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The Disability Retirement Initial Information Certification for the Public Employee Retirement System of Idaho (PERSI) serves as an essential form for members seeking disability retirement benefits. It is used primarily to gather information necessary for assessing eligibility under specific Idaho statutes and regulations. Applicants must provide personal details alongside medical records certifying their disability to initiate the review process.
Applicants seeking disability retirement must carefully fill out every section of the form. Begin by carefully reading the instructions, ensuring that you understand each requirement and the information each section demands. Enter all necessary personal information, complete the certification of understanding regarding eligibility requirements, and acknowledge any responsibilities for submitting medical documentation.
Criteria for eligibility entail an evaluation based on the definition of disability as per Idaho law. It generally requires the applicant to demonstrate an inability to engage in any substantial gainful activity due to a medically determinable physical or mental impairment, expected to last not less than twelve months or result in death.


Applicants have multiple submission options, including:
The application process typically involves:
While this certification is specific to Idaho, and thus follows state mandates, aligning your application to these statutes is critical for approval. Each state may contain nuances in their procedural or legal requirements significant to process understanding, although substantial variations are generally not expected with a form that closely ties to state legislation.
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| Versions | Form popularity | Fillable & printable |
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| 2012 | 4.5 Satisfied (40 Votes) |
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Apr 15, 2021 Welcome to PERSI Orientation. Plan forms are available by calling Empower Retirement at 1-866-437 Choice 401(k) Hours of Operation Boise Office
Use this form to designate beneficiaries to receive your PERSI Base Plan and Choice 401(k) Plan death benefits.