Federal and Postal Disability Retirement: Applying the Legal Standard

In preparing, formulating and filing a Federal Disability Retirement application with the Office of Personnel Management, it is important to understand the legal criteria of “preponderance of the evidence”, to attempt to meet the legal criteria; to state and argue that the legal criteria has been met, and to reiterate and show how the legal criteria has been met.

Thus, as the Office of Personnel Management is a bureaucracy with multiple levels replete with clerical and administrative staff, it is important to present, to show, to reiterate, and to affirm:  the point to get across must be established in a succinct, effective, efficient manner, but it must be firmly established.

“Preponderance of the evidence” can be quite subjective, but within the context of such subjectivity, it encompasses the conceptual analogies of:  X is more likely than not; the quantitative weight of the evidence shows that the burden of proof has been met; the qualitative whole has proven that one is entitled to Federal Disability Retirement benefits; the compendium of evidence, both medical and supporting, shows that Mr. Y’s medical condition does indeed prevent him from performing one or more of the essential elements of his job; and similar conclusions to be reached as a result of the entirety of the evidence presented.

Of these analogies noted (which is not meant to be an exhaustive list, but merely an attempt to illustrate the meaning of the concept of “preponderance of the evidence”), the one which is most dangerous for people to embrace, is the “quantitative weight” of evidence.  For, ultimately, gathering a thick stack of medical documentation is the easiest way to put together a Federal Disability Retirement application, but the least effective.  And in the end, it is effectiveness which we seek, and not ease of completion.

Sincerely,

Robert R. McGill, Attorney

Medical Retirement Benefits for US Government Employees: Inconsistencies

While the legal standard of “preponderance of the evidence” is the statutorily mandated criteria to be applied as the burden of proof in a Federal Disability Retirement application under FERS or CSRS, the question which needs to be asked is:  Assuming that a Federal Disability Retirement application under FERS or CSRS contains sufficient medical documentation to meet the legal criteria, what is it that would undermine the application and result in a denial of the Federal Disability Retirement application?  

The overwhelming pattern of that which defeats a Federal Disability Retirement application from being approved — at any stage of the process — is the revelation of inconsistencies between various aspects of the application.  

Thus, whether it is the internal inconsistency of medical records versus the medical narrative report which the doctor has prepared; the apparent inconsistency between a Supervisor’s Statement and the Applicant’s Statement of Disability; or the potentially exaggerated inconsistency between the Applicant’s Statement of Disability and the Medical Narrative Report(s) — such are the fodder which the Office of Personnel Management is looking for in order to provide a substantiating and justifying basis to deny a Federal Disability Retirement application under FERS or CSRS.  

One must understand, however, that many inconsistencies are merely “apparent”, and can be easily explained — if needed to be explained at all.  Thus, for example, notations in the medical records/office notes where the treating doctor has annotated numerous instances of “improvement” from a previous office visit, are merely apparently inconsistent with a conclusion that a person can no longer perform one or more of the essential elements of one’s job.  

An exaggerated Applicant’s Statement, however, which overstates one’s medical conditions beyond what the doctor is willing to state, can be a more difficult inconsistency to overcome and correct.  It is important to always recognize the difference between apparent, inherent, and natural inconsistencies, and to understand that some inconsistencies need to be “left alone”, while others may need to be attended to.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: OWCP & OPM

The distinction between the Office of Workers’ Compensation Program (OWCP) and Federal and Postal Disability Retirement benefits under either FERS or CSRS from the Office of Personnel Management (OPM) is one which must be clearly made so that a Federal or Postal worker does not confuse the two; for, in confusing the two, there are numerous instances in which the Federal or Postal worker believes that he/she is receiving one or both — as the Statute of Limitations has already run out or is about to run out.  OWCP is a separate, distinct, and independent benefit from OPM Disability Retirement benefits.  

It is administered by the Department of Labor, and is designed to provide for temporary compensatory benefits based upon an on-the-job injury (as opposed to the issue being “neutral” and irrelevant in a Federal Disability Retirement application under FERS or CSRS), or an occupational illness or disease, and is meant to allow for a period of time in which the injured Federal or Postal Worker can recuperate or become rehabilitated, then return back to work.  There is no designated time-frame as to how long a medical condition must last (whereas for OPM Disability Retirement benefits, a medical condition must last for a minimum of 12 months).

