Federal Employees Retirement System (FERS) Disability Retirement: Further SSDI Considerations

In filing for Federal or Postal Disability Retirement under FERS, one must, of course, file for SSDI.  Whether you want to pursue SSDI aggressively or not, depends upon what one’s future plans will be.  Remember that you can make (in addition to the disability annuity paid) up to 80% of what one’s former Federal or Postal job currently pays. 

Thus, take the following hypothetical:  An individual makes $60,000.00 per year, and files for Disability Retirement under FERS.  In the first year, the individual’s annuity would be $36,000; and every year thereafter, it would be $24,000.00.  On top of that annuity amount, however, the former Federal or Postal employee could go out and become employed, and make up to $48,000.00 per year at another job, on top of the $24,000.00 in disability annuity, for a combined income of $72,000.00. 

Now, some might be critical of the fact that under the rules governing OPM Disability Retirement, one can actually make more total income — 120% — than before becoming qualified for FERS Disability Retirement.  Some have called this a “windfall”.  Instead, one should look at it this way:  it is a thoughtful paradigm, because the system encourages a person to become productive in some other capacity.  Moreover, that person further contributes to the system which he or she left, by paying Federal taxes through the “other” employment.  Incentives work, and in this case, it makes economic sense for both the Federal government and for the disabled former federal or postal employee.

Sincerely, Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: Considerations Prior to Pursuing SSDI Aggressively

In filing for Federal Disability Retirement benefits under FERS, one must file for SSDI and submit proof of such filing with the Office of Personnel Management at the time of approval of the Federal Disability Retirement application.  For CSRS individuals who file for Federal Disability Retirement, no such filing is required, precisely because the framework of a CSRS retirement/disability retirement is not tied into the Social Security system. 

Remember that, under FERS, when a Federal or Postal Worker files for Federal Disability Retirement benefits, all that is necessary is to fulfill the requirement of “filing” — meaning, that a receipt must be submitted evidencing the filing of an SSDI application.  One does not need an approval or a denial — merely a receipt showing that one has fulfilled the statutory requirement of filing.  Ultimately, of course, the Office of Personnel Management is seeking to discover whether or not the Federal or Postal worker is eligible for SSDI, and if so, that an offset will be triggered.  Because of the possible offset (and the potential repercussions of OPM refusing to reinstate the full FERS Disability Retirement benefits in the event of an SSDI/FERS disability retirement annuitant having reached a status of gainful employment — see my previous blog post), one needs to take into consideration all of the factors, circumstances, future goals and future plans, before one decides to “aggressively” pursue SSDI benefits.  

Sincerely,

Robert R. McGill, Esquire

Federal Employees Retirement System (FERS) Disability Retirement: SSDI & FERS Offset (Continued…)

If a former Federal or Postal employee receives both FERS Disability Retirement annuity, as well as SSDI (with the proper offset), and finds a job, makes sufficient income to exceed the cap for SSDI — to the extent that Social Security finds that he or she is no longer “entitled” to SSDI benefits and suspends SSDI payments:  will the Office of Personnel Management recalculate the FERS Disability Retirement and reinstate the amount which was previously offset, to restore the full FERS Disability Retirement annuity?  The answer:  A number of recent cases have resulted in a “No”.  Petitions and Appeals are in the works. 

The reasoning and rationale of the Office of Personnel Management is that, because the individual is still “entitled” to SSDI benefits, but the benefits have merely been “suspended”, therefore the FERS Disability Retirement annuity is still offset by the “entitled” amount, not by what is actually received.  Pending the outcome of any Petitions for Review and Appeals to the U.S. Federal Circuit Court of Appeals, Federal and Postal Disability Retirement annuitants must be careful in deciding whether or not to actually pursue SSDI.  If one is planning to work at another job, with a reasonable expectation of exceeding Social Security’s cap for employment income, the fact that if one is restored to earning capacity, one’s FERS Disability Retirement may not be allowed to be recalculated to make up for the lost offset, should be taken into consideration.

