Federal & Postal Disability Retirement from the U.S. Office of Personnel Management: Continuity of Care

Most things in life require a continuity of care.  Yes, projects will often have an inception date, and termination point where, once completed, no further maintenance of effort is required.  But other concerns require further and elaborative engagements beyond the linear horizon of attendance, including:  teeth, dogs, children, marriages, and Federal Disability Retirement benefits.

When a Federal employee or U.S. Postal worker obtains that vaunted and desirable letter of Approval from the U.S. Office of Personnel Management, whether the Federal or Postal worker is under FERS, CSRS or CSRS Offset, the tendency is to think that one may then fade into the proverbial sunset, ever to receive a Federal Disability Retirement annuity and focus upon one’s health, medical conditions and the medical care required.

But then there comes additional contacts from OPM — perhaps not for a few years; perhaps not for a decade.  But the potentiality of the contact is there, and one must lay down the framework of preparatory care in order to respond appropriately.  If not, what will happen is this:  A fairly innocuous request for employment information can result in a termination of the disability annuity, based upon a “finding” that you have been deemed medically recovered.

That “Final Notice” from the Office of Personnel Management does, fortunately, allow for Reconsideration rights, as well as further rights of appeal to the U.S. Merit Systems Protection Board.  Additionally, there is a proper methodology for responding to OPM, to enhance and greatly ensure the continuation of one’s Federal OPM Disability Retirement benefits.

Wrong steps can lead to negative results; unresponsive panic without proper legal argumentation can have the unwanted consequences of an unnecessary loss of one’s Federal Disability Retirement annuity.  The best approach is always to respond with the legal armaments and arsenal one is provided with, and to maintain a continuity of care for preserving one’s Federal Disability Retirement benefits.

Sincerely,

Robert R. McGill, Esquire

 

OPM Disability Retirement: Always the Long Term

Always remember that Federal Disability Retirement under FERS or CSRS must be looked at for “the long term”.  Even after one obtains and secures the benefits under Federal Disability Retirement (annuity, health insurance, etc.), one must always be vigilant in protecting the benefit — for you can always be selected randomly to answer a Medical Questionnaire.  I often tell my clients after securing an approval for his or her Federal Disability Retirement benefits, that now that you have it, you will never lose it unless you are “stupid”.  By “stupid”, I do not mean that it is impossible to lose it; only that you must be either recklessly careless, or thoughtless, in losing the benefit. 

There are different ways of losing the benefits received under Federal Disability Retirement:  the two most commons ways are —  making more than the allowable 80% of what your former job currently pays or failing to properly answer the Medical Questionnaire.  The former needs constant and careful planning when you get a job; the latter requires that you carefully monitor the answers provided by your treating doctor.  Whichever the case may be, it is important to take any correspondence received from the Office of Personnel Management seriously — whether before, during, or after the process of obtaining Federal Disability Retirement under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Future Perspectives

People often act without forecasting prospective issues. In filing for disability retirement, it is important to take into account the emphasis and basis upon which one files for Federal Disability Retirement, because when an approval is given by the Office of Personnel Management, OPM identifies the specific medical disability upon which they granted the approval. As such, it is important for the applicant to base the application upon the medical condition/disability, in the sequence of importance, the most serious to the least serious.  This is important not only for purposes of winning disability retirement cases, but further, with a view to the future:  when the random Medical Questionnaire is sent to a disability retirement annuitant, if the medical condition upon which you were approved for was a minor, “least serious” medical condition, then 5 years or 10 years down the road, it may well have “resolved”, which puts you in danger of losing your disability retirement benefits.  This is why it is important to have a view to the future, and guidance and advice from an attorney is important in securing that future investment.  For, ultimately, obtaining disability retirement benefits which could potentially be the primary source of income for the next decade or two, is an investment for the future.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Which Disabilities To List

When I look at a potential disability retirement case, I find it helpful to look at the case not only prospectively, but retrospectively. While not a “rule” cast in stone, when the Office of Personnel Management approves a disability retirement case, it will normally attach a page which identifies which disability — normally one, often two, sometimes three — was/were the basis for the approval.  Thus, it is important when preparing a disability retirement packet and application, to identify which medical disabilities will be listed and depended upon; and further, once is it approved, it is helpful to look to the future, for there is a random chance that every 2 years or so, you will be selected to answer a Medical Questionnaire to determine if you are still disabled.

