OPM Disability Retirement Denial: The Middle Stage

It is like those siblings who are “in between”; of caught in relevance and significance by being squeezed on the one side by the “giant first one”, and on the other side by an even greater presence; and, somehow, the middle stage is lost and forgotten.  Is that how life itself is viewed, as well?  Of being cooed and oohed over the baby-years, and then forgotten once the younger sister comes into the family; or of being cast aside by children in their teenage years, then suddenly realizing that time lost can never be regained, but recognizing that one’s parents now are too old to appreciate?

Is that why the “Middle Ages” are viewed as irrelevant, stuck between the “Ancient Era” of the great Roman and Greek periods, and then suddenly skipped over into the Renaissance and into modernity?

The “Middle Stage” is like the Middle Age years — of being present but quickly fading; of being there but barely noticed; of shying away and fearing the next stage because the one before was so full of energy and the disappointment of the failures of the previous stage is merely a foresight into the fearful expectations of the next.

For Federal employees and U.S. Postal workers who suffer from a medical condition such that the medical condition now prevents the Federal or Postal employee from performing one or more of the essential elements of one’s Federal or Postal job, the “Middle Stage” is called the “Reconsideration Stage” of the administrative process.

The Reconsideration Stage is the stage where the Federal or Postal Disability Retirement application has been denied at the Initial Stage, and it is the Stage before the Third Stage — an appeal to the U.S.Merit Systems Protection Board.  It is not a stage to be “overlooked” — as some inevitability of a further denial — but one which provides for an opportunity to enhance and add to one’s Federal Disability Retirement application by providing additional medical and other documentation in order to obtain an approval from the U.S. Office of Personnel Management, whether the Federal or Postal employee is under FERS, CSRS or CSRS Offset.

If the applicant decided to forego consulting with an attorney at the Initial Stage of the Federal Disability Retirement process, then it is a good time to consider contacting an attorney at the “Middle Stage” — the Reconsideration Stage of the process — to discuss the next and crucial steps in order to correct any past mistakes and affirmatively assert the proper legal basis in meeting the preponderance of the evidence criteria in your quest to obtain Federal Disability Retirement benefits from OPM.

Sincerely,

Robert R. McGill, Esquire

 

OPM Medical Retirement from Federal Employment: The Reconsideration Stage

Much time is often wasted upon rebutting incoherent arguments.  Such a statement is true in a great many sectors of life, as well as with an initial denial received from the U.S. Office of Personnel Management.

The first reaction in response to an Initial Denial received from the U.S. Office of Personnel Management, is to panic and become disheartened:  The Federal Disability Retirement applicant has waited many, many months, just to get to this point of being denied an application which was thought to clearly meet the legal standard of preponderance of the evidence, and perhaps the medical narratives and treatment records clearly and unequivocally established the nexus between one’s medical condition and the essential elements of one’s job.

What could have gone wrong?  What was deficient?  What unanticipated mistakes were made?

To top it all off, a quick perusal of the denial letter makes it appear as if the application never had a leg to stand on –  seemingly contradictory statements extrapolated; selective quotes from doctors, supervisors, etc., that tend to undermine the proof needed; deficient documentation and multiple garbled references to the “Disability Retirement Law” that has simply not been met.

How does one counter and rebut such an overwhelming denial of one’s carefully gathered and constructed information?

There is the “proper” and “effective” way, but one’s initial inclination in reactive form is normally not the way to go about it.

The Federal employee or U.S. Postal worker who finds himself/herself in such a situation – of facing an initial denial from the U.S. Office of Personnel Management – will often want to just “give up” and try to endure the pain, anguish and cognitive deterioration by going back to work (if that is even possible and the Federal or Postal employee has not yet been separated from service), or just simply walk away from one’s well-deserved Federal Pension and early Federal Disability Retirement benefits, and forego the benefits earned and vested.

Of course, that is precisely the thought-process that the U.S. Office of Personnel Management wants you to embrace.

It is often stated (erroneously) that filing a Federal Disability Retirement application through the U.S. Office of Personnel Management is not an “adversarial” process – and that OPM is not there to “fight you”, but rather, to ensure that all Federal Disability Retirement applications fulfill the requirements of the law.

If that were truly the case, then why does an OPM denial point out only the deficiencies, and never the positive aspects of a Federal Disability Retirement application?  Why do OPM denials always present themselves as overwhelmingly unqualified and argued as if there is absolutely no basis or chance of an approval?

Precisely – because, despite stating otherwise, the administrative process of trying to obtain Federal Disability Retirement benefits from OPM is just that:  an adversarial process which requires an advocate to fight for your rights.

