Federal Disability Retirement Application: Making Innuendoes

OPM is always looking for a motive.  It is like they are criminal prosecutors at the Justice Department, trying to always find some nefarious reasons as to why a Federal or Postal employee is filing a Federal Disability Retirement application.

Take, for example, one recent case which comes to mind: An individual was filing for Federal Disability Retirement application.  The Applicant’s spouse traveled a lot, and so the applicant had to switch doctors often.  The applicant had his/her brother oversee the medical treatment because of the lack of continuity in medical care.  When it came time to file for Federal Disability Retirement benefits, the brother wrote the medical report.

The case went before the U.S. Merit Systems Protection Board and, within the Agency File were a series of emails sent between OPM Medical Specialists questioning whether this was a “fraud” case and expressing suspicions over why the applicant’s “brother” would be writing a medical report, etc.  At the Hearing of the case, of course, the brother — a medical doctor of longstanding stature — testified up front and bluntly: Yes, I am the brother of X, and I oversee the treatment regimens because of the lack of continuity of care, etc.  Factual, straightforward, nothing to hide.  But not for OPM, who is always looking for nefarious motivations and making innuendoes even though there is no basis for it.

Contact an OPM Disability attorney who specializes in Federal Disability Retirement Law, and counter the suspicious and unfounded innuendoes which OPM is apt to make — even in those cases where there is a simple and straightforward explanation, if only OPM would listen.

Sincerely,

Robert R. McGill, Esquire

 

FERS Disability Retirement Help: OPM’s Medical Specialists

OPM — the U.S. Office of Personnel Management — has “Medical Specialists” from the “Boyers Division” to review, evaluate, assess and ultimately make decisions upon each Federal Disability Retirement application submitted by Federal and Postal employees under FERS.

Now, there is no doubt that they possess unique medical knowledge — to whatever degree that they hold, from whatever perspective they come from, and the context of their applying such knowledge and background, etc.  But they are not lawyers.

Doctors and nurses have a specific perspective in viewing the world, just as lawyers and engineers, also, have a unique perspective. Their background and expertise is like a colored lens through which the world is seen.

Federal Disability Retirement is not just about a medical condition; it is, instead, the nexus between the medical condition and one’s ability/inability to perform one or more of the essential elements of one’s Federal or Postal job, within the context of a continuously-growing body of law.  That is why OPM’s Medical Specialists are often wrong in their conclusions in making a determination on a Federal Disability Retirement application.

If you need to file for Federal Disability Retirement benefits, or have been denied such benefits from OPM, contact a FERS Disability Lawyer who specializes in Federal Disability Retirement Law; for, in the end, it is not up to OPM’s Medical Specialists to make the final conclusion on a Federal Disability Retirement application — rather, it is The Law.

Sincerely,

Robert R. McGill, Esquire

 

Postal & Federal Disability Retirement: OPM’s Characterization

You just want to get a benefit you are not entitled to; you don’t really have a medical condition that prevents you from performing your job; your performance reviews are great; you received a cash award just a year ago; your supervisor doesn’t identify any service deficiencies; even though your Human Resource Office certified that your Agency could not accommodate you, we don’t believe them — etc., etc., etc.

In filing a Federal Disability Retirement application to the U.S. Office of Personnel Management under FERS, you will necessarily have a certain perspective as an individual requesting that you be approved for Federal Disability Retirement benefits.  No one at OPM will meet you in person.  You will be “known” and “characterized” based upon a paper-presentation to the U.S. Office of Personnel Management.  OPM will likely have a different characterization of you.

What will make the difference between an approval and a denial?  The Law.

Contact an OPM Disability Lawyer who specializes in Federal Disability Retirement Law and make sure that OPM’s characterization of you is rebutted and preempted at the outset — by The Law.

Sincerely,

Robert R. McGill, Esquire

 

FERS & CSRS Disability Retirement for Federal and USPS Workers: New Faces

Old timers will often smirk cynically and observe:  Time will cure them of such a naive perspective.  Or, to paraphrase a famous line from a well-know Christmas movie, Youth is wasted on the young (hint:  the scene were Jimmy Stewart is throwing a rock at the old abandoned house).  Youth and inexperience are often accompanied by enthusiasm and a fresh perspective. Lack of knowledge is compensated — some would say “overcompensated” — by an eagerness which sees no boundaries or obstacles.

There are clearly some new hires at the U.S. Office of Personnel Management as of this date, and their unique approach in viewing and evaluating a Federal Disability Retirement application, whether under FERS or CSRS, must be contended with.

The fundamental problem with newcomers is not that they don’t know what they are doing; rather, it is often the converse — they think they do know what they are doing, and when girded by a list of criteria which is applied in an inflexible fashion, one often gets blinded by the confusion of the forest while having a myopic view of an individual tree.  The great equalizer in countering lack of knowledge, fortunately, is the law itself; and while a list of applicable criteria provided to a fresh face may well assist the OPM employee to evaluate a claim, it can never replace the necessity of knowing the law.

For anyone filing a Federal Disability Retirement application with the U.S. Office of Personnel Management, now constitutes the time to employ all of the tools which the compendium of cases decided, and statutes reinforced, accord in arguing one’s case.  Time will certainly tell, but for the present, it is advisable to dot all I’s and cross each T, carefully and with great scrutiny.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal & Postal Workers: New OPM Case Workers

In a perfect world, any administrative determination — or any judicial, quasi-judicial or official analysis and evaluation of a “case” of any nature —  should be governed by precepts and criteria which are deemed “objective” in the sense that a standard application of a determining calculus would be applied without any subjective, arbitrary elements involved.  But this is not a perfect world, and as such, there are always “subjective” elements which become part and parcel of any determination, administrative or otherwise.