Thus, if you list a minor medical condition, and you get approved for that minor medical condition, if you recover from that condition, you can potentially lose your disability retirement benefits in the future. (Note:  for those of you who are my clients, please do not worry; no client of mine who has received a Medical Questionnaire has ever lost his/her disability annuity)   Thus, it is important to identify those medical conditions which are the “most serious”, and base your medical disability retirement packet upon the most serious, long-term disability first –before listing secondary or additional medical disabilities.  This is not to say that you should not list more than one medical disability; indeed, in preparing my packets for my clients, I will often list more than one, but I do it in sequential fashion, and when I put together my legal memorandum in arguing my case on behalf of my client, I constantly refer back to the central medical disability.

Sincerely,

Robert R. McGill, Esquire

OPM’s Medical Questionnaire and the Issue of Accommodations

In this article, I will be addressing two separate issues: First, the issue of OPM’s Medical Questionnaire, and next, the issue of Accommodations.

OPM’s Medical Questionnaire

At each stage of the process, an annuitant must always see his or her monthly annuity as a right which must be fought and protected. In recent months, I have seen an increase in cases where an individual has been an annuitant, but has lost his or her annuity because OPM’s Medical Questionnaire (sent out to selected annuitants every two years) was not taken seriously. Whether the increase is by coincidence — that a greater number of annuitants failed to respond to the Medical Questionnaire seriously, or because the Office of Personnel Management is scrutinizing annuitants more carefully — is irrelevant; what is relevant is that, whether you are fighting to obtain your disability retirement, or fighting to keep your disability annuity, the approach should always be consistently the same: be prepared to defend your disability annuity aggressively.

Some basic rules in responding to OPM’s Medical Questionnaire:

Rule #1: Take it seriously. Yes, the four questions seem fairly straightforward and innocuous: Get your treating doctor to provide current clinical findings based upon a recent examination; get a current diagnosis; a current prognosis; and finally, a clinical assessment of risk of injury or hazard to self if you returned to your former job. This all sounds simple enough, and it is, if you follow the first rule: take it seriously.

Rule #2: Don’t have your doctor send in the updated medical report directly to OPM without letting you first see it. I have represented more people for breaking this rule. Think about it — why would you allow a report to be sent to OPM without first reviewing it? Take responsibility; protect your disability annuity. Make sure the doctor is addressing the issues that need to be addressed – and properly.

Rule #3: Make sure that your doctor addresses the specific medical conditions for which you obtained your disability retirement. While you may have had 5 different disabilities that impacted your ability to perform your job when you first applied, when the Office of Personnel Management grants you your disability retirement, if the first one listed on your application qualifies you, they will grant you the disability retirement based upon that first disability, and will not proceed to consider the remaining 4 disabilities. In responding to OPM’s Medical Questionnaire, the disability annuitant must establish that he/she suffers from the same disability upon which the disability retirement was based, and that he remains unable to perform the duties of the last position he occupied prior to being granted disability retirement, or that his condition is incompatible with useful and efficient service or retention in the position. See Tompkins v. Office of Personnel Management, 72 M.S.P.R. 400, 404 (1996); Prestien v. Office of Personnel Management, 8 M.S.P.R. 698, 704-05 (1981). Further, an annuitant is not entitled to continuation of disability retirement simply on the basis that his physical condition is unchanged since he was granted disability retirement, where present medical evidence does not establish that he is disabled. See Dougherty v. Office of Personnel Management, 36 M.S.P.R. 117, 121 (1988). When I have represented a client and obtained disability retirement for my client, I send out a letter apprising the client of his future rights and obligations — one of them being, to keep in regular contact with his treating doctor, so that when or if a Medical Questionnaire is received, there is already an established doctor-patient relationship, and you don’t go about scrambling to find a doctor who is willing to write a responsive report to the Medical Questionnaire.

Finally, Rule #4: Keep it simple. The doctor’s response to OPM’s Medical Questionnaire need not be lengthy and complex: indeed, it can be a single paragraph, and refer to a recent examination, and include treatment or office notes, and simply state: Current diagnosis; symptoms; prognosis; and a statement that “X is still disabled based upon medical condition Y from his former job as a ________, and cannot go back to his former job because of his medical conditions.”

