FERS & CSRS Disability Retirement for Federal and USPS Workers: Proof, Assertion, and the Conceptual Distinction

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, it is necessary — first and foremost — to understand that the benefit of Federal Disability Retirement is not an “entitlement” under any definition of the word; there is no automatic triggering mechanism by which a Federal or Postal employee becomes a Federal Disability Annuitant, unless one proves, by a preponderance of the evidence, that one has met all of the eligibility requirements necessary to obtain the benefit.

Further, while the standard of proof established by statute is a relatively low one in comparison to others (i.e., “preponderance of the evidence” merely requires that the truth of X is more likely than not, as opposed to other, more onerous standard of proof, such as “beyond a reasonable doubt” or “clear and convincing”, etc.), nevertheless, the mere assertion of a statement of facts will not qualify the Federal or Postal employee for Federal Disability Retirement benefits.

A standard — or “burden of proof” — means exactly that:   One must prove it, and proof requires more than the mere assertion that X is so.  Specifically, in a Federal Disability Retirement application, one must prove that one is medically unable to perform one or more of the essential elements of one’s Federal or Postal position, and in order to meet that burden, medical documentation of a sufficient and persuasive nature must be submitted along with a Federal Disability Retirement application, which includes many Standard governmental forms.

Knowing and recognizing the conceptual distinction between asserting X and proving X is an important first step in preparing, formulating, and successfully filing for Federal Disability Retirement benefits.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Logistics, Strategy and Substantive Paradigm

In any and every endeavor, whether on a large scale or of little consequential impact, a tripartite approach must be devised:  the logistics of the case (the “how” and the mundane mechanics of procedural actions involved); the strategy of it (the methodological plan of action, involving the choice of which issues to prioritize and tackle, etc.), and finally, the substantive paradigm of the case.

It is often the latter which is overlooked, precisely because everyone is always too busy trying to immediately figure out what to do and how to do it.  In a pragmatic sense, the logistical plan and the strategic outlay are crucial in any legal action; as a persuasive foundation for winning, however, devising a substantive paradigm of a case may be the essence of a winning path.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, the Federal or Postal employee who encounters the myriad of voluminous standard forms to be filled out, the need to obtain medical reports and records, and to simply survive the morass of administrative and bureaucratic requirements, leaves one merely attempting to stay afloat in the logistical mandates — of trying to satisfy all of the Agency demands and requirements.

Additionally, to even contemplate devising a “strategy” of how to go about proving, by a preponderance of the evidence, one’s Federal Disability Retirement case, becomes an obstacle and a burden, especially when one is having to deal with the medical condition and treatment of that condition concurrently with the stress of trying to complete a Federal Disability Retirement application.

As for the substantive paradigm of a case?  That may be the customary casualty of a Federal Disability Retirement case — that coordination of all issues, of the medical, the position one occupies, the persuasive legal argumentation, in a compendium of interconnected sources, arguing to the U.S. Office of Personnel Management the what, where, why and irrefutable how, in a Federal Disability Retirement application.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Workers: Listing, Prioritizing and Weaving

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, the Federal or Postal employee who is formulating the Applicant’s Statement of Disability on Standard Form 3112D must describe the medical conditions which will be proven to impact upon one’s inability to perform one or more of the essential elements of one’s job.

Submission of the “list” of medical conditions will concretize and place boundaries around the issue to be litigated. Once submitted through the Agency or the U.S. Postal Service, then forwarded to Boyers, PA and assigned a CSA Number, the medical conditions described will be the only ones which can be argued.  Further, once a Federal Disability Retirement application is approved, the approval letter will have an attachment which describes and identifies those medical conditions which the Office of Personnel Management found the applicant to be disabled for (is this the feared split infinitive?).

Thus, by way of example, if a Federal or Postal employee filed for Federal Disability Retirement benefits based upon medical conditions X, Y and Z, and OPM based its approval only upon medical condition Y, then for any future Medical Questionnaire requesting an updated status on the annuitant’s medical condition, it is only medical condition Y which would be relevant.

As such, in the very preparation of the applicant’s statement of disability, important decisions must be made which will have significant future consequences:  which medical conditions to list; how to prioritize the medical conditions; whether to weave secondary conditions into the applicant’s statement, and to what extent, etc.

While some of the issues will be determined by the medical narrative report(s) prepared by the treating doctors, it is ultimately the responsibility of the Federal or Postal employee who is considering filing for Federal Disability Retirement benefits — along with his or her attorney — to set the course for future events in a manner which will ensure not only present success, but future security.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Government Employees: Different Pockets

There is often a confusion over different pockets and their intersecting relations — of SSDI (Social Security Disability Insurance with the Social Security Administration); OWCP administered under the Federal Employees’ Compensation Act (OWCP/FECA); Federal Disability Retirement under FERS or CSRS, as approved or denied by the U.S. Office of Personnel Management; and, in addition, there are those who are eligible for VA Disability benefits, for a Scheduled Award from OWCP, and complications which can occur with private disability insurance policies.