Sincerely,

Robert R. McGill, Esquire

 

Federal Disability Retirement Attorney: The Second, Reconsideration Stage

It is not a reflection upon the validity of one’s medical condition; a denial from the U.S. Office of Personnel Management can mean multiple things, not the least of which may include:  insufficient proof failing to rise to the level of satisfying the preponderance of the evidence standard.

Federal Disability Retirement applications are compiled in a myriad of manners; yes, the standard forms themselves tend to compel a certain semblance of conformity, but ultimately the strength of a case will depend upon the supportive documentation attached, and here is “the rub”:  there still exists the “human element” in the reviewing analysis of a Federal Disability Retirement application.

Yes, certain sets of legal criteria are applied (but who and how are they interpreted in their application?); and while satisfaction of the legal criteria is supposed to be determined by the general principle of “preponderance of the evidence“, who and what complies with meeting such a standard?  How is such satisfaction determined?  Such questions, of course, imply a human element in the administrative process of an OPM Disability Retirement review, and whether we like it or not, reveals an underlying connection to imperfection and fallibility.

There is no mathematical algorithm of mechanistic applications which will completely correct the underlying problems inherent in human review within the context of a bureaucratic process.  Fortunately, however, the process itself contains a self-corrective device: different stages and levels of review, which allows for the Federal employee or the U.S. Postal worker to provide additional supportive documentation in order to reinforce and strengthen one’s Federal Disability Retirement case.

There are limitations, however, and that is why “corrective action” at the Second, Reconsideration Stage of the administrative process of Federal Disability Retirement is just that — it is to “correct” the mistakes, lapses and inherent lack identified in the original Federal Disability Retirement packet.  The “limitations” are set by law, and are determined by how one characterizes one’s medical conditions in the Statement of Disability as perpetuated on SF 3112A.

Care should always be taken, of course, in the initial preparation of a Federal Disability Retirement application, whether the Federal or Postal employee is under FERS, CSRS or CSRS Offset, and before it is forwarded through one’s agency to the U.S. Office of Personnel Management.  But in the end, one must recognize that the entirety of the administrative process is one which involves multiple stages of a bureaucratic procedure, and the Second, Reconsideration Stage is merely another level of self-regulating refinement to ensure that the human element, including mistakes and misapplication of the law, is expunged to the extent possible, and instead, that the objective application of the law is uniformly dispensed in order to reach a statistically acceptable algorithm of fairness and impartial determination.

Sincerely,

Robert R. McGill, Esquire

OPM FERS/CSRS Disability Retirement: Approaching a Reconsideration

The proverbial definition of insanity is to engage in the same repetitive activity with the expectation of receiving a different result.  While such a definition may not provide a clinically accurate or legally acceptable formulation, it does implicate the chaotic character and the futile act of responding in a particularly fruitless manner.

For Federal and Postal employees who have attempted to file for Federal Disability Retirement benefits through the U.S. Office of Personnel Management, whether under FERS or CSRS, and have received an initial denial, the process of having OPM reconsider one’s case must be approached in a 2-tier manner:  First, one must meet the “deadline” of filing for Reconsideration with OPM within thirty (30) days of the denial, or upon receipt of the denial (although, to be on the safe side, it is best to use the former date as opposed to the latter);  next, with the box checked to indicate submission of additional medical documentation, to then gather, prepare, compile and submit additional medical evidence within thirty (30) days thereafter, unless a further extension is needed and requested.

However, one should also understand that in an OPM Reconsideration case, it will not be the same Case Worker who will review the case, but it will be reviewed thoroughly by someone else as if it had never been previously reviewed. As such, there is the confounding conundrum of a dual anomaly: The First Case Worker who issued the denial based the denial upon certain specific points; yet, what the First Case Worker denied the case upon, may have no bearing upon what the Second, Reconsideration Case Worker will evaluate the case upon.

What does one do? Whatever one’s answer is to this complex conundrum, do not engage in the proverbial act of insanity; better to get some legal guidance than to spin one’s wheels in an insane world of futility.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Responding to Stupidity

Sometimes, one’s initial reaction in a situation — professional setting, social discourse, event gathering, etc. — requires a momentary pause; and it is precisely that couple of seconds of gathering one’s thoughts which saves one from further putting fuel upon a potential fire.

Perhaps you have every right to have responded with a drip of sarcasm; or others would have approved of the lashing back; and still others would say that the response was appropriate and deservedly given.  But the greater question should always be:  how effective was the response; did it evoke the necessary end; and for whose benefit was the aggressive retort given — for the benefit of truth, or for one’s own satisfaction?