Thus, to reiterate: Take the OPM Medical Questionnaire seriously; keep in regular contact with your doctor; make sure the doctor addresses the medical conditions that you were found to be disabled for; and don’t allow the doctor to send it directly to OPM without first reviewing it.

Second Issue: Accommodations

Recent cases by the Merit Systems Protection Board continue to affirm the very important legal principle of protecting Federal and Postal employees from being assigned ad hoc, or “made-up” jobs, while still being slotted in the original position, as reflected in one’s PS or SF form 50. Just because you are offered a “modified position” that appears to be ‘official’, if you haven’t been reassigned to a vacant position that actually exists, then you are still eligible for disability retirement. Don’t be fooled. In the recent case of Cadman v. OPM, Docket No. CH-844E-07-0002-I-1, the Merit Systems Protection Board, upon a Petition for Review by the Appellant, again revisited this issue, and again referred to the important case of Ancheta v. Office of Personnel Management, 95 M.S.P.R. 343 (2003). In Ancheta, the Board held that a modified job in the Postal Service that does not “comprise the core functions of an existing position” is not a “position” or a “vacant position” for purposes of determining eligibility for disability retirement. The Board noted that a “modified” job in the Postal Service may include “’subfunctions’ culled from various positions that are tailored to the employee’s specific medical restrictions,” and thus may not constitute “an identifiable position when the employee for whom the assignment was created is not assigned to those duties.” Id., at p. 14. The Board thus suggested that a “modified” job in the Postal Service generally would not constitute a “position” or a “vacant position.” Id. Thus, what the Board in Ancheta was saying, and reaffirmed and reiterated in Cadman, is that the “made-up” job that the Postal Service puts on an “official-looking” Modified Job Offer Sheet, is in all likelihood not an accommodation. This is true of jobs in non-Postal Federal Agencies, also.

The Board’s holdings in Cadman and Ancheta, and the long line of such legal reasonings, clearly strengthen Postal and Federal employees’ rights concerning disability retirement, when placed in the context of longstanding law as held by the Federal Circuit Court in Bracey v. Office of Personnel Management, 236 F.3d 1356, 1358 (Fed. Cir. 2001). I have previously addressed this issue in my other articles, of course, but let me reiterate that in Bracey, the Federal Circuit Court delineated and outlined the applicable provisions governing disability retirement, stating that “the pertinent OPM regulation elaborates on the statutory definition by providing that an employee is eligible for disability retirement only if (1) the disabling medical condition is expected to continue for at least one year; (2) the condition results in a deficiency in performance, conduct, or attendance, or is incompatible with useful and efficient service or retention in the employee’s position; and (3) the agency is unable to accommodate the disabling condition in the employee’s position or in an existing vacant position.” In Bracey, the Court clearly stated that an employee must be reassigned to a “vacant” position, and not one which was merely “made up”, and the reasoning of the court is clear: the Court Stated:

“We Agree with Mr. Bracey that OPM’s argument fails, because the term ‘vacant position’ in section 8337 refers to an officially established position that is graded and classified, not to an informal assignment of work that an agency gives to an employee who cannot perform the duties of his official position. A ‘position’ in the federal employment system is required to be classified and graded in accordance with the duties, responsibilities, and qualification requirements associated with it.” Id. at p. 1359

Further, the Court went on to state that the term “vacant position” means “something that is definite and already in existence rather than an unclassified set of duties devised to meet the needs of a particular employee who cannot perform the duties of his official position.” Id. at 1360.

Putting Bracey, Ancheta, and Cadman together, Federal and Postal employees have a formidable argument which protects their disability retirement rights: When you become medical unable to perform one or more of the essential elements of you job, as outlined in your position description, Agencies cannot leave you in the same job slot and make up different things for you to do. The idea of ‘accommodation’ is a term of art, and must not be viewed in the way that the ‘general public’ might view it: if you have a medical condition or disability, and your employer says that the Agency has ‘created’ a position that somehow does away with those essential elements of your job that you cannot do anymore, that is NOT an accommodation. In fact, an accommodation is the very opposite: it is where the Agency provides some means such that you CAN continue to do all of the essential elements of your job.

