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

Federal Employee Medical Retirement: Another Day to Fight

I often tell young people who are contemplating going to Law School that, to become a lawyer, one must accept a life of constant contentiousness.  While “professional courtesy” in the field of practicing law is often spoken about, and courtroom decorum is indeed important to maintain, it is nevertheless a profession which faces controversy, contentiousness, debate, disagreement — and, yes, disagreeableness.

One might think that in the field of Administrative Law, such as Federal Disability Retirement law, where the singular issue is whether a Federal or Postal employee is eligible for Federal Disability Retirement benefits, that the level of confrontation and contentiousness may be limited.  It is not.

This is because the emotional, mental, financial and future security of an individual is at stake.  At any given moment in time, the client who is counting on getting an approval from the Office of Personnel Management, may feel the anguish of the wait.

It is up to the Attorney who represents the Federal or Postal employee to win the fight, and to know that so long as there is another day to fight, there is always a chance that the client will obtain the Federal Disability Retirement benefit that he or she rightfully deserves.  Today or tomorrow is another day to fight, and it is another day of contentiousness which is worth it, because that is what we are paid to do.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Complex Case

It goes without saying that each case of preparing and filing a Federal Disability Retirement application under FERS or CSRS is a “complex case”.  There are multiple intervening issues, including peripheral issues encompassing OWCP filings; issues with SSDI and whether to aggressively pursue it even with the offset and the lower cap for earnings; EEOC filings and collateral issues which may or may not have a direct impact upon the issues which must be focused upon in filing for Federal Disability Retirement benefits.  It is the job of an OPM Disability Attorney to tailor the issues, such that the peripheral issues do not overwhelm and dictate the centrality of a case; and to ensure that the central focus remains like a magnifying glass upon those issues which are relevant, not only to the client and to the entire process, but most importantly, to the person reviewing the case at the Office of Personnel Management.  Whenever an inquiry begins with the statement, “Mine is a rather complex case,” I realize that the primary job is to try and simplify the complexities, and that begins with narrowing the issue down to the single focus of the reason why the caller is calling in the first place:  the medical condition, and how that medical condition impacts one’s ability to perform one’s job.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Patience and the Attorney

Attorneys have limitations.  This may be a surprise to some people; many believe that because an attorney is involved, mountains can be moved and cases can be immediately resolved.  There are always “war stories” about the worker that X knows who filed a Federal Disability Retirement application under FERS or CSRS and got it approved within a couple of weeks, and got paid immediately the day after.  One should always be suspicious of such stories; they may or may not be true, but there is never a way to verify the truth, falsity or exaggeration of such stories without directly contacting the individual.

What is “known” for certainty is that the Office of Personnel Management is a large governmental entity; it moves slowly; “demanding” that something must get done immediately, merely because one is represented by an attorney, will not necessarily make it so.  If a client hires an OPM Disability Attorney because he or she thinks that the OPM Disability Retirement application will go to the front of the line and bypass all administrative obstacles, then there must be some misunderstanding.

A Federal Disability Attorney should be hired to represent a disabled Federal or Postal employee based upon the following criteria:  (1)  The application stands a better chance of approval at the first stage, and (2) in the event of a federal disability denial, a responsive rebuttal will continue to increase the chances of ultimate approval.  For, that is the point of legal representation — ultimate approval.

The “fight” may have many rounds; it is the ultimate round of success which the attorney is most concerned with, in order to secure the long-term future of the client. Yes, the immediate pain of waiting, of financial uncertainty, etc., is very trying, and hardships abound.  That is where patience must come in.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Law and Language

Language is the playground of the Attorney.  It is the heart and soul of his or her profession.  Through language, the attorney describes, delineates, argues, and provides a sequential (hopefully) rebuttal and attack upon any attempt by the “opposing” forces or the named “adversary” to undermine one’s logically structured application — in this case, an application for Federal Disability Retirement benefits under FERS or CSRS.  While logic and argumentation are the chosen methodology of attack, it is the stringing of descriptive words to create concepts; the sequencing of concepts in order to provide complex compounds of winning arguments; and the totality of language in order to convey meaning, persuade and bring about agreement. 

In Administrative Law arenas, especially in the law of Federal Disability Retirement, it is especially important to have the ability to describe, delineate, argue and persuade — because the package of persuasion is in written format — and the reader (a claims clerk at the Office of Personnel Management) does not know the disability retirement applicant personally, and only comes to know the issues, the person, the medical condition, and the intertwining compexity of the medical condition upon the person, through the words which are put together.  As such, how a Federal Disability Retirement packet is put together, which words are chosen, too few, too many, and what definitional arrows are meant to be conveyed, not only comprise part of a Federal Disability Retirement application; in many ways, it comprises the entirety of the process.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: The Appropriate Language Game

In filing an application for OPM Disability Retirement benefits under FERS or CSRS, there are many questions that are posed for the person who is just being introduced to the concept of potentially filing for Federal Disability Retirement benefits under FERS or CSRS, and many of the sub-topical concepts are often “counter-intuitive”.  This is because most people — including doctors and practicing lawyers — are unfamiliar with the laws, processes, procedures and regulations surrounding and governing Federal Disability Retirement laws under FERS and CSRS, but are instead familiar with the legal arenas of Social Security Disability, Veteran’s Administration disability benefits or Department of Labor, Office of Worker’s Compensation issues. 