Sincerely, Robert R. McGill, Esquire

FERS Disability Retirement: SSDI & FERS Offset

Federal and Postal Disability Retirement annuitants under FERS were required to file for SSDI as part of the process.  Most Federal and Postal employees who filed for Federal Disability Retirement benefits under FERS, never obtain an approval for SSDI.  This is natural, of course, and is part of the overall “framework” of the interaction between FERS Disability Retirement benefits and SSDI.  FERS Disability Retirement (as well as CSRS Disability Retirement) encourages Federal and Postal Workers to become employed in the private sector, and to become “productive” (translation:  continue to pay more taxes) in some other area of employment. 

Because Disability Retirement benefits under FERS or CSRS does not pay a great amount (60% of the average of one’s highest three consecutive years the first year under FERS, and 40% thereafter; a different computation methodology for CSRS employees, who are becoming rarer each year), the paradigm and plan of the Federal payment system for Disability Retirement annuitants had an implicit public policy approach of “encouraging” all such annuitants to find other employment.  Unless, of course, in addition to the FERS Disability Retirement annuity, one became entitled to SSDI payments, in which case the “cap” for income from other employment becomes much, much lower.  Many considerations should be thoughtfully approached when filing for SSDI, including plans for future employment.  Otherwise, some problems may be encountered if the annuitant receives both FERS Disability Retirement benefits, SSDI, and exceeds the cap from other employment.  More to Follow.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Applicant Tendency

An applicant or potential applicant for Federal Disability Retirement benefits under FERS or CSRS exhibits tendencies which can range on a wide spectrum of behavior, thoughts, fears, actions and reactions.  Some individuals believe that his or her application is so self-evident and self-explanatory, that all that is necessary is to obtain the medical records, list the diagnosed medical conditions on the Applicant’s Statement of Disability, file it, and…  When the Denial letter appears from the Office of Personnel Management, there is the surprise and shock, and the:  “I thought that…” 

Then, there is the other extreme of the spectrum, where there is an almost irrational fear that unless every ache and pain is detailed in long, explanatory narratives, and pages of pages of “personal experience” diary-like formatted chronologies are submitted with the packet, with tabulated references to justify each and every medical experience from two decades before until the present, that the Office of Personnel Management will deny the application.  Remember this:  It takes just as short a time to deny the first type of application as it does the second.  The Office of Personnel Management does not read through any materials which it deems “superfluous“.  Somewhere in the middle between the two extremes is normally the correct balance.  Or, as Aristotle would say, it is important to achieve the mean between the two extremes.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: Agency Tendency

A Federal or Postal Worker who has worked for any number of years, already knows (intuitively) what the Agency’s response is going to be when he or she files for Federal Disability Retirement benefits under FERS or CSRS:  Self-protection, minimal cooperation, and a “know nothing” and “do nothing” approach.  This is merely the tendency of most agencies.  Every now and then, there is an exception to this general perception of how a Federal Agency will respond and react; normally, however, any such exception is merely a reflection upon an exceptional individual — a supervisor who is truly looking out both for the best interests of the agency, as well as for a Federal or Postal worker who deserves praise and cooperation as he or she enters into a difficult phase of life. 

Agencies tend to respond in a “self-protective” mode; of covering itself; of being uncooperative, thinking that an individual who is filing for Federal Disability Retirement benefits is (A) no longer of any use to the agency, (B) reflects badly upon the overall perception of the agency, or (C) is merely faking the disability.  The truth of the matter is that a Federal or Postal employee who is filing for Federal Disability Retirement benefits has probably exhausted all possible alternatives, and has killed him/herself in trying to continue to work.  However, sympathy and empathy are two emotions which Agencies sorely lack in, both qualitatively and quantitatively; and as with all tendencies, it is good to be aware of them, if only to be on guard.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Tendencies

There are certain tendencies which seem to exhibit themselves on a spectrum of behaviors, and the pattern is fairly common.  As such, it is important to be aware of the natural tendencies of all parties involved when filing for Federal Disability Retirement benefits under FERS or CSRS.  For instance, it is a common tendency for the doctor — Family Doctor, Orthopaedic Surgeon, Neurologist, Psychiatrist, etc. — to avoid having to write a medical narrative report for a Federal Disability Retirement application.

What to do about it?  To try and place the doctor at ease by explaining the process in as direct, simple and concise manner as possible; then to tie the importance of the request for a Medical Narrative Report to the overall treatment plan for the patient — you.  To have an attorney involved can further ease the natural anxiety of a doctor — but it helps to have the client/patient forewarn the doctor as to the role and involvement of the attorney.