The general rule with respect to each can be summarized as follows:  Offset between FERS & SSDI (100% the first year, 60% every year thereafter); one can get approved concurrently for OWCP/FECA, but the Federal or Postal employee must choose to receive from one or the other, and not both; the Federal or Postal employee can receive a scheduled award while at the same time receiving a FERS Disability Retirement annuity, because a Scheduled Award is considered compensation for a rated injury, as opposed to continuation of one’s pay; there is no offset between FERS or CSRS Disability Retirement benefits and VA Disability benefits; private disability policies depend upon the contractual language of the policy itself, and must be reviewed individually as to any provisions of offset or dollar-for-dollar reduction of benefits based upon receipt of any other benefit.

These are the general criteria concerning the intersecting impact of each upon the other.  In the end, reaching into different pockets will normally result in an increase, and rarely (if ever) a decrease of benefits, even with offsets.  However, overreaching, as the case may be, can result in unintended consequences of overpayment and required repayment.  Be aware and informed.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Disparate Information in a Disability Retirement Application

The difference between success and an almost-successful endeavor is normally not based upon the information available, but rather, the effective use of the available information.  Just as most “secrets” are neither hidden nor unknown, but rather depend upon who knows it, how it is used, and when it is acquired; similarly, the availability of information disseminated throughout our lives — via the internet, through publications, through media outlets, etc. — is generally not the basis for success.  Disparate information compiled in a bulk bound conglomeration is normally not an effective way of presenting something.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, it is important to go beyond mere compiling of information and data in presenting one’s case to the U.S. Office of Personnel Management.  Remember that Federal Disability Retirement is not an entitlement; rather, it is a benefit which is available upon proving one’s case.  Proof of a case depends upon multiple factors: indeed, the Office of Personnel Management will often state the following in denying a Federal Disability Retirement application:  “The mere fact that you have a medical condition does not mean that you are eligible for Federal Disability Retirement benefits.”

The existence of a medical condition is a necessary requirement; facts supporting one’s case can be persuasive; the laws governing Federal Disability Retirement and the eligibility criteria should be cited; the nexus between one’s Federal and Postal position and the medical condition should be established; then, beyond each of the disparate informational islands, a coordination of the information is necessary. For that, an approach which involves a paradigm of how one should win a case is important.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: Pushing the Reset Button

Preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, is like the proverbial phrase of pushing the “reset” button.  While the phrase is overused and in many ways has lost its useful meaning, the conceptual underpinning implies that it allows for a fresh start.

The decision itself is often the largest hurdle to overcome; once made, it allows for a goal-oriented outlook on a different course of action, and often compels the Federal or Postal worker to manage one’s “life-affairs” with greater determination and incentive, perhaps because one is provided with another proverbial gift:  the “light at the end of the tunnel”.  For, the darkness which pervades is often characterized by the morass of daily pain, the chronicity of the pain, the endless and incessant meaninglessness — of the vicious cycle of coming to work only to survive; then to go home only to recuperate in order to turn right around and go into work for another day of survival; and, often, to an agency which eyes the Federal or Postal worker with suspicion and with little or no loyalty, compassion or sympathy.

Federal Disability Retirement is meant as a mechanism for recuperation from one’s medical condition — a medical condition which prevents one from performing one or more of the essential elements of one’s particular kind of job, but which will allow for future work in another vocation.  It is the ultimate “reset button” — to allow for the beginning towards a different tomorrow.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: The Viability of the Case

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, the initial question for the Federal or Postal employee who is contemplating such an endeavor — i.e., he or she is in the “preparation” state of the administrative process — is whether or not one has a “viable” case.

Viability of a Federal Disability Retirement case is based upon the supportive input of a treating doctor — whether it is one’s Primary Care Physician, Orthopaedic Specialist, Neurologist, Psychiatrist, etc. Because Federal Disability Retirement is not an entitlement, but rather a benefit which must be proven by a preponderance of the evidence, as such, one must approach the preparation and formulation of the case based upon factors pointing towards the viability of “winning”. There is never a guarantee that a Federal or Postal employee will be approved for a Federal Disability Retirement application.  Each case must be evaluated in light of the uniqueness of the facts, circumstances, and relevant positional requirements involved.

As part of any such review and analysis of a case, one must look at the extent of support one can expect from the treating doctor.  As such, a case will often require some further development; of persuasion on the part of the doctor that all reasonable modalities of treatment have been engaged in; that the condition will reasonably last for a minimum of 12 months (which can be part of the prognosis of the patient); and that it meets the legal standard in accordance with OPM, the MSPB and the statutory authorities which govern such standards — that, essentially, the medical conditions are inconsistent with the particular type of job which the Federal or Postal employee must perform.

Viability is determined by multiple factors — medical, legal, and the rational nexus between one’s medical condition and the particular kind of job one is required to perform.  It must be evaluated with a knowledge of all three — the law, the medical condition, and the unique, intimate connection to the Federal or Postal position.

Sincerely,

Robert R. McGill, Esquire