Colorado § 31-31-810 - Disability decisions and appeals.

§ 31-31-810. Disability decisions and appeals.

(1) (a) The association makes the determination of disability, whether the disability is occupational or total, whether the disabling condition is on-duty, and the amount of the disability retirement benefit. The association may consider any evidence it deems relevant in making the determination, including reports made by physicians, who may be appointed upon the recommendation of a medical advisor with whom the board shall contract to provide advisory services.

(b) The association may request that any physician appointed to examine the disability applicant also provide an opinion as to whether the applicant's injury was received while performing official duties or whether the applicant's occupational disease arose out of and in the course of the applicant's employment. The association may investigate claims at the time of initial application for benefits or subsequent to an award of benefits to determine eligibility or continuing eligibility for such benefits. The association may appoint investigators and other personnel as necessary to carry out this function.

(c) An applicant may appeal the decisions made by the association pursuant to this subsection (1) through the administrative review procedures set forth in the rules adopted by the board. A final decision from the association can only be reviewed by proper court action subject to rule 106 (a)(4) of the Colorado rules of civil procedure.

(d) In connection with this subsection (1), the board:

(I) May appoint hearing officers to conduct hearings on any issue relating to an applicant's disability; and

(II) May adopt rules to establish a process for the administrative review of disability applications, including standards of review for the applications, without board review.

(2) If the association determines that an applicant for disability is not disabled and the applicant is on sick leave, disability leave, or other type of leave of absence, is serving in a temporary position pending the determination of an application, or has been terminated from employment by the employer on the basis of an alleged disability, the employer shall reinstate the applicant to active service in the same position the applicant held prior to the commencement of such leave, assignment to a temporary position, or termination. If the employer refuses to reinstate the applicant to the applicant's prior position, the employer shall thereafter pay benefits to the applicant as if the applicant had been determined occupationally disabled by the association. The employer shall continue to pay such benefits until the applicant is reinstated to the applicant's prior position or declines an offer of reinstatement.

(3) A member whose disability retirement benefits cease and who is not restored to active service or a member who elects to terminate their disability retirement benefits is entitled to:

(a) Any vested benefit earned through their years of service prior to becoming disabled, payable at normal retirement age; or

(b) A refund of the member's contributions if no benefit is vested.

Source: L. 2026: Entire part R&RE, (SB 26-039), ch. 37, p. 163, § 1, effective August 12.

ANNOTATION

Annotator's note. Since § 31-31-810 is similar to § 31-31-803 and its antecedent provisions, relevant cases construing those provisions have been included in the annotations to this section.

District court or reviewing court should not substitute its own judgment as to the weight of the evidence for that of the board. Ross v. Fire & Police Pension Ass'n, 682 P.2d 496 (Colo. App. 1984), aff'd, 713 P.2d 1304 (Colo. 1986).

Statute provides that board is not bound by physicians' determinations on whether disability exists and, therefore, board did not abuse its discretion in denying disability application even through two of the reexamining physicians found the applicant to have a disability. Ross v. Fire & Police Pension Ass'n, 682 P.2d 496 (Colo. App. 1984), aff'd on other grounds, 713 P.2d 1304 (Colo. 1986).

Eligibility of plaintiff for occupational disability benefits where medical opinions of physicians panels conflicted was a question for the board to determine and, since competent evidence supported board's denial of benefits, court of appeals was correct in reinstating board's decision. Ross v. Fire & Police Pension Ass'n, 713 P.2d 1304 (Colo. 1986).

Limitations imposed by the amendment providing that investigation of a member shall not be pursued when more than five years have elapsed since the date of the award, must be pleaded and proved as an affirmative defense. Kilbourn v. Fire and Police Pension Ass'n, 971 P.2d 284 (Colo. App. 1998).