Attorneys and doctors are “natural enemies” (i.e., attorneys sue doctors; doctors hate to be sued; ergo, doctors have a natural tendency to dislike lawyers).  If the patient/client, however, approaches the doctor and explains that the lawyer who is representing him or her is there to explain the process, to guide the doctor in the preparation of the entire packet, including giving guidance to the doctor in formulating a medical narrative report, then the tendency towards anxiety and reluctance to assist in a Federal Disability Retirement application can be lessened and overcome.  Tendencies are there to be recognized, then to be adjusted in order to achieve a positive outcome.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: A Doctor’s Comfort Level

Doctors are funny creatures.  Administrative matters are often distasteful; yet, most doctors recognize that it is a necessary evil as part of the general practice of medicine.  Doctors often act arrogantly; yet, their arrogance is often in reaction to questions and statements which they deem to be irrelevant or insolent.  In filing for Federal Disability Retirement benefits under FERS & CSRS, it is obviously important to get the active, affirmative support of a treating doctor.  How does one go about doing this?  It is ultimately up the patient.  Remember — we are speaking about a “treating doctor” — not a stranger, but a person who, normally over the course of many years, has come to know, evaluate and treat the potential applicant who is filing for OPM Disability Retirement benefits.  Over the years, therefore, hopefully a relationship has grown to fruition.  Asking the treating doctor to support you in a Federal Disability Retirement application — or, if an attorney is hired, to let the doctor know that his or her legal representative will be requesting a medical report — should be the culmination of that special relationship which has developed:  the doctor-patient relationship, one which has grown over the many years of contact, discussion, conversation, and treatment.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement Benefits for Federal & Postal Employees: The Doctor and the FCE

For whatever reason, the treating doctor — unless he or she is a specialist (i.e., an Orthopaedic Surgeon, a Rheumatologist, a Pain Management Specialist, etc.) — is often uncomfortable and feels a sense of inadequacy in making a determination as to whether a Federal or Postal employee is unable to perform one or more of the essential elements of his or her job.

Under such circumstances, it may be fruitful for physical medical conditions, to undergo a Functional Capacity Evaluation (an “FCE”).  An FCE provides — in addition to “objective” diagnostic test results — an independent basis upon which to rely upon, in formulating a medical opinion.  The FCE provides, for the treating doctor, a “test” upon which the doctor can formulate an opinion, based upon reasonable medical certainty, as to the physical limits, endurance, and capabilities of an individual.

Further, the Office of Personnel Management is often impressed with an FCE.  Ultimately, the medical opinion of the treating doctor, based upon a long history of clinical examinations, diagnoses based upon generally accepted criteria within the medical profession, diagnostic testing, and an attempt at reasonable treatment modalities:  all together, comprise a valid basis for formulating and rendering a medical opinion in a Federal Disability Retirement case.

Nevertheless, if an FCE makes the treating doctor that much more comfortable in coming to a medical opinion, then by all means, go through with the FCE.  It can only make your OPM disability case stronger.

Sincerely,

Robert R. McGill, Esquire

 

Medical Retirement Benefits for Federal & Postal Employees: The Treating Doctor

In a Federal Disability Retirement application under FERS & CSRS, what distinguishes the entire process of proving, by a preponderance of the evidence, that a Federal or Postal employee is unable to perform one or more of the essential elements of one’s job — from other processes, such as Social Security and OWCP — is that the evidentiary weight is placed upon a treating doctor.  There are “other” types of doctors other than treating doctors:  specialists who are referred to for consultative purposes; doctors who specialize in determining functional capacity & evaluate the functional limits of an individual; occupational specialists, etc.  Why a “treating” doctor?  Because we are talking about workers who, over time, find that he or she is no longer able to perform the essential elements of a job and, over that same time, it makes sense that a doctor would be treating that individual.  Disability Retirement is not normally filed as a result of a traumatic accident (although that can happen, also); rather, a Federal or Postal employee normally files a Federal Disability Retirement application because of a condition which develops over time.  That is why the “treating” doctor would be the best source of knowledge and information:  because, through clinical examinations, long-term doctor-patient relationship, the treating doctor can make a long-term assessment based upon all of the facts and circumstances of the patient.

Sincerely,

Robert R. McGill, Esquire