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The "Tier 6 63/10 and Special Plan Members" application form is specifically designed for members of the New York City Employees' Retirement System (NYCERS) who are applying for disability retirement benefits. This form encompasses two main programs: Tier 6 63/10, which refers to New York state’s retirement plan provisions for public employees hired after April 1, 2012, requiring them to have 10 years of service credit and be at least 63 to retire; and Special Plan Members’ provisions that may apply additional requirements or benefits.
Gather Required Documents: Before beginning the application, ensure you have all pertinent documents, which include employment history records, medical reports detailing your disability, and any identification or NYCERS-specific member information.
Fill Out Personal Information: Begin by providing your personal details such as full name, address, NYCERS membership number, and retirement plan details.
Detail Service History: Complete the section detailing your employment history, including positions held, service dates, and accumulated service credits.
Medical Evaluation and Disability Details: Attach medical evaluations and fill out sections relating to the nature of your disability, including physician reports and any relevant treatments received.
Select Benefit Options: Choose your preferred benefit options, which could include choices on temporary benefits and tax withholding.
Review and Submit: Carefully review your completed form and any attached documents for accuracy before submission. Submit the form via the chosen method, ensuring receipt is acknowledged.


The application supports legally substantiated requests for retirement due to disability. It must comply with NYCERS regulations and document any claims with verified medical and employment records. Misrepresentation in the application can lead to denial of benefits and potential legal consequences.
Failure to properly submit all required information or meet eligibility requirements can result in delays, application denials, or appeals necessity. Misrepresentation or false information can lead to disqualification from benefits and potential legal repercussions. It is crucial to comply thoroughly with every application and procedural requirement, adhering to provided guidelines for documentation and submission.
Upon submission, the application undergoes a review process within NYCERS:
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