40.63(11)
(11) In this section "substantial gainful activity" means employment for which the annual compensation exceeds, for determinations made in the calendar year commencing on January 1, 1982, $3,600 or, for determinations made in subsequent calendar years, the amount applied under this section in the previous calendar year increased by the salary index and ignoring fractions of the dollar.
40.65
40.65
Duty disability and death benefits; protective occupation participants. 40.65(2)(a)(a) This paragraph applies to participants who first apply for benefits before May 3, 1988. Any person desiring a benefit under this section must apply to the department of industry, labor and job development, which department shall determine whether the applicant is eligible to receive the benefit and the participant's monthly salary. Appeals from the eligibility decision shall follow the procedures under
ss. 102.16 to
102.26. If it is determined that an applicant is eligible, the department of industry, labor and job development shall notify the department of employe trust funds and shall certify the applicant's monthly salary. If at the time of application for benefits an applicant is still employed in any capacity by the employer in whose employ the disabling injury occurred or disease was contracted, that continued employment shall not affect that applicant's right to have his or her eligibility to receive those benefits determined in proceedings before the department of industry, labor and job development or the labor and industry review commission or in proceedings in the courts. The department of industry, labor and job development may promulgate rules needed to administer this paragraph.
40.65(2)(b)1.1. This paragraph applies to participants who first apply for benefits under this section on or after May 3, 1988.
40.65(2)(b)2.
2. An applicant for benefits under this section shall submit or have submitted to the department an application that includes written certification of the applicant's disability under
sub. (4) by at least 2 physicians, as defined in
s. 448.01 (5), who practice in this state and one of whom is approved or appointed by the department, and a statement from the applicant's employer that the injury or disease leading to the disability was duty-related.
40.65(2)(b)3.
3. The department shall determine whether or not the applicant is eligible for benefits under this section on the basis of the evidence in
subd. 2. An applicant may appeal a determination under this subdivision to the department of industry, labor and job development.
40.65(2)(b)4.
4. In hearing an appeal under
subd. 3., the department of industry, labor and job development shall follow the procedures under
ss. 102.16 to
102.26.
40.65(2)(b)5.
5. The department shall be an interested party in an appeal under
subd. 3., and the department shall receive legal assistance from the department of justice, as provided under
s. 165.25 (4).
40.65(3)
(3) The Wisconsin retirement board shall determine the amount of each monthly benefit payable under this section and its effective date. The board shall periodically review the dollar amount of each monthly benefit and adjust it to conform with the provisions of this section. The board may request any income or benefit information, or any information concerning a person's marital status, which it considers to be necessary to implement this subsection and shall require a participant to submit a certified copy of his or her most recent state or federal income tax return. The board may terminate the monthly benefit of any person who refuses to submit information requested by the board or who submits false information to the board.
40.65(4)
(4) A protective occupation participant is entitled to a duty disability benefit as provided in this section if:
40.65(4)(a)
(a) The employe is injured while performing his or her duty or contracts a disease due to his or her occupation;
40.65(4)(b)
(b) The disability is likely to be permanent; and
40.65(4)(c)1.1. The disability causes the employe to retire from his or her job;
40.65(4)(c)2.
2. The employe's pay or position is reduced or he or she is assigned to light duty; or
40.65(4)(c)3.
3. The employe's promotional opportunities within the service are adversely affected if state or local employer rules, ordinances, policies or written agreements specifically prohibit promotion because of the disability.
40.65(4m)
(4m) A protective occupation participant who is a state motor vehicle inspector hired on or after January 1, 1968, is not entitled to a duty disability benefit under this section for an injury or disease occurring before May 1, 1990.
40.65(4r)
(4r) A protective occupation participant who is an emergency medical technician is not entitled to a duty disability benefit under this section for an injury or disease occurring before the date on which the department receives notification of the participant's name as provided in
s. 40.06 (1) (d) and
(dm).