I know that I keep reminding you of this, but I think that it is worth repetitive reminders: Disability retirement is a benefit that all Federal and Postal employees signed onto when you became employed. Many private sector jobs don’t offer this benefit, but then, such private sector jobs of equivalent positional requirements often pay more in base salaries. It is one of the benefits you acquired — a right — in the event of a medical condition or disability which prevents you from continuing in your career. As such, when you can no longer continue in your Federal or Postal job, you must look upon disability retirement as a right and an investment for your future — one which must be aggressively sought after, and once obtained, protected with similar diligence and aggressiveness.

I am an attorney who specializes in representing Federal and Postal employees to obtain and retain disability retirement benefits. Like the giraffe, you cannot allow for appearances to fool you; you must always and aggressively protect your rights and future. The leopard is known for quickly and aggressively capturing its prey; the camel is known for long and sustained trips. You need to be both a leopard and a camel – to pursue your future investment aggressively, and to sustain your investment for a long time into the future.

For more information, contact me in one of these ways: (1) view my website at www.FederalDisabilityLawyer.com; (2) email me at federal.lawyer@yahoo.com; or call me at 1-800-990-7932.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: OPM's Methodology

When the Office of Personnel Management (OPM) approves a federal disability retirement application, a separate page from the approval letter will often be attached, which states the medical basis upon which the disability retirement application was approved. The separate page will often state something to the effect of: “You submitted an application for disability retirement based upon medical conditions, A, B, C & D; however, your application was approved for medical condition B only.”

The concern here, of course, is that if you are later selected to answer an OPM Medical Questionnaire asking you to re-establish your medical disability for continuation of your disability annuity some years later, that you make certain that you answer such a Medical Questionnaire based upon that very medical condition upon which you were approved. This is obviously important. Some have questioned whether or not you can appeal the approval letter based upon the fact that you believe OPM should have approved you based upon a different medical condition. In my view, this is not an appealable issue, and if you question OPM as to whether they should have considered you disabled based upon another medical condition, you may be in greater danger by OPM reversing themselves based upon a re-review of your case. It is best to leave “well enough alone”. Accept the approval letter based upon the identified medical condition, and inform your treating doctor that you may need his input in the future — to address that very medical condition for which you were approved.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Clarification of Issues for FERS & CSRS Employees

In moderating the Martindale-Hubbell Message Board for Federal Disability Retirement Issues, two areas of law need clarification for those out there contemplating filing for Federal Disability Retirement under FERS or CSRS: First, the issue of whether a potential applicant needs to wait to be separated from Federal Service in order to obtain the “Bruner Presumption“, before filing for disability retirement.

The short answer is an unequivocal, “No”. To wait for an agency hoping that they will separate you for your medical inability to perform your job, is like waiting for your rich uncle to die and leave you an inheritance: It may never happen, and even if it does, it may not be worth it. While the Bruner Presumption is a nice additional weapon to have in arguing for an approval, it is not a necessary element.

The most important element in an OPM disability retirement case is to have a supportive doctor. Application of the Bruner Presumption — a recognition by the Agency that they cannot accommodate you, and further, that you cannot perform your job as a result of your medical condition, while a weapon in arguing for an approval to OPM, is not necessary in most cases. The point is to make sure your supporting medical documentation is strong, thereby negating the need for the Bruner Presumption.

Further, another common confusion which people have is what it means to be “separated from service”. The Statute of Limitations in Federal Disability Retirement cases is 1 year from the date a Federal Employee is separated from Federal Service. The 1-year does NOT begin when a person is on LWOP, or when a person is on FMLA, or any other reason. The 1-year begins when a person is officially terminated, separated, or taken off of the rolls of Federal Service, or when a person resigns from the Federal Service. It is 1 year from that date that a person must file for Federal disability retirement benefits, or you lose your right forever to do so.

Second, and finally (at least for this particular Blog piece), with respect to the 80% rule — where a person can earn income up to 80% of what one’s former Federal job currently pays: this is in addition to the disability retirement annity that a person receives.

Think about it, and it is logical: disability annuity is not “earned income”; the 80% rule applies only to “earned income”. Thus, for example, a person who was making $60,000 at a Federal job, who goes out on disability retirement, would get $36,000 the first year under FERS (60%), and $24,000 per year every year thereafter (40%). At the same time, that person can go out and make up to $48,000 per year (80% of $60,000), with that amount going up slightly each year (assuming that the payscale in the Federal system goes up each year for that same pay and grade). I hope this clarifies some of the issues that may have given rise to some confusion.

