Georgia PSERS Disability Part IV: Physician's Report

Georgia's Public School Employees Retirement System, administered by ERSGA, covers school bus drivers, food service workers and other non-certified school staff. Part IV of the PSERS Disability Retirement Application asks each treating physician to evaluate, against the attached job description, whether the member is medically or physically incapable of the duties and whether that is likely permanent.

Who completes it

The member completes Sections 1 to 3, including a release of all medical and psychiatric records. The physician, hospital or clinic completes Section 4, Employee Disability Information, and signs Section 5, the Physician, Hospital, or Clinic Certification.

Submitting and payment

How to submit it
The member submits the complete, original PSERS application packet (Parts I to V) to ERSGA; incomplete packets are returned and not processed.
Who pays
ERSGA asks the physician to bill the patient for any charges relating to the report.

Good to know

  • PSERS warns that a member who terminates employment before ERSGA receives and acknowledges the disability application is not eligible for disability retirement.
  • Records for the past 18 months must be attached, and a separate Part IV is needed from every medical provider listed in Part II.
  • The physician checks one opinion: able, unable but may recover by a date, or unable and recommending disability retirement, listing the duties the member cannot perform.
  • This Part IV mirrors the ERS version (E9-ERS); the PSERS copy is coded E9-PRS, revision 08/2026, and is decided by the ERSGA Medical Board.

Get the official form

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

Disability Retirement Application Part IV: Employee's Request for Disability Information From Physician/Physician's Report (PSERS)

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 is covered by Georgia PSERS disability retirement?

The Public School Employees Retirement System covers non-certified school staff such as school bus drivers and food service workers. ERSGA administers PSERS, so the disability application, including Part IV, goes to ERSGA and is reviewed by the ERSGA Medical Board rather than by the Teachers Retirement System.

What must the physician decide on the PSERS Part IV?

Using the attached job description, the physician gives a current evaluation of whether the member is medically or physically incapable of performing the duties and whether the incapacity is likely permanent, then checks one required box: able, unable but may recover by a stated date, or unable and recommending disability retirement.