, with a Client ID or Social Security number. A currently licensed and practicing attending physician or therapist completes Section 2, attaches all current relevant medical reports, and signs under penalty of perjury with specialty, license number and board certification status.

Submitting and payment

How to submit it
The completed form is mailed to CalSTRS together with the Cash Balance Disability Benefit Application (CB587).

Good to know

  • If the physician answers that the impairment is not total and permanent, they skip to the signature section; the etiology and duration questions apply only to a yes answer.
  • Total and permanent disability is defined in Education Code Section 26144 as an incapacity expected to prevent creditable service for a continuous period of at least one year.
  • Erasures and white-out void the form; errors must be lined through, corrected and initialed. Failing to answer CalSTRS requests within 45 days can lead to rejection.
  • This form applies only to Cash Balance participants. Defined Benefit disability applicants have no physician form; CalSTRS requests their medical records case by case.

Get the official form

Download the current version from the source each time; forms change without notice.

Cash Balance Benefit Program: Physician's Certification

Official pagePDF

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

Who can complete CalSTRS form DSCB1528?

Section 2 must be completed by an attending physician or therapist who is currently licensed and practicing. The signer certifies under penalty of perjury that the answers are complete and true, and gives medical specialty, license number and whether they are board certified. All current relevant medical reports should be attached.

What does total and permanent mean on the CalSTRS Cash Balance form?

The instructions quote Education Code Section 26144: any medically determinable physical or mental incapacity expected to prevent the participant from performing creditable service for the employer for a continuous period of at least one year. The physician answers yes or no to that question before describing etiology and duration.

What happens if CalSTRS finds the disability is not total and permanent?

The application for the disability benefit, and any beneficiary designation made for that benefit, is automatically cancelled. Errors, omissions or late records on DSCB1528 can also delay processing, so the physician should complete every required item and include current reports.