Sincerely,

Robert R. McGill, Esquire

In Filing for Disability Retirement, Remember the Basics

In the opening sentence of Davis v. the Office of Personnel Management, PH-844E-06-0242-I-1, the Merit Systems Protection Board reminds us all that the “burden of proving entitlement to a retirement benefit is on the applicant…” In past federal disability articles, I have discussed a variety of issues, from important legal principles based upon Bruner v. OPM, to showing how to build the “proper bridge” in preparing a disability retirement application. In preparing a disability retirement application, however, remember to always satisfy the “basics”, because if you fail at the basic level, you will never get to the “substantive” level to argue your case. Davis is a case about a disability retirement applicant whose application was denied at the first Stage (the “initial application stage”) because she “did not present any medical evidence to support her claim.” Strike One — how can you file a medical disability retirement application without any medical evidence?

Next, Ms. Davis failed to file her “Request for Reconsideration” within the 30-day period. She filed it 5 days late. Strike Two — you won’t even be able to argue the substance of your disability retirement case if you don’t take care of the “basics” — like filing your Request for Reconsideration in a timely manner. In OPM’s denial letter, it clearly stated: “Your Request for Reconsideration must be received by OPM within 30 calendar days from the date of your initial denial letter.” Ms. Davis had no excuse.

Now, every now and then — but very, very rarely — an exception will come along. Such was the case in Goodman v. Office of Personnel Management, 100 M.S.P.R. 43 (2005), which was cited as a distinguishing case by the Board. In Goodman, multiple factors allowed the appellant to be excused for her tardiness — including, being misled by OPM verbally over the telephone; receiving the denial letter some three weeks after being postmarked (thereby leaving her with only a week to respond); and being a quadriplegic who had to rely upon others to assist her in responding. Be aware: only under the most exceptional of circumstances will being late in responding be excused. You must take care of the basics, before going on to the substance of a case.

Ms. Davis filed an appeal to the Full Board. Her appeal was, as you might guess, denied. The Board stated that in cases such as this, where Ms. Davis “fails to show that she was not notified of the deadline and was not otherwise aware of it, or that she was prevented by circumstances beyond her control from making the request within the time limit, we will not reach the issue of whether OPM was unreasonable or abused its discretion in denying her untimely request for reconsideration.” (italics added).

Strike three. Ms. Davis is out. As I have reiterated throughout this article, unless you take care of the basics, you cannot even get to the substance of your disability retirement claim. Like the parable of the mighty army which could defeat its enemy, that army could not survive to fight the battle unless it took care of a basic need — water for its troops to cross the scorching desert to meet its enemy. It failed to take care of the basics.

In life, we are all busy doing multiple things, and when a Federal or Postal Employee comes to a point in his or her life where filing for disability retirement becomes a necessity, it is often a good idea to hire an attorney — not only to ensure that the “basics” are taken care of, bur further, to make sure that you get the opportunity to argue the substance of your particular case. My name is Robert R. McGill, Esquire. I am a duly licensed Attorney who specializes in representing Federal and Postal Employees, to obtain disability retirement benefits through the Office of Personnel Management. If you would like to discuss your particular case, you may contact me at 1-800-990-7932 or email me at federal.lawyer@yahoo.com, or visit my website at www.FederalDisabilityLawyer.com.

As an aside, let me point out some other “basics”:

1. Remember that you have one (1) year from the date you are separated from service to file for disability retirement. The one (1) year date does not begin when you stop working; it doesn’t begin when you get placed on LWOP; it doesn’t begin from the time you get disabled. It begins from the date you are separated from Federal Service.

2. For my clients (and those who are not my clients) whom I got disability retirement for — remember that you are allowed to get another job and make up to 80% of what your position currently pays, in addition to the disability annuity you are receiving. It is earned income that counts — not rental income, not investment income, and certainly not your disability income.

3. A teaser — I will probably address this issue in my next article — the Office of Personnel Management seems to, more recently, be scrutinizing those who are already receiving medical disability retirement benefits. For those of my clients (and those who are not my clients) who receive disability retirement, remember to take OPM’s Medical Questionnaire seriously. I have had more cases than usual where disability annuitants have had their disability income discontinued. More on this later….

 

Robert R. McGill, Esquire