Federal and Postal Disability Retirement: Sufficiency of Evidence

At what point is the sufficiency test satisfied?  Who determines when the bathtub is full enough in order to bathe?  What constitutes the threshold of being gluttonous on Thanksgiving, as opposed to having had a hearty meal? And, for a FERS or CSRS Disability Retirement application, what standard determines whether or not a person has submitted evidence sufficient to meet the preponderance of the evidence test, in order to persuade the U.S. Office of Personnel Management that a Federal Disability Retirement application has met its burden, and that the Federal or Postal employee is therefore eligible and entitled to receive an approval and a subsequent annuity?

Clearly, it cannot be mere volume of medical reports and records; for, otherwise, cases with barely a dozen pages of a report, diagnostic test results and some office notes would not pass through the scrutiny of the OPM Caseworker.  If not volume, then is it the quality of the report and records?  Here, too, while a well-documented file may generally meet the sufficiency test, there are times when OPM will insist upon treatment notes for the past 18 – 24 months before considering a case for approval.

The sufficiency test is often an admixture of quality, quantity, and a compendium of selectively highlighted documentation which, in their totality, prove an OPM Federal Disability Retirement case.  There are no two cases alike, though similarities may abound.  Each case must be seen in its own unique light, and within that context, a case must be carefully constructed and compiled.  Only in this manner and approach will the sufficiency test be met, and only after a careful and thorough review of the facts, issues and particular uniqueness of a given case — somewhat in a reflectively similar manner as OPM will do in reviewing the submitted case.

Sincerely,

Robert R. McGill, Esquire

 

Medical Retirement Benefits for US Government Employees: Physicians

Physicians are peculiar animals.  They are here to help; and from their perspective, success is measured in terms of how rarely a patient returns for further care.  The ultimate sentence of failure is to conclude that nothing further can be done for an individual, and one must therefore declare that the patient is permanently disabled.

For the Federal or Postal employee contemplating filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, such a perspective on the part of the physician is important before approaching the treating doctor with a request for a medical report.  That is why the SF 3112C is such an ineffective vehicle of communication.

Consider this:  SF 3112C is a government-prepared form; it is formulated by Federal bureaucrats; the language merely proposes generic guidelines concerning what is required — without any amendments or consideration of case-law refinements which have been promulgated over the evolution of Federal Disability Retirement laws over these many years.

Perhaps more importantly, however, is the lack of bedside manners in handing to a physician a standard form.  While many physicians themselves lack adequate bedside manners, it is the epitome of bad form to thrust a pre-printed form (no pun intended) under the nose of a physician who is supposed to be treating and taking care of you, and to declaratively order, “Fill this out”.  Even an addendum of “please” will not adequately modify such an affront.

The physician-patient relationship is one based upon communication, knowledge, personal sharing, and a good bit of explaining.  Taking the time to prepare a physician is the least one should do in preparing for an effective Federal Disability Retirement application.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for US Government Employees: The Narrative of Emotion

Often, when one has been embroiled in a prolonged battle with another person, an organization, agency, etc., the embattled state itself takes on a life of its own, and decisions which should be based upon a rational perspective, what is in one’s best interest, etc., are cast aside.  That is why divorce proceedings — ones which involve little children — are such traumatic events to witness.  But domestic relations litigation is not the only type of proceedings which tear at one’s soul.

Often, a Federal or Postal employee will be involved in countless years of procedural and administrative litigation — including EEO filings, formal grievances, lawsuits filed in Federal courts, etc. — which take their toll upon one’s family, one’s career, and one’s health.  Sometimes, the engagement of litigation becomes a way of life, and the daily turmoil constitutes the norm by which one lives.

When one’s health is impacted, however, the Federal or Postal Worker who considers filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, will sometimes allow for the years of battle to cloud one’s judgment.  While historical narratives concerning the background of one’s medical conditions may be somewhat appropriate in preparing and formulating one’s Federal Disability Retirement Applicant’s Statement of Disability, one should be cautious in filing a narrative of emotion — that exhaustive rant against a particular supervisor or coworker; against the agency; and against the world which has turned into an enemy of daily turmoil and emotional upheaval.

