Federal Employee Disability Information: OPM’s Methodology

There may be a single criteria to meet, with subsets of requirements that must be complied with; yet, multiple methodologies in approaching the singular.  How can that be?  Isn’t it all simple, where you read what is required, then gather up all of the evidence that appears to meet it and simply send it all in?  That is the “volume methodology”.

Can a single sentence in a medical report ever meet the legal criteria in an OPM Disability Retirement case — i.e., a “qualitative” methodology, as opposed to a quantitative one?  Sometimes.

Isn’t the law clear in what is required, and isn’t it a matter of just amassing the medical evidence to meet the requirements as stated?  Hmmm…. For Federal employees and U.S. Postal workers who suffer from a medical condition such that the medical conditions prevent the Federal or Postal employee from performing one or more of the essential elements of one’s Federal or Postal job, it is important to understand, somewhat, OPM’s Methodology in reviewing and deciding upon a case.

First of all, not all medical conditions are equal.  Perhaps that is self-evident, but for the Federal or Postal employee who suffers from one or another medical condition, and must endure the daily pain, restriction and limitations imposed thereby, it may not be so self-evident.

Second, OPM is not some “neutral” Federal Agency that reviews a Federal Disability Retirement application with dispassionate objectivity, ready to grant an “approval” because you “believe” your medical evidence is “sufficient” to meet the legal requirements as stated.  Sufficiency is the gatekeeper that denies many a Federal Disability Retirement case — and it is not a methodology that is satisfied by quantitative (volume) means, not even necessarily by qualitative standards; rather, it is the reviewer (i.e., the “Medical Specialist” at OPM) who determines by some unknown and unknowable standard when the goal-post has been crossed.

Thus, in an OPM Disability Denial Letter, one may read a reference to one’s doctor’s note or a quotation from a medical report from one’s doctor, and think, “Good, this is very supportive” —then, with an appended end to the paragraph stating, “Such medical evidence does not sufficiently meet the standards to qualify for OPM Disability Retirement”.  Huh?

Think about it this way: “Sufficiency” may mean different things to different audiences; for example, what is a “sufficient” amount of food for a lion, as opposed to a domesticated kitten?

OPM’s methodology is, at best, malleable, as language in law is likewise changeable.  It is good to know this for Federal and Postal employees who are either getting ready to file for Federal Disability Retirement benefits, or who are in the middle of a fight to obtain it; for, in the end, consulting with an OPM Disability Retirement lawyer allows you to arm yourself with knowledge for the battle that OPM’s Methodology in determining Federal Disability Retirement cases must be prepared, like any legal battle that involves “criteria” to be interpreted.

Sincerely,

Robert R. McGill, Esquire

 

OPM Disability Benefits: The Afterthought

It is perhaps best that anticipatory planning, based upon predictive analytics, is an afterthought for human intuition and predilection of priorities in life.  Otherwise, one can remain in a world of obsessive preventative maintenance of efforts, and never accomplish what needs to be done today.

Future forebodings aside, and whether an individual engages in hazardous duties which exponentially increase the statistical curve for the onset of an occupational disease or injury, or the development of a medical condition through repetitive and overuse of a particular appendage or anatomy; regardless, the bifurcation of thought from the daily aches and pains from one’s body, warning of impending and future difficulties, is ignored and banished, to be reflected upon in some future corner of pondering.

Human beings have an almost unlimited capacity for relegating present concerns to the realm of an afterthought, and the benefit of disability retirement will naturally take a backseat for those in the youthful set, precisely because disability is associated with thoughts of avoidance, sort of in the company of old age, infirmity, and early onset of dementia.  As well it should be.  But for Federal employees and U.S. Postal workers who find themselves with a medical condition, such that the medical condition begins to impact one’s ability and capacity to perform all of the essential elements of one’s job, and therefore becomes a threat to one’s livelihood, the afterthought becomes the primary issue, and it is then that one sounds a heavy sigh of relief in knowing that an employment benefit includes a Federal Disability Retirement packet.  But once the acknowledgment comes to the fore, the reality further hits one, that you must prove your case, and it is not merely a matter of entitlement.

Federal Disability Retirement, filed through one’s agency if you are not separated for over 31 days, must ultimately arrive at the doorstep of the U.S. Office of Personnel Management, whether you are under FERS, CSRS or CSRS Offset.  OPM is the agency which makes the decision upon a Federal Disability Retirement application (and that’s the reason why this medical benefit is also known as ”OPM Disability Retirement”).

While there are minimum time in-service requirements (18 months under FERS and 5 years under CSRS), it is the compendium of proving one’s case under the legal standard of preponderance of the evidence, which must be submitted in order to win.  Afterthoughts are human evolutionary means of avoiding unseen dangers; but when the afterthought becomes a present danger, it is time to become aware of the surroundings, context, and content of the formidable opponent one must face.

Sincerely,

Robert R. McGill, Esquire