Misnomers and the OPM’s Disability, Reconsideration & Appeals Division

The problem with misnomers is not just the inaccuracy of designation which is either explicitly or implicitly conveyed, but the unintended consequences of the string of reactions and responses which can occur as a result thereof.  Sometimes, interpretive mistakes occur purely on a subjective basis; in which case it is not truly a case of a misnomer, but rather merely the misunderstanding by the recipient of the information.  Other times, a word or designation can be open to multiple meanings, where reasonable people can differ on the inferences to be made.

For Federal and Postal employees who have filed for Federal Disability Retirement benefits through the U.S. Office of Personnel Management, whether the Federal or Postal Service employee is under FERS or CSRS (such acronyms have specific, esoteric meanings only to Federal or Postal employees, and as such, cannot constitute an objective misnomer, but rather a potentially subjective one), the complexity of the administrative and bureaucratic process can result in the failure to recognize and properly respond to various misnomers throughout the process.

For example, when a Federal Disability Retirement case is assigned to an Administrative Specialist at the U.S. Office of Personnel Management, and one receives a letter informing the Federal or Postal Disability Retirement applicant that X is further needed — the identification of the OPM Representative that he or she is from the “Disability, Reconsideration & Appeals Division” is both confusing and a misnomer.

For, the recipient of the letter (and just to receive any correspondence from OPM other than an approval letter or a denial letter is an amazing fact in and of itself) can well infer from the designation that his or her Federal Disability Retirement application has already been denied without notification (i.e., because it is in the “Reconsideration & Appeals Division”). In fact, all cases fall under the aegis of “Disability, Reconsideration & Appeals” section of the U.S. Office of Personnel Management.

Misnomers may be unintended. It is the recipient and the responder who must, unfortunately, live with the consequences.

Sincerely,

Robert R. McGill, Esquire

 

Medical Retirement Benefits for US Government Employees: Sounds Good

There are various stages of the administrative process designated and defined as “Federal Disability Retirement” — the initial application stage of the process, where one must attempt to prove by a preponderance of the evidence that one is eligible for Federal Disability Retirement benefits; if disapproved and denied, then the Reconsideration Stage of the process (where one may submit additional medical and other documentary evidence to persuade the Office of Personnel Management to reverse themselves); an appeal to the U.S. Merit Systems Protection Board, where the Federal or Postal applicant’s Disability Retirement application is taken out of the hands of OPM and transferred to an Administrative Judge, who will hear the case anew, without regard to what OPM has decided in the past; a further appeal to the Full Board of the MSPB in the event that the Administrative Judge issues an Initial Decision which affirms and upholds OPM’s denial of the case; and a further appeal to the Federal Court of Appeals for the Federal Circuit.

Throughout this process, and especially in the administrative stages before the Office of Personnel Management, one should make a distinction between “sounding good” and “being right”.  Hopefully, the Federal or Postal employee who has filed for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, is both right and sounding good. But there is a distinction to be made.  For example, OPM will often — in their denial letter — “sound good” but be completely wrong on the law.  They will cite medical textbooks which skew the legal standard of review; creep into the discussion of a denial letter such terms as “no significant disability rating to speak of,” or that you don’t suffer from a disability which “incapacitates” you.  It all “sounds good”, but it is not true precisely because it is not the applicable standard of law to be applied.

At the initial stages of the process, OPM can get away with such nonsense, because most people don’t recognize the untrue and inapplicable standard of law being applied.  In the later stages of the process, however, when an Administrative Judge hears a case, it becomes important not only to “sound good”, but to also apply the right legal criteria.

Appearance versus reality — it is the argument of Western Civilization from the pre-Socratics onward.  As Alfred North Whitehead once observed, all of philosophy was already written by Plato and footnoted by Aristotle.  That statement both sounds good, and is indeed right on point.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: The Human Factor

In preparing, formulating and filing a Federal disability Retirement application under FERS or CSRS, the self-contradiction involved in the entire process is that the Federal Disability Retirement packet is being submitted as a “paper presentation” to people at the Office of Personnel Management, yet, concurrently, the preparation of the submission is done with the intent of eliminating the “human factor”, and instead to meet all of the critical elements and the legal burden of proof.  