In Federal Disability Retirement cases, there are OPM (an abbreviated acronym for U.S. Office of Personnel Management) Claims Representatives, or “case workers”, who have had many years of experience, and those who have just recently been hired, trained, and been “let loose” in order to apply their limited knowledge.  There is definitely a change, and quite a noticeable one, in having a case reviewed by a novice at the Office of Personnel Management, as opposed to receiving a determination by a “seasoned” OPM worker.

Issues which are peripheral and do not impact the centrality of a Federal Disability Retirement case are often focused upon and detailed with irrelevant argumentation.  But that is the nature of an “administrative process”, where there are multiple layers and levels of appeals and reviews.

Ultimately, that is why there is a “Reconsideration Stage” — to allow OPM to review the decision of the first-level personnel, and to correct any misguided decisions made at that first level.  Further, there is the Merit Systems Protection Board, where an Administrative Judge will review the decision of OPM independently.  This is a “process“, as opposed to a single filing, and it is wise to remember it as such.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: A Fair Hearing

It is a common complaint against the Office of Personnel Management that the particular Claims Representative who reviewed the file and issued a denial in a Federal Disability Retirement application failed to look at, or review, the medical evidence; that the denial letter was merely a restatement or regurgitation of a template referring to a 7-part criteria, and makes statements which could easily have been “cut and paste” from a thousand other such denials.  

Indeed, there have been times when references to a denial were clearly (and mistakenly) extracted from another file, where the names of doctors and medical documents are referred to which have no relation to the particular individual, and are clearly mixed in from another case.  

To be fair, a counter-argument to such criticism is that there is no bureaucracy, with so many cases to review and properly evaluate, and with so few personnel and staff to undertake the massive workload, that could or should “reinvent the wheel” each time a case is set to be reviewed.  Obviously, certain language that is applicable in all (or most) cases will be re-stated, and templates used where such have been standard language used in the past.  Applicable language and statements which merely reiterate the legal and statutory criteria; introductory remarks; conclusory statements — they are all part of a paradigm and template which any administrative bureaucracy may apply.  

But the criticism goes much deeper than that:  It is often the case that, clearly, the Claims Representative who wrote the denial did not even read his or her own denial.  Proofreading is an essential part of reviewing, writing, and issuing a decision.  OPM must ultimately realize that each decision is an important, crucial, and often critical point of importance in the life of the applicant.  It is a Federal or Postal worker who has previously dedicated many years of his or her life to a career with the Federal Sector, and the applicant for Federal Disability Retirement benefits deserves a fair hearing.  A fair hearing is defined by a careful evaluation of the particular case.  That is not too much to ask for.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: Sometimes, It’s “The Law”

An assumption is often made that the “Disability Specialist” at the Office of Personnel Management who reviews the Federal or Postal Disability Retirement application understands, comprehends, and applies the laws governing Federal Disability Retirement applications.  Now, such an assumption may be logical and reasonable, to the extent that one thinks (A) that those who aspire to working in a specific specialty have some knowledge or understanding of the specialty, and (B) if a decision is made which involves discussing “the law”, one presumes that the mere discussion of it proves some knowledge of it.  

The problem with such reasoning, however (apart from the popular tripartite acronym which originates from the word “********-u-me”), is that it betrays the facts:  often, from reviewing the denial letters generated from the Office of Personnel Management, it is painfully clear that the administrative specialist, the legal specialist, or whatever other “specialist” designation has been embraced by the worker at the Office of Personnel Management, simply fails to apply all of the applicable laws which govern Federal Disability Retirement applications.  This is understandable, to this extent:  OPM representatives (other than those representing OPM at the MSPB level) are not lawyers, and as such, do not keep up with the latest evolution of the laws governing Federal Disability Retirement issues.  Whether that is a good thing or a bad thing, is another matter altogether.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: The Chasm between Denials

From the perspective of an individual Applicant for Federal Disability Retirement benefits under FERS & CSRS, the individual applicant does not normally observe some other person’s Federal Disability Retirement application, and therefore never has the opportunity to see the “greater process” at work, or patterns of behavior on the part of the Office of Personnel Management.  Yet, there are indeed patterns, and that is why an experienced attorney who has seen literally thousands of Federal Disability Retirement cases over numerous years, has an advantage in responding to OPM’s denials.  Experience lends itself to greater observation.  Experience over time reveals certain patterns.  And patterns of behavior can reveal important principles. 

Certain OPM Representatives provide detailed and (often) irrelevant factual references which can be ignored; others like to “cite the law” and believe that such citations appear irrefutable and authoritative; and still others give scant discussion to laws or to facts.  Thus, there often appears to be a great chasm between the types of denials.  Whether or not there are such differences, an applicant who has received a denial for his or her Federal Disability Retirement case needs to respond to any such denial with a three-pronged attack:  Medical refutation; Factual correction; Legal assertion.  Such an attack will cover any chasm which might exist between the different individuals who send out a denial letter.  More importantly, it will cover the necessary elements for winning a Federal Disability Retirement case.

Sincerely,

Robert R. McGill, Esquire