Focus upon the essence of a Federal Disability case.  It may be time to leave behind that prolonged state of embattlement, and find a quiet spot in the pasture of one’s future, and enjoy a day of peace by securing one’s future with a Federal Disability Retirement annuity.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Alternatives and the Sense of Guilt

In the course of speaking with thousands of Federal and Postal employees over the years, with those who are contemplating filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, both under FERS & CSRS, two prevailing themes often overshadow the discourse:  the sense that there are few alternatives left because of the impact of one’s medical condition upon one’s ability/inability to continue to pursue the intended career-course of one’s life; and secondly, a sense of guilt (or sometimes interpreted as shame) that such a course of action triggers.

The former response (that there are limited alternatives remaining) can often be resolved by a change of perspective:  To accept one’s medical condition, while difficult, is a reality which must be embraced, and in doing so, to be open to a change in vocation and previously-set view of where one wants to go in life.

The latter — of having a sense of guilt or shame for considering the course of filing for Federal Disability Retirement benefits — is often a result of misunderstanding the option of Federal Disability Retirement.  For, Federal Disability Retirement under FERS or CSRS is merely part of one’s compensation package which one signed onto when you became a Federal or Postal employee.  It is not an acceptance of defeat; it is not a resignation from one’s goals; rather, it is an avenue to embrace a course of rehabilitative stage of life in order to be able to recover sufficiently to pursue a different vocation and a different course of action in one’s life.

To remain steadfast and have a sense of fidelity is indeed an honorable thing; but to remain steadfast on a train bound for disaster, is merely a stubborn trait of foolhardiness.

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

OPM Disability Retirement: Choosing the Right Perspective

In filing an application for Federal Disability Retirement benefits under FERS or CSRS, it is important to keep in mind the differing and different perspectives that are involved in the entire process — including (but not limited to) the Agency’s perspective, the doctor’s, the view from the Office of Personnel Management; and not the least of which, is the perpective of the Applicant.  Out of all of the differing and different perspectives, while the applicant may have some persuasive input on the others, there is only one perspective where one has full control and authority over — that of the applicant filing for Federal Disability Retirement benefits under FERS or CSRS.  Thus, with that in mind, the applicant has various choices —  to select a tone, demeanor and approach on a wide spectrum where on the one side is the “purely subjective” and on the extreme other side is the “purely objective” (assuming, of course, that there is such an animal as that called “purely objective”).  This has to do with the tone of the application, which will influence the content to some extent.  More discussion later.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Differing Perspectives

The old adage, “Walk in your fellow man’s shoes for a mile” is a saying which is meant essentially to teach a child (and many adults) to have a different perspective than one’s own, self-centered universe.  In practicing law, it is a good idea to attempt to obtain a perspective from the multitude of differing “shoes” — and this is especially important in putting together a Federal Disability Retirement application under FERS or CSRS. 

The gathering of such differing and different perspectives — that of the treating doctor; that of the applicant; that of the Agency (the Supervisor and the Agency in its determination that accommodation or reassignment is not available or appropriate for a given employee, given the particular medical conditions and the type of positional duties of the specific job which the Applicant must perform, as well as taking into account what constitutes “efficiency” in the Federal Service, etc.); and further, that of the Office of Personnel Management. 

It is the job of the Attorney representing a Federal or Postal employee in preparing a Federal Disability Retirement packet under FERS or CSRS, to pull together the various perspectives; write up and prepare, and gather the information from the multiple and differing perspectives; to neutralize those perspectives which may impact negatively upon the Federal disability retirement application; then to present the fullness of the different perspectives such that it meets the legal criteria and “perspective” of the Representative from the Office of Personnel Management:  that “ultimate” perspective which determines a “yes” or “no” in determining the viability of a Federal Disability Retirement Application.

Sincerely,

Robert R. McGill, Esquire