The distinctions are important to keep in mind for many reasons, if merely to understand that a person who has filed for OWCP benefits has NOT concurrently satisfied the filing requirements for OPM disability retirement benefits.  One must affirmatively file for,and prove by a preponderance of the evidence, that one is eligible and entitled to OPM disability retirement benefits under FERS or CSRS.  Complacency in the receipt of OWCP payments may shockingly come to an end one day; it is a good idea to prepare, formulate, and file for Federal Disability Retirement benefits under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: The Process of Eligibility

The problem with possessing power is that it must be accompanied by truth, validity and rational foundations, if it is to be effective over the long term.  

In filing a Federal Disability Retirement application under FERS or CSRS, there is the process of proving one’s eligibility by meeting the burden of proof, termed as the “preponderance of the evidence“.  A disagreement can occur during the process, in that the Representative from the Office of Personnel Management can deny the Federal Disability Retirement application.  

Such a denial can occur twice at the OPM level — at the Initial Stage of the process, then at the Reconsideration Stage of the process.  OPM possesses the power to approve or deny each Federal Disability Retirement application.  Often, however, the denial itself fails to be accompanied by a rational discourse which strives to meet the high standards that a Federal Agency should always adhere to — guided by the truth and validity of any claims made in a denial letter.  Too often, the discourse which is the basis of the denial merely regurgitates a series of template-like statements, and then the OPM denies the claim.  

Fortunately, however, OPM is not the only Agency which makes the determination during the entirety of the process.  After the second denial, it then loses its jurisdiction over a case, and an appeal can be made to the Merit Systems Protection Board.  

The integrity of the entire process depends upon the independence of the MSPB in reviewing all such cases, and indeed, the Administrative Judges at the MSPB review each case carefully, with an open mind, and with the proper application of the law.  Each Judge must render a decision which contains the rational basis of a decision, based upon precedents and statutory legal underpinnings.  To have the full benefit of the process is indeed the basis of a system with integrity.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Meeting the Burden of Proof

The difference between “telling” and “showing” is a distinction which is often made in distinguishing between bad literary writing and good literature; such a distinction is applicable in practicing effective law, also.  

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, it is important to meet the burden of proof in order to show the Office of Personnel Management that one is entitled to Federal Disability Retirement benefits under FERS or CSRS.  To “meet the burden of proof” is to show, by a preponderance of the evidence, that one has met all of the legal criteria for such eligibility (e.g., that one has a medical condition; that the medical condition prevents one from performing one or more of the essential elements of one’s job; that certain identified elements of the job cannot be accommodated, etc.).  

The key is that one must “show”, and not merely tell, and that is where the distinction between effective and ineffective formulation of a Federal Disability Retirement application presents itself.  To merely assert that “X is a fact” and then to declare that the burden of proof has been met, is an ineffective methodology of formulating one’s argument.  On the other hand, to describe the factual underpinnings, then to further describe how the natural conclusion from such facts lead to the inescapable conclusion that a legal criteria has been met, is to provide for an effective argument.

The Office of Personnel Management is open to persuasion; it must merely be shown the way through descriptive analysis of the medical facts and conclusions which must be met, in meeting the legal burden of proof in a Federal Disability Retirement application under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

Early Retirement for Disabled Federal Workers: Essential Elements

In preparing, compiling, formulating and filing a Federal Disability Retirement application under FERS or CSRS, one must prove by a preponderance of the evidence (a legal standard which has been set by statute) that a Federal or Postal worker who has a minimum of 18 months of Federal Service (under FERS) or 5 years (under CSRS) suffers from a medical condition such that the medical condition prevents one from performing one or more of the essential elements of one’s particular kind of job. 

The concept of “essential elements” is variously defined and expanded upon by court cases, but one way to identify the “core elements” of a particular job is to review the position description, and to extrapolate from the official description of the job.  Another place, of course, is the Agency’s performance review, which will often identify the core elements. 

One should never overlook the obvious, in addition to that which is identified in the position description — the fact that one is required according to the position to work full time; to be “on site” for many jobs (thereby precluding tele-commuting as a viable permanent accommodation); and certain other inherently obvious elements which are often mentioned in passing — such as sitting for long periods of time (a sedentary position); being required to stand or walk for extended periods of time; and other such “essential elements” which make up a position, and are inherently required by the very nature of the job.  Those “obvious” but often unmentioned essential elements are notable for the fundamental requirements of being able to successfully perform a job.  They should not be overlooked.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement Benefits for Federal & Postal Employees: Are all Doctors Necessary?

In a Federal Disability Retirement case under FERS or CSRS, is it necessary to obtain the medical opinion of each and every doctor for each and every medical condition listed on the Applicant’s Statement of Disability (SF 3112A)?  To put the question in another way, Must there be a one-to-one correspondence between the medical condition listed or described, and the doctor who is specifically treating the medical condition? 