In a professional context, of course, it is probably never appropriate to respond in an unprofessional way, if merely by definition alone.  Similarly, in a FERS or CSRS Federal Disability Retirement context, when one receives a denial from the U.S. Office of Personnel Management, there are statements made — whether one pertaining to mis-application or mis-statement of the law; or perhaps a wrong reference to a medical report; or even more egregious, a selective use of a statement from a medical report or record taken out of context — which can deservedly provoke a response involving sarcasm, a deluge of epithets, or worse, a barrage of ad hominem attacks — and in each case, it would be neither appropriately given, nor proper in a professional sense.

Fortunately, paper presentations and paper responses have the advantage of time over social discourse and person-to-person contact.

Holding one’s breath and counting 3 seconds, or 10, or perhaps an eternity, is an effective way of avoiding catastrophe.  Writing a diatribe of what one wants to say, then trashing it, is also acceptable.  On the other hand, beware of that “send” button; and, moreover, never push that “send to all” button.

That would indeed be unprofessional.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: The Crucial Reconsideration Stage

In engaging the U.S. Office of Personnel Management for Federal or Postal Disability Retirement benefits, whether under FERS or CSRS, it is important to recognize the differences between the administrative and legal stages involved.

There is, of course, the initial application stage; one cannot overemphasize the importance of proper preparation and compelling formulation of one’s Federal Disability Retirement packet, for the First Stage of the process.  However, regardless of the adequacy of one’s Federal Disability Retirement submission at this initial stage, there are going to be a certain percentage which are denied, and which therefore must be propelled into the Second Stage of the Administrative process.

This next step is often identified as the “Reconsideration Stage” in the process of attempting to prove one’s eligibility for Federal Disability Retirement benefits.  It is known as such, because at this stage, one has the right to have one’s case “Reconsidered”; in order to do that, however, you must notify the U.S. Office of Personnel Management within thirty days of the date of their denial letter, or within receipt — but one should be cautious of the latter timeframe, as it can be rather tricky, and thereby one should proceed on the assumption that the 30-day timeframe begins from the date of denial as reflected on the Letter of Denial, just to be on the “safe side” of things.  To ensure compliance, the undersigned attorney always requests the reconsideration via a trackable delivery device, so that proof of delivery can be shown if necessary.

This Second Stage of the process in attempting to become eligible for Federal Disability Retirement benefits is a crucial stage in the process, because if it is denied again at this stage, then one must file an appeal to the U.S. Merit Systems Protection Board, and put on one’s case before an Administrative Judge — a complex process which takes it out of the hands of the U.S. Office of Personnel Management and places it in an entirely separate determining entity.

While each stage of any bureaucratic process can be deemed “crucial”, it is this point of differentiation which makes the Reconsideration Stage unique:  it is the last chance before entering into the complex arena of legalese.  Thus, for those already confounded by the complexities of the administrative process, the land mines to be confronted at the Merit Systems Protection Board will only be exponentially multiplied.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Government Employees: Someone Else’s Argument

Have you ever sat with company at a dinner table, and engaged in a conversation where it appears as if you are continuing someone else’s conversation?  Or your presence is merely a substitute for an extension of a previous debate or discussion?  Where a topic is brought up, and immediately a barrage of critical attacks — of arguments you have never made, and of statements you don’t recall disseminating (and where this is only 5 minutes into the salad and you’ve barely tasted the first glass of wine)?

The problem with unfinished business is that the transference of what one wanted to say is normally unloaded upon the wrong subject.  Conversations, debates, forums of intellectual exercises in linguistic battles — it is a rare person who has been able to convey the full force of one’s collective thoughts and beliefs on the matter, and it is more often the case that one leaves with the regretful remorse of, “I wish I had brought that point up…”  But rarely do second chances present themselves in a satisfactory follow-up forum; unless you are the unfortunate object for an unexpected dinner invitation.

In responding to a denial of a Federal Disability Retirement application with the U.S. Office of Personnel Management, whether under FERS or CSRS, the applicant — through his or her Federal Disability Retirement attorney — needs to understand that the person who issues the denial will not be the same person who will review any additional submissions or legal arguments at the Reconsideration Stage.

It will be reviewed, in legal parlance, de novo.  As such, while the basis of the denial as issued by the Caseworker at OPM at the First Level should be taken into consideration, one should approach the case in light of the following question: To what extent will the Reconsideration Branch care as to the original basis of the denial of the first caseworker?  If it is being reviewed de novo, the approach should be to go over all of the elements — and to reinforce and amend those weak points, some of which may overlap what the first caseworker pointed out, others which may not.

