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Application for Article 15 Disability Retirement (RS6340) For NYSLRS Tier 3, 4, 5 and 6 members to a

Application for Article 15 Disability Retirement (RS6340) For NYSLRS Tier 3, 4, 5 and 6 members to a 2026

Application for Article 15 Disability Retirement (RS6340) For NYSLRS Tier 3, 4, 5 and 6 members to a Preview on Page 1

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The document is an application for Article 15 Disability Retirement, requiring personal information from the applicant, including medical conditions, treatment history, and details about any accidents related to their disability. It also includes an authorization for the release of health information under HIPAA, allowing the New York State and Local Retirement System to access the applicant's medical records necessary for processing the retirement application.

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Click ‘Get Form’ to open the Application for Article 15 Disability Retirement (RS6340) in the editor.
Begin by entering your NYSLRS ID and Social Security Number at the top of the form. Ensure accuracy as this information is crucial for processing your application.
Fill in your personal details including name, sex, date of birth, and address. Use clear typing or print in blue or black ink for legibility.
Indicate your payroll status by checking 'Yes' or 'No' regarding whether you are currently receiving salary. If 'No', provide an explanation.
Detail your medical condition(s) that have led to your disability claim. You may attach additional sheets if necessary.
List all doctors who have treated you, including their specialties and contact information. This section is vital for verifying your medical history.
Complete the hospitalization section by providing details of any relevant hospital stays related to your condition.
If applicable, describe any accidents that contributed to your disability and provide witness information on an additional sheet if available.
Finally, ensure you sign the application on the reverse side and submit it in a confidential envelope as instructed.

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Versions	Form popularity	Fillable & printable
2022	4.3 Satisfied (31 Votes)
2018	4.3 Satisfied (23 Votes)
2011	4 Satisfied (60 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Who is eligible for NYS disability retirement?

Eligibility. To qualify for an Article 15 disability retirement benefit, you must have at least ten years of credited service, unless your disability results from an accident you sustain on the job.

Can you retire with article 15?

You will be eligible for a service retirement benefit when you docHub age 55 and have five or more years of credited member service. If you are a Tier 3 member, you may retire under Article 14 or Article 15. However, your benefit, in most cases, will be greater under Article 15.

Can a federal employee retire with 15 years of service?

If you retire at the MRA with at least 10, but less than 30 years of service, your benefit will be reduced by 5 percent a year for each year you are under 62, unless you have 20 years of service and your benefit starts when you docHub age 60 or later.

What is the difference between tier 4 and tier 6 NYS retirement?

Tier 4 member contributions are capped at 3 percent and end after 10 years. Tier 6 members must work to age 63, up to 40 years of service, or face heavy penalties. Tier 4 members can retire at 55 with 30 years of service.

What is tier 5 and 6 for NYS retirement?

Tier 5 and 6 members may retire as early as age 55 and receive a reduced retirement benefit, or delay retirement until age 62 for Tier 5 members or age 63 for Tier 6 members, and collect their full benefit.

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Is it better to go on disability or retire?

In most cases, Soldiers who have completed 20 years of active service are eligible to receive Retired Pay at the end of their career. The Date of Initial Entry into Military Service (DIEMS) determines which of the three retirement systems a Soldier falls under.

Application for Article 15 Disability Retirement (RS6340) For NYSLRS Tier 3, 4, 5 and 6 members to a 2026

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