40.65(5)(a)(a) The monthly benefit payable to participants who qualify for benefits under
s. 40.63 or disability benefits under OASDHI is 80% of the participant's monthly salary adjusted under
par. (b) and
sub. (6), except that the 80% shall be reduced by 0.5% for each month of creditable service over 30 years or over 25 years for persons who are eligible for benefits under
subch. II at the date of application, but not to less than 50% of the participant's monthly salary. For participants who do not qualify for benefits under
s. 40.63 or disability benefits under OASDHI, the monthly benefit under this section is 75% of the participant's monthly salary adjusted under
par. (b) and
sub. (6), except that the 75% shall be reduced by 0.5% for each month of creditable service over 30 years or over 25 years for persons who are eligible for benefits under
subch. II on the date of application.
40.65(5)(b)
(b) The Wisconsin retirement board shall reduce the amount of a participant's monthly benefit under this section by the amounts under
subds. 1. to
6., except that the board may determine not to reduce a participant's benefit because of income related to therapy or rehabilitation. The Wisconsin retirement board may assume that any benefit or amount listed under
subds. 1. to
6. is payable to a participant until it is determined to the board's satisfaction that the participant is ineligible to receive the benefit or amount, except that the department shall withhold an amount equal to 5% of the monthly benefit under this section until the amount payable under
subd. 3. is determined.
40.65(5)(b)1.
1. Any OASDHI benefit payable to the participant or the participant's spouse or a dependent because of the participant's work record.
40.65(5)(b)2.
2. Any unemployment compensation benefit payable to the participant because of his or her work record.
40.65(5)(b)3.
3. Any worker's compensation benefit payable to the participant, including payments made pursuant to a compromise settlement under
s. 102.16 (1). A lump sum worker's compensation payment or compromise settlement shall reduce the participant's benefit under this section in monthly amounts equal to 4.3 times the maximum benefit which would otherwise be payable under
ch. 102 for the participant's disability until the lump sum amount is exhausted.
40.65(5)(b)4.
4. Any disability and retirement benefit payable to the participant under this chapter, or under any other retirement system, that is based upon the participant's earnings record and years of service. A reduction under this subdivision may not be greater in amount than the amount of disability or retirement benefit received by the participant. If the participant is not eligible for a retirement benefit because he or she received a lump sum payment or withdrew his or her contributions on or after the date the participant became eligible to receive a benefit under this section, the amount received or withdrawn shall reduce the participant's benefit under this section in the amount of benefit that would be payable if, on the date the amount was received or withdrawn, the full amount received or withdrawn was applied under
s. 40.23 (2m) (d) as additional employe contributions credited to the participant's account.
40.65(5)(b)5.
5. All earnings payable to the participant from the employer under whom the duty disability occurred.
40.65(5)(b)6.
6. All earnings payable to the participant from an employer, other than the employer under whom the duty disability occurred, and all income from self-employment, the total of such earnings and income shall reduce the participant's benefit as follows:
40.65(5)(b)6.a.
a. For the amount of the total that is less than 40% of the participant's monthly salary, one-third of such amount;
40.65(5)(b)6.b.
b. For the amount of the total that is from 40% to 80% of the participant's monthly salary, one-half of such amount; and
40.65(5)(b)6.c.
c. For the amount of the total that is more than 80% of the participant's monthly salary, two-thirds of such amount.
40.65(5)(c)
(c) The Wisconsin retirement board may not reduce a participant's benefit because of income or benefits that are attributable to the earnings or work record of the participant's spouse or other member of the participant's family, or because of income or benefits attributable to an insurance contract, including income continuation programs.
