Disability Retirement Kits

Overview

Disability Retirement Kits

Mail completed Disability Applications to NYCERS at 30-30 47th Ave., Suite 1010, Long Island City, NY 11101. Mail Medical forms 605, 606, 607, 608, 609 and 613 to NYCERS’ Medical Division at 335 Adams Street, Suite 2300, Brooklyn, NY 11201. All forms can be brought to our Customer Service Center at 340 Jay Street in downtown Brooklyn.

Form

Enhanced Disability Benefit Election – 22-Year Plan Uniformed Correction Force Members
Form #194

For members of the Uniformed Correction Force 22-Year Plan (CF-22) who wish to elect the Enhanced Disability Benefit (EDB) program. This form must be filed with NYCERS no later than June 30, 2017. (Correction Force members who become participants in the CF-22 Plan on or after January 1, 2017 will automatically be enrolled in the CF-22 EDB and do not need to file this form.)

Form 623

WTC Agency Report
Form #623

This form is to be completed by the agency whose employee (or former employee) has filed a Notice of Participation with NYCERS indicating that he/she participated in WTC Rescue, Recovery or Clean-Up Operations during certain qualifying periods between September 11, 2001 and September 12, 2002.

Form 622

WTC Notice of Participation
Form #622

This Notice is for any active, vested or retired member (retired after 9/11/01) who participated in World Trade Center (WTC) Rescue, Recovery or Clean-up Operations between September 11, 2001 and September 12, 2002. This form must be filed with NYCERS no later than September 11, 2018.