                                 CODE OF VIRGINIA

ORDER OF THE VIRGINIA RETIREMENT SYSTEM (§ 9.1-404)

A. 1. The Virginia Retirement System shall make an eligibility determination
within 45 days of receiving all necessary information for determining
eligibility for a claim filed under § 9.1-403. The Virginia Retirement System
may use a medical board pursuant to § 51.1-124.23 in determining eligibility.
If benefits under this chapter are due, VRS shall notify the nonparticipating
employer, which shall provide the benefits within 15 days of such notice, or VRS
shall pay the benefits from the Fund on behalf of the participating employer,
contributing nonprofit private institution of higher education, or contributing
private police department within 15 days of the determination, as applicable.
The payments shall be retroactive to the first date that the disabled person was
no longer eligible for health insurance coverage subsidized by his employer.

   2. Two years after an individual has been determined to be a disabled person,
   VRS may require the disabled person to renew the determination through a
   process established by VRS. If a disabled person refuses to submit to the
   determination renewal process described in this subdivision, then benefits
   under this chapter shall cease for the individual, any eligible dependents,
   and an eligible spouse until the individual complies. If such individual does
   not comply within six months from the date of the initial request for a
   renewed determination, then benefits under this chapter shall permanently
   cease for the individual, any eligible dependents, and an eligible spouse. If
   VRS issues a renewed determination that an individual is no longer a disabled
   person, then benefits under this chapter shall permanently cease for the
   individual, any eligible dependents, and an eligible spouse. If VRS issues a
   renewed determination that an individual remains a disabled person, then VRS
   may require the disabled person to renew the determination five years after
   such renewed determination through a process established by VRS. The Virginia
   Retirement System may require the disabled person to renew the determination
   at any time if VRS has information indicating that the person may no longer be
   disabled.

   3. For any medical review conducted for the purpose of making an eligibility
   determination pursuant to this section, VRS shall require such review to be
   conducted by a licensed health practitioner. For purposes of this section,
   &#8220;licensed health practitioner&#8221; means a person licensed to practice
   medicine or osteopathic medicine pursuant to the provisions of Chapter 29
   (&#xA7; 54.1-2900 et seq.) of Title 54.1, a person licensed to practice
   nursing pursuant to the provisions of Chapter 30 (&#xA7; 54.1-3000 et seq.) of
   Title 54.1, or a person licensed to practice psychology pursuant to the
   provisions of Chapter 36 (&#xA7; 54.1-3600 et seq.) of Title 54.1.
   &#8220;Licensed health practitioner&#8221; includes a person issued a
   comparable license, as determined by VRS, by the District of Columbia or a
   state that is contiguous to the Commonwealth.

B. The Virginia Retirement System shall be reimbursed for all reasonable costs
incurred and associated, directly and indirectly, in performing the duties
pursuant to this chapter (i) from the Line of Duty Death and Health Benefits
Trust Fund for costs related to disabled persons, deceased persons, eligible
dependents, and eligible spouses on behalf of participating employers,
contributing nonprofit private institutions of higher education, and
contributing private police departments and (ii) from a nonparticipating
employer for premiums and costs related to disabled persons, deceased persons,
eligible dependents, and eligible spouses for which the nonparticipating
employer is responsible.

C. The Virginia Retirement System may develop policies and procedures necessary
to carry out the provisions of this chapter.

HISTORY: 1995, cc. 156, 597, § 2.1-133.9; 1998, c. 712; 2001, c. 844; 2016, c.
677; 2017, c. 439; 2022, c. 484; 2025, cc. 204, 219.