40.65(6)
(6) The Wisconsin retirement board shall adjust the monthly salary of every participant receiving a benefit under this section using the salary index for the previous calendar year as follows:
40.65(6)(a)
(a) For the purposes of
sub. (5) (b) 6., annually on January 1 until the participant's death;
40.65(6)(b)
(b) For the purposes of
sub. (5) (a), if the participant is receiving an annuity under
s. 40.63 (1), annually on January 1 until the participant's death; and
40.65(6)(c)
(c) For the purposes of
sub. (5) (a), if the participant is not receiving an annuity under
s. 40.63 (1), annually on January 1 until the first January 1 after the participant's 60th birthday. Beginning on the January 1 after the participant's 60th birthday the participant's monthly salary shall be increased annually in a percentage amount equal to the percentage amount of dividend awarded under
s. 40.27 (2) until the participant's death. Notwithstanding
s. 40.27 (2), any benefits payable under this section are not subject to distribution of annuity reserve surpluses.
40.65(7)(a)(a) This paragraph applies to benefits based on applications filed before May 3, 1988. If a protective occupation participant dies as a result of an injury or a disease for which a benefit is paid or would be payable under
sub. (4), and the participant is survived by a spouse or an unmarried child under age 18, a monthly benefit shall be paid as follows:
40.65(7)(a)1.
1. To the surviving spouse, if the spouse was married to the participant on the date the participant was disabled within the meaning of
sub. (4), one-third of the participant's monthly salary as reflected at the time of death until the surviving spouse marries again.
40.65(7)(a)2.
2. To the guardian of a surviving unmarried child under age 18, $15 per child until the child marries, dies or reaches 18 years of age.
40.65(7)(a)3.
3. The total monthly amount paid under
subds. 1. and
2. may not exceed 65% of the participant's monthly salary as reflected at the time of death. Any reduction of benefits caused by such limitation shall be done on a proportional basis.
40.65(7)(am)
(am) This paragraph applies to benefits based on applications filed on or after May 3, 1988. If a protective occupation participant dies as a result of an injury or a disease for which a benefit is paid or would be payable under
sub. (4), and the participant is survived by a spouse or an unmarried child under the age of 18, a monthly benefit shall be paid as follows:
40.65(7)(am)1.
1. To the surviving spouse until the surviving spouse remarries, if the spouse was married to the participant on the date that the participant was disabled under
sub. (4), 50% of the participant's monthly salary at the time of death, but reduced by any amount payable under
sub. (5) (b) 1. to
6.
40.65(7)(am)2.
2. To a guardian for each of that guardian's wards who is an unmarried surviving child under the age of 18, 10% of the participant's monthly salary at the time of death, payable until the child marries, dies or reaches the age of 18, whichever occurs first. The marital status of the surviving spouse shall have no effect on the payments under this subdivision.
40.65(7)(am)3.
3. The total monthly amount paid under
subds. 1. and
2. may not exceed 70% of the participant's monthly salary at the time of death reduced by any amounts under
sub. (5) (b) 1. to
6. that relate to the participant's work record.
40.65(7)(am)4.
4. Benefits payable under this paragraph shall be increased each January 1 by the salary index determined for the prior year.
40.65(7)(b)
(b) Any person entitled to a benefit under both this subsection and
ch. 102 because of the death of the same participant, shall have his or her benefit under this subsection reduced in an amount equal to the death benefit payable under
ch. 102.
40.65(9)
(9) This section is applicable to protective occupation participants who apply for a benefit under this section on or after July 1, 1982. A participant may not apply for a benefit under this section if he or she is receiving a benefit under s.
66.191, 1981 stats., on July 1, 1982.
40.65 Cross-reference
Cross-reference: See s.
891.45 for provision as to presumption of employment-connected disease for certain municipal fire fighters.
40.65 Annotation
The Wisconsin Retirement Board may not reduce duty disability benefits under sub. (5) (b) 3. for worker's compensation benefits which are paid to a participant before the duty disability payments commence, and may do so only for worker's compensation not yet paid. Coutts v. Wisconsin Retirement Board, 201 W (2d) 178, 547 NW (2d) 821 (Ct. App. 1996).