In those “other” areas of legal specialties, there are doctors who simply specialize in making disability determinations — of evaluating a “patient”, determining the extent of the disability, having the Federal or Postal employee undergo a “Functional Capacity Evaluation“, and ascribing a “disability rating” and determining when, or if, the person has reached “Maximum Medical Improvement“.  Each arena of law has what Wittgenstein once coined as a “language game” — a specific set of language usage which applies only within a certain context, and those “other areas” of law are often inconsistent and foreign to the arena of Federal Disability Retirement issues under FERS or CSRS.  Often, when people call me, one of the first things I do is to set about “teaching” the caller the differences, distinctions, and inapplicability of one set of language games upon another set of language games, as well as how the two (or three) relate to each other.

Sincerely,

Robert R. McGill, Esquire

FERS Disability Retirement: Learning from Experience

The problems inherent in filing a Federal Disability Retirement application under FERS or CSRS are multi-fold and multi-tiered.  Even today, after years and years of practicing in this particular area of law, there is rarely a day which goes by that I haven’t learned something new — whether a slight wrinkle in OPM Disability Retirement law; whether in a nuance of a description of a particular medical condition; or in simply how a doctor has described a specific condition and its particular and unique impact upon a patient.  Experience comes from making mistakes; mistakes can be human, technical, or a combination of both.

Unfortunately, for the Federal or Postal worker who is filing, or contemplating filing, for Federal Disability Retirement benefits under FERS or CSRS, the process itself is essentially a “one-time” endeavor.  Yes, a person can theoretically file, then refile at a later time (side-stepping the issue of res judicata, which can, in most instances, be gotten around); but for the most part, a Federal or Postal employee who is filing for Federal Disability Retirement benefits is doing it once, and only once.

As such, it is NOT the time to obtain “experience” — i.e., there is little room for “learning” from “mistakes”.

There is “good experience” and “bad experience”, but both are experiences nonetheless.  In filing an application for Federal or USPS Disability Retirement benefits, however, it is the former which needs to be experienced, and not the latter, and in such a filing process, there is indeed a difference between the two.

Sincerely,

Robert R. McGill, Esquire

 

Federal and Postal Disability Retirement: The Lost Cause

For a lawyer, it is indeed the “lost cause” which is the most challenging of cases.  This is no less true in Federal Disability Retirement cases for Federal and Postal Employees under FERS & CSRS.  In fact, in some instances it is all-the-more-true, because there is necessarily involved a physical or psychiatric medical condition which makes the case all the more worthwhile in fighting for. 

The concept of the “lost cause” is evocative of the famous scene from Frank Capra’s classic movie, Mr. Smith Goes to Washington, of course; and no lawyer, no matter how good, should be so arrogant as to think that he or she meets with the standard of what Jimmy Stewart was fighting for.  For one thing, lawyers get paid for what they do.  Yet, it is indeed the “lost cause” cases which often spur the attorney in any area of law, with eagerness and pride. 

Whether to obtain Federal Disability retirement benefits for an individual who was wrongfully terminated for extraneous reasons; proving to the Judge that, despite post-termination medical documentation, one can and should logically extrapolate that the medical conditions existed prior to separation from Federal Service; to persuade the Office of Personnel Management that the Agency knew, or should have known, of the medical condition, and should have terminated the individual for his or her medical inability to perform one or more of the essential elements of one’s job, as opposed to the manner in which the Agency went forth; these are all microcosmic examples of “lost causes”; and it is indeed the lost cause which is the most challenging of cases for an attorney.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Arguing the Case

I recently wrote an article in FedSmith.com where I argued that the process of argumentation is often just as important as the substance of the argument itself.  For instance, technically speaking, the mere fact that a Federal or Postal employee under FERS or CSRS receives a proposed removal for one’s medical inability to perform one’s job, without actually being removed for that medical inability, does not accord one the Bruner Presumption.  And, indeed, there may be various valid reasons why a Federal Agency will hold off from actually removing an employee — often to the advantage of the Federal employee.

During such a “suspension” period (sort of like being in purgatory in the Federal sector) between having a proposed removal and actually being removed, while one may not obtain the advantage in a Federal Disability Retirement application of the Bruner Presumption, one can still argue that one is essentially entitled to the Bruner Presumption, and that is often just enough to win the argument.  Thus, as I argued in the FedSmith article, the process is sometimes just as effective as the substance of the argument.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Approvals & Disapprovals

Approvals of Federal Disability Retirement applications under FERS & CSRS, for an attorney who specializes exclusively in that area of law, are self-evidently a professionally satisfying bit of news.  If the OPM Disability approval occurs at the initial stage of the Federal Disability Retirement process, all the better; it means that everything was properly prepared and executed. 

Disapprovals, of course, constitute a temporary setback.  It is a disappointment.  Professionally, it means that the Office of Personnel Management found something wanting; it may not be substantive; it may be as simple as the OPM Representative being in a bad mood on a given day. At the same time, it is a challenge for the Attorney — a time to redouble one’s efforts, discern what is needed to win at the Reconsideration Stage, and win the full confidence of the client.  Winning a case only lasts for the day of the win.  Every attorney worth his or her salt wants to win every case. 

Watching the Olympics during these couple of weeks, it is interesting to see how “winning” is an inherently human desire.  But as with everything in life, it is not just winning; it is how one wins.  Watching each athlete conduct him or herself, it is interesting to observe how there are “winners for the moment”, and “winners in a greater-context-of-life”.  This is not to even discuss the “losers” — or those who believed they should have gotten a gold medal, but instead had to “settle” for silver or bronze.  How one loses at anything in life —  a sporting event, a contest, competition, or a legal case — and how one responds to the “loss”, is what is important.

Sincerely,

Robert R. McGill, Esquire