Certainly, in today’s world of medicine, where specialization is the key to treatment because of the complexity of each field of medicine and the successful treatment of diseases and medical conditions, it has become a fact of life that patients are “referred out” to various specialists.  Thus, the Primary Care Physician is often merely the “gate-keeper” of referrals, coordinating the medical treatment of a patient by overseeing the referrals to various specialists who treat various medical conditions.

An applicant for Federal or Postal Disability Retirement benefits under FERS or CSRS who must prove, by a preponderance of the evidence, his or her eligibility for Federal OPM Disability Retirement benefits, must submit substantiating medical documentation to prove his or her entitlement. 

As with all such questions, the answer to the above question is, “It depends”.  A one-to-one correspondence is not necessarily required; where helpful, of course, the referral specialist’s medical opinion should be used.  However, one should never underestimate the importance and force of the coordinating physician — the Primary Care Physician himself/herself.

Sincerely,

Robert R. McGill, Esquire

Federal & Postal Service Disability Retirement: The Workplace

When a Federal or Postal employee is considering filing for Federal Disability retirement benefits under FERS or CSRS, there are many and varying conflicting responses, wrapped and bundled in emotional turmoil, reactionary and concerned viewpoints, etc.  Stories of a “hostile work environment”, of discriminatory actions, harassing supervisors, etc., are often part of the “narrative” of a person considering filing for Federal Disability Retirement. 

One must be careful, however, that when the affirmative decision to file for disability retirement is made, that only those relevant aspects of the narrative be included in the final disability retirement packet.  Things which do not provide a compelling basis for proving, by a preponderance of the evidence, the necessary criteria for meeting the legal standard to be approved for Federal Disability Retirement benefits under FERS or CSRS or, just as importantly, things which will harm a disability retirement application– they should be left out of the final narrative. 

Such issues surrounding a “hostile work environment” or a harassing supervisor — such perspectives or narrative formulations which come close to the dangerous precipice of showing that one’s medical disability is merely a “situational” disability (those medical conditions which are specifically confined to a specific situation in a specific agency’s office environment) — should certainly be left out of the final narrative.  This brings up a further point, which I have touched upon many times in the past:  a person without an attorney to formulate the narrative in filing for Federal Disability Retirement benefits is often too close to his or her own case, and cannot objectively present the proper narrative to the Office of Personnel Management.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Agency's Power

I hear it in both the content of the question and the anxiousness in the voice of a potential client seeking representation to obtain Federal Disability Retirement benefits under FERS or CSRS:  Can the agency influence the application negatively?  Can they terminate me upon learning that I am seeking disability retirement?  Can they stop me from using my sick leave?  The power of the Federal Agency can be overwhelming, but there are limits as to what “influence” they can have over a Federal Disability Retirement application. 

Ultimately, good or bad, the Office of Personnel Management is the agency which makes the determination on an approval for all disability retirement applications, and as I have written in many articles in the past, the best way to “neutralize” the power of an agency is to prepare the medical aspect of the Federal Disability Retirement application in an excellent manner.  This is done, first and foremost, by garnering the support of the treating doctor, gathering the best medical evidence possible, etc.  Other actions of the agency — of attempting to place you on AWOL, or filing an adverse action during the process, can normally be stopped by an attorney experienced in Federal Disability Retirement laws.  Disability Retirement under FERS or CSRS is not just a matter of filling out forms; it is a matter of securing the future.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Process at the MSPB

When a FERS or CSRS disability retirement application has made its way in the “process” to the “Third Stage” — the Merit Systems Protection Board — then I (as an attorney) must be unequivocal in my recommendation:  You need an attorney.  I believe that individuals who file for Federal Disability Retirement benefits should retain a competent attorney at every stage of the process, but there are always considerations of financial ability, and perhaps other considerations, which prevent someone from hiring an attorney at the initial stages of the process. 

At the MSPB level, however, it is important for two (2) reasons (there are many, many other reasons as well, but for brevity’s sake, I choose the main reasons):  1.  It is extremely important to prove by a preponderance of the evidence that you meet the eligibility requirements, to an Administrative Judge, who is both a lawyer and a Judge, and therefore has the knowledge and background to make a reasoned assessment of the evidence presented, and 2.  You must be able to present the case in such a way that, if the Administrative Judge makes an error in his or her decision, you are prepared to appeal the case to the next level.  In order to be able to appeal the case to the next level, you must know the law, be able to present your evidence at the MSPB in accordance with the law, and therefore be able to argue that a decision rendered against you is in violation of the law.  In order to do this, you need an Attorney.

Sincerely,

Robert R. McGill, Esquire