SURVIVOR BENEFITS
40.70
40.70
Life insurance coverage. 40.70(1)
(1) Except as provided in
sub. (11), each eligible employe of an employer shall be insured under the group life insurance plan provided under this subchapter if all of the following apply:
40.70(1)(a)
(a) The employer is a participating employer under the Wisconsin retirement system and was included in the group life insurance program by s.
40.20 (5m), 1979 stats., or the governing body of the employer has adopted a resolution in a form prescribed by the department to make coverage available to its employes or is the state. Coverage may also be extended by rule to employes under other retirement systems if the employer adopts a resolution as specified in this paragraph. A certified copy of the resolution shall be filed with the department and the resolution takes effect on the first day of the 4th month beginning after the date of filing. An employer may provide group life insurance for its employes through separate contracts in addition to, or in lieu of, the group life insurance provided by the department under this subchapter.
40.70(1)(b)
(b) The employe files with the department an application, to be effective on a date fixed by the department, for one or more of the types of coverage established under this subchapter. The group insurance board may provide a different method of enrollment than provided under this subsection.
40.70(1)(c)
(c) The employe pays the employe contribution toward the life insurance premium under
s. 40.05 (6).
40.70(2)
(2) A resolution adopted under
sub. (1) (a) takes effect only if the department determines that at least 50% of the eligible employes of that employer will be covered at the time that the resolution is effective. The department's determination shall be based on the employer's prior year-end report of the number of employes participating in the Wisconsin retirement system or, if the employer was not a participating employer in the prior year, on the number of employes who, on or before the 15th day of the month immediately preceding the effective date of the resolution, have applied for group life insurance coverage under this subchapter. If the department nullifies a resolution based on insufficient participation, the employer may not file another resolution under
sub. (1) (a) during the first 6 months after the date of the previous filing.
40.70(3)
(3) Employers may adopt resolutions providing all the coverages provided under this subchapter or provided by contract or may identify in the resolution only specified coverages that are authorized by contract to be offered separately. Employes may file an application under
sub. (1) (b) for the amount of coverage provided under
s. 40.72 (1) and for any other coverage offered by their employer. The department shall determine the method of administration and the procedure for collection of premiums and employer costs.
40.70(4)(a)(a) The governing body of any employer may do any of the following:
40.70(4)(a)1.
1. Change the coverage that it makes available to its employes under
s. 40.72 (2) or
(3) by adopting an amended resolution and filing a certified copy of the amended resolution with the department.
40.70(4)(a)2.
2. Withdraw from making coverage under this subchapter available to its employes by adopting a withdrawal resolution and filing a certified copy of the withdrawal resolution with the department.
40.70(4)(a)3.
3. Nullify its amended resolution or withdrawal resolution at any time before it becomes effective by adopting a nullifying resolution and filing a certified copy of the nullifying resolution with the department.
40.70(4)(b)
(b) Except as provided in
sub. (5), amended resolutions and withdrawal resolutions take effect on the first day of the 4th month beginning after the date of filing. Nullifying resolutions take effect on the date of filing.
40.70(4)(c)
(c) If a withdrawal resolution becomes effective, the employer may not file another resolution under
sub. (1) (a) during the first 12 months after the effective date of the withdrawal resolution.
40.70(5)
(5) The department may accept or reject an amended resolution, or a resolution under
sub. (1) (a) that is filed after the employer's withdrawal resolution becomes effective, and may charge the employer for any postretirement insurance liability.
40.70(6)
(6) Except as provided in
sub. (7m), any employe who has not applied for coverage under
sub. (1) within 6 months after becoming eligible for coverage or any employe whose insurance terminates under
sub. (8) shall not thereafter become insured for that coverage unless prior to the attainment of age 55 the employe furnishes evidence of insurability satisfactory to the insurer, at his or her own expense. If the evidence is approved, the employe shall become insured on the first day of the first month beginning after the approval.
