Federal Employee Medical Retirement: The Bureaucratized Process

One cannot expect any entity, organization, or group of individuals to reinvent the wheel for each product, service or response; streamlining and repetitive conformity of a product, issuance or completion of a case is the way of the world; it is how the Model T became a successful capitalistic venture; it is how China dominates the world of marketing.  But in the world of Due Process, one cannot formulate a mass production of effective advocacy without trampling upon the rights of an individual.

Thus, on both sides of the process of preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, each case must be responded to in accordance with the specific, unique facts as constrained by the individual circumstances.

Conversely, one should expect — and demand of the U.S. Office of Personnel Management — that something more than a mere template of a response should be issued, after a careful and thorough review of a Federal Disability Retirement application.

If a FERS or CSRS Disability Retirement application is approved by OPM, then of course one can expect merely a letter of approval which is identical to thousands of others.  If denied, however, the denial letter should reflect a careful, thorough and individualized letter, reflecting the scrutiny of one’s particular disability retirement packet.

Anything less would be to trample upon one’s due process rights as a Federal or Postal employee.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Workers: Responding to OPM Templates

One can readily discern a template-based letter; it attempts to appear as if the denial is tailored to the particular set of circumstances and unique medical submissions of the Federal or Postal employee to whom the letter is addressed, but upon closer inspection, most of the language could to interchangeably utilized for anyone or everyone.

There may be a paragraph or two which quickly identifies or otherwise lists certain specific medical reports, with names of doctors and the dates of their reports; aside from such references, however, the rest is merely a template of language which is cut and pasted for purposes of justifying a denial.

Such is the administrative, bureaucratic approach of the U.S. Office of Personnel Management.  And, indeed, templates in and of themselves are not necessarily indicative of anything negative; for, as reinvention of the wheel should not be performed for each task engaged, so every Federal Disability Retirement application must meet a certain set of legal criteria, and to that extent they are “all the same”.  The problem in responding to a template-based denial from the U.S. Office of Personnel Management, however, is the disadvantage one is placed in for responding to such a Letter of Denial.  For, the template can contain multiple points which seemingly require a response, and which may appear overwhelming.

Don’t be fooled.  To address each and every point of contention is often to get mired into a level of minutiae which need not be engaged.  Take a wider view of things, and get some guidance and advice.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: “It May Sound Good”

There is the statutory legal criteria which is mandated by law, by case-law, and by regulatory dictum as to the proper application of review in making a determination on a Federal Disability Retirement application, whether under FERS or CSRS.  Yet, the question is whether or not the Office of Personnel Management has applied the proper legal criteria in making its determination, and the answer to such a question can only be evaluated based upon the language which is utilized by OPM in its denial letter. 

An approval letter issued by the Office of Personnel Management is entirely unrevealing, precisely because it is simply a template letter advising the approved Federal Disability Retirement annuitant of the next steps to follow.  However, when a denial letter is issued by the Office of Personnel Management, often the Claims Representative will insert language which “sounds good” and proper, and even convincing — but ultimately, wrong as far as the proper application of the law is concerned.  For example, OPM may assert with unequivocal brevity that there lacks “compelling medical evidence” in the Federal Disability Retirement application.  “Compelling” is not a legal criteria required by statute, case-law, or regulatory dictum.  As such, it is a meaningless word-usage.

Moreover, it is harmful to a case because it means that OPM applied a standard of review which is nowhere found in any statute.  Further, it gives an appearance of authenticity and authoritative credibility where none exists.  What to do about it?  It needs to be addressed and pointed out — but diplomatically.  Diplomacy is nothing more than a forceful rebuttal clothed in the finery of courtesy, but it is a necessary ingredient in establishing the proper tone and tenor of a response to OPM.

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

FERS & CSRS Disability Retirement for Federal and USPS Workers: The Cost of Doing Nothing

The Office of Personnel Management has been sending out a number of decisions, and many have been denials.  They seem to come in batches; whether by coincidence, or in systematic fashion, OPM has tended in recent months to send out denials which fail to explain, leaving aside any concept of “discussion“, the basis of their denials.  

The irony of having a section entitled, “Discussion”, then merely delineating a regurgitation of the “applicable criteria to be eligible for Disability Retirement benefits“, then making a conclusory & declarative statement somewhat in the form of:  “You do not meet criteria X and Y” is hardly a “discussion” of the issues.  Moreover, even in the denials which appear to be lengthy is the number of sentences, paragraphs or pages, the content is devoid of any substantive discussion of the issues.  It is more often simply a reference to a doctor, without any rational basis given as to what is lacking, but merely ending with a statement of conclusion, saying, “No objective medical evidence was provided,” or “The medical evidence does not show that…”  One would expect that a logical structure of reasons would be provided, but such an expectation would fall short of what actually occurs.  The real problem is that, in reading such a denial letter, one doesn’t know where to start, what to answer, or what additional information needs to be submitted.  Thus, you must “read between the lines”.  The cost of doing nothing is to get a further denial; that is simply not an option.  The best option is to reinforce what is already there.

Sincerely,

Robert R. McGill, Esquire