It may not be the best approach to argue to a dinner guest who wasn’t present at the first round of arguments; the points you are trying to make may not be heard because the bell has already rung, and the fighter in the second round has been replaced with someone upon whom you have never previously landed a punch.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: Cornering OPM’s Malleable Stance

At the initial stage of the process identified as “Federal Disability Retirement” from the Office of Personnel Management, whether under FERS or CSRS, it is often difficult for the Federal or Postal worker to grasp the various components which must be gathered, formulated, prepared and consolidated, in order to meet the legal criteria for eligibility.

Once submitted, if an approval is received from the Office of Personnel Management, then one need not be further concerned with whether or not the legal criteria was “met” (although one should still be vigilant in doing those tasks and preparatory work in order to retain and maintain one’s right to Federal disability retirement benefits).

If a denial is received from the Office of Personnel Management, then it is necessary to file a Request for Reconsideration within the thirty (30) day time period, and begin to determine which of the multiple issues OPM has delineated as being the basis of a deficient Federal Disability Retirement application.

Some attempt to do this via a “shotgun” approach — of spraying every answer available and hoping that some of the arguments, supplemental documents, statements, etc., hit the mark in some way.  A different approach is to selectively choose those issues which appear to be central to the case, and answer the essential ones, allowing for such answers to concurrently address the peripheral points brought out by OPM.  A third approach is to identify and consolidate OPM’s alleged basis for the disapproval, consolidate the issues into 2 or 3 main points, then “corner” the arguments by addressing them, concluding that the Federal or Postal employee has addressed the concerns of OPM and therefore OPM should not be able to change them at the Merit Systems Protection Board.

While an MSPB appeal is conducted “de novo” (“anew” or “afresh”, without regard to any previous determinations), it is nevertheless an effective methodology to point out the malleability of OPM’s varying stances, and thereby effectively streamline that which needs to be proven at the MSPB level.  A leopard which changes its spots too often loses its credibility, and making sure that OPM stays in one place is a useful tool in winning a Federal Disability Retirement application, whether under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement for Federal Workers: When a Mistake is Made

Mistakes made in preparing, formulating and filing for Federal Disability Retirement benefits under FERS or CSRS, from the U.S. Office of Personnel Management, are usually correctable, and for a number of reasons:  most mistakes merely require additional clarifications; some “mistakes” are only apparently so, but substantively valid otherwise; and ancillary mistakes of an innocuous nature can reflect the inconsistencies of reality, as opposed to a direct contradiction between two or more persons.

While blinders cannot be placed upon the Case Worker at the Office of Personnel Management once a Federal Disability Retirement application has been submitted, nor does it usually require such drastic measures.

The question to be asked, of course, is whether or not the alleged “mistake” should be addressed, to what extent, and how prominently?  For, the old Shakespearean adage that “thou protesteth too much” can apply in a Federal Disability Retirement application, where too much emphasis upon a particular issue can unduly magnify the issue itself, as opposed to dealing with the issue in a passing manner.

Thus, a statement made in the Applicant’s Statement of Disability, or by a treating doctor, which indicates an undermining of meeting the legal criteria of eligibility in a Federal Disability Retirement application, should probably be addressed.

A direct statement made in a Supervisor’s Statement may or may not be relevant.  Often, such statements are merely opinions meant to undermine a Federal Disability Retirement application, but whether it is worth addressing is a discretionary issue.  The real issue concerning discrepancies or mistakes have to do with who is making it into a loud noise; and the one who makes the loudest noise, is often the one who attracts the greatest attention.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement for Federal Workers: Reconsiderations

When a Federal Disability Retirement application under FERS or CSRS is denied at the first stage of the process, a Federal or Postal worker who filed for the benefit has the administrative right to request that it be “reconsidered” by the Office of Personnel Management.  Once requested, the case file is turned over to the “Disability Reconsideration Branch” of the office, and will be reviewed and evaluated by a Disability Specialist — not the same person who reviewed it at the Initial Stage of the process. 

A person who has filed for Federal Disability Retirement benefits has thirty (30) days to Request Reconsideration.  While the 30-day period may arguably have some flexibility based upon when the applicant actually received the denial letter, it is nevertheless a good policy to adhere to the 30-day time-frame by counting the date of the denial letter as the “beginning” date.  Obviously, it is better NOT to be placed in a position of having to argue whether or not the applicant met the 30-day deadline.  Further, it is best to send it in via a means where confirmation of receipt can be shown.  OPM is a large bureaucracy, and things get lost in the morass of the volume of submissions.

Sincerely,

Robert R. McGill, Esquire