40.70(7m)
(7m) If, as a result of employer error, an employe has not filed an application with the department as required under
sub. (1) (b) or made premium contributions as required under
sub. (1) (c) within 60 days after becoming eligible for group life insurance coverage, the employe is considered not to be insured for that coverage. The employe may become insured by filing a new application under
sub. (1) (b) within 30 days after the employe receives from the employer written notice of the error. An employe is not required to furnish evidence of insurability to become insured under this subsection. An employe becomes insured under this subsection on the first day of the first month beginning after the date on which the employer receives the employe's new application under
sub. (1) (b).
40.70(8)
(8) An insured employe may at any time cancel one or more of the types of life insurance coverage provided under this subchapter by filing a cancellation form with the employing office. The cancellation form shall be transmitted immediately to the department. The cancellation shall be effective and the insurance shall cease at the end of the calendar month which begins after the cancellation form is received by the appropriate office.
40.70(9)
(9) The life insurance shall terminate as provided in the contract which shall also provide an option for an employe to convert insurance coverage upon termination of employment if covered by the insurance during the entire 6 months preceding termination or if covered by the insurance from the initial effective date for that employer, to the date of termination.
40.70(10)
(10) The group insurance board may provide for the continuation or suspension of insurance coverage during any month in which no earnings are received during a leave of absence.
40.70(11)
(11) An eligible state employe shall not be insured under the group life insurance provided under this subchapter if the employe elects insurance coverage with a county under
s. 978.12 (6).
40.71
40.71
Death benefit eligibility. The following described persons are entitled to death benefits from the Wisconsin retirement system, in the form and at the times specified:
40.71(1)
(1) The beneficiary of any participant or of any annuitant on the date of death of the participant or annuitant. For purposes of this subsection:
40.71(1)(a)
(a) A participant is deemed a participating employe on the date of death even though the participant is then an applicant for a retirement or disability annuity, except as provided by
s. 40.63 (8) (h), if the participant's application was received by the board within 30 days after the participant ceased to be a participating employe and the participant would have been entitled to the annuity had the participant lived.
40.71(1)(b)
(b) If the date of death is less than one year after the last day for which earnings were paid, a participant is deemed a participating employe on leave of absence, notwithstanding the fact that no formal leave of absence is in effect, if the participating employer for which the participant last performed services as a participating employe has not filed notice of the termination of employment prior to the employe's death.
40.71(1)(c)
(c) If the death of a participating employe on leave of absence, other than a leave for purposes of military service, arises from employment by any employer other than a participating employer, employment is deemed to have terminated and the participant shall not be considered a participating employe on the date of his or her death.
40.71(1)(d)
(d) Every participant is deemed an annuitant immediately upon the effective date of the participant's annuity, or the date the application is received by the department if the participant is living on that date, whichever is later.
40.71(1)(e)
(e) Any annuitant whose annuity is terminated shall cease to be an annuitant as of the last day of the month preceding the last day on which the annuity is payable.
40.71(2)
(2) Any death benefit may be paid as a beneficiary annuity, subject to
s. 40.73 (3), or as a single cash sum as specified by the beneficiary in the application for the death benefit unless the participant prohibited payment of a single cash sum in a written notice received by the department prior to the participant's death. A prohibition on payment of a single cash sum shall not be effective if the monthly amount of the annuity would be less than the amount determined under
s. 40.25 (1) (a) or if the beneficiary is the participant's estate or a trust in which the beneficiary has a beneficial interest.
40.71(3)
(3) Whenever any death benefit is payable in a single cash sum, it shall be paid only after receipt by the department of the following:
40.71(3)(a)
(a) A copy of the death certificate of the participant or annuitant;
40.71(3)(b)
(b) A written application of the beneficiary for the benefit; and
40.71(3)(c)
(c) Any additional evidence deemed necessary or desirable by the department.