The human factor necessarily involves human elements, and therefore the potential for errors.  There is no mathematical formula in preparing a Federal Disability Retirement application.  It is not an exact science, and one cannot predict the guarantee of a Federal Disability Retirement application as to its approval.  

Because of the human element involved, one can only attempt to formulate the packet by inoculating against the potential of human errors, and that means that one must understand and interpret all of the legal criteria which are necessary for a successful approach to the process.  The human factor is countered by more human factors — that is why there is a process of appeals — before administrative judges, and Judges at the U.S. Court of Appeals for the Federal Circuit.  The appellate process is a further attempt to review the possibility of human errors, and an attempt to correct such human errors.  

If there was a mathematical construct which could precisely determine the eligibility of each Federal Disability Retirement submission, and there was unanimous agreement that the computer model was fair and without error, perhaps such a computer program will one day make the determination of an approval or denial of a Federal Disability Retirement application.  That is doubtful, however, because we are dealing with human beings, human medical conditions, and human suffering.  As such, the human factor can never be entirely eliminated, and nor should it.

Sincerely,

Robert R. McGill, Esquire

Early Retirement for Disabled Federal Workers: The Appeals

While it is often stated that a Federal Disability Retirement application has three (3) stages to the process, there are additional appellate stages which must be considered, and certain additional steps and actions must be undertaken, in order to preserve the viability of the final two stages of the process.  The initial three stages are comprised of the (A) Initial Application Stage of the process in preparing and filing for Federal Disability Retirement benefits under FERS & CSRS; then (B) if it is denied at the Initial Stage, there is the Reconsideration Stage, where one may submit additional medical documentation and legal arguments, and finally (C) an appeal to the Merit Systems Protection Board, which takes the Federal Disability Retirement application out of the control and hands of the Office of Personnel Management, and allows for an Administrative Judge at the MSPB to hold a Hearing and make a determination.  

The two additional stages of the process for Federal and Postal workers who have filed for Federal Disability Retirement benefits, are:  (1)  a Petition for Full Review (which I recommend should be taken, in the event of a further denial by the Administrative Judge at the MSPB Appeal) and (2) the U.S. Court of Appeals for the Federal Circuit (which can be filed with directly after being denied at the MSPB level, skipping over the Petition for Full Review).  The last two stages of the process — the Petition for Full Review and the U.S. Court of Appeals for the Federal Circuit — will not consider any “new evidence” (except in some rare instances), but will be a review as to whether any error of law occurred.  As such, all of the previous steps of the process would be reviewed, and that is why at each and every step, it is important to know what is important in preserving one’s right to an appeal, what is a basis for an appeal, etc.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: Decisions during the Process

In making decisions during the process of filing for Federal Disability Retirement benefits under FERS or CSRS, it is obviously important to make the “right decision” at each stage of the process.  Thus, for example, if a person files for Federal Disability Retirement, at the first stage it is important to determine which medical conditions to identify and base the application upon; at the Second, Reconsideration Stage, it is important to first identify what substantive concerns which the Office of Personnel Management is proposing (in any given denial of a Federal Disability Retirement case, it is often not that obvious what the OPM Representative is actually stating), and how to go about rebutting and answering the concerns (as opposed to taking a “shotgun approach” and trying to answer each and every concern expressed by the OPM Representative), and further, at the Merit Systems Protection Board, it is vitally important to place all evidence, legal precedents, arguments and objections on the record, so that if the Administrative Judge in the case denies your claim, you have a legal basis to file an appeal.  As always, it is important to see the entire application submission, from beginning to end, as a “process”.

Sincerely,

Robert R. McGill, Esquire