Tag Archives: appeal to first OPM denial decision

OPM Disability Retirement Denials: Selective reasoning

Of course, we all engage in it; some, merely by withholding certain known facts; others, by emphasizing and asserting portions of the logic employed while ignoring or deliberately averting the focus of other aspects.  Selective reasoning through deliberate omission is the height of pragmatic oppression; for, when it is accomplished with knowledge and self-admission of premeditation, it involves a mind that knows the difference between proper application of logical reasoning and the intentional misrepresentation of facts.

We engage in such folly during the course of normal fights and argumentation; for, to win is the basis of arguing, and the ends often justify the means.  Logic is a learned tool.  It is the foundation of sound reasoning.  It is not an inherent, in-born or even in-bred character of man, but it can bring out the evil therein.

As a tool, those who are good at it have a greater responsibility to use it wisely, honestly and with proper motives.  It is the “selective” part of the reasoning that makes for honesty of dishonesty in the reasoning process, and the anomaly and irony, of course, is that the process itself — of reasoning — necessarily involves selectivity, for logical argumentation encapsulates proper and effective selection of facts, syllogistic approaches and propositional logic all bundled into one.

The U.S. Office of Personnel Management engages in selective reasoning, and their denials of Federal Disability Retirement applications reveal a level of such selectivity that one must conclude that it is being done intentionally and with deliberate knowledge.

Beware of denials; for, they try and make it appear as if you never had a chance to begin with in your FERS Disability Retirement application. OPM will selectively choose to extrapolate from various medical reports and records, and fail to mention or highlight the selective portions omitted, then reason that there was “insufficient” medical evidence despite facts and rational argumentation to the contrary.

Do not despair, and do not simply allow for the 30-day time period in which to file for Reconsideration to lapse; for it is precisely such selective reasoning that is meant to discourage, and to make you think that the denial is dismissively disproportionate so as to justify giving up altogether — which is precisely what their selective reasoning is meant to accomplish.

Sincerely,

Robert R. McGill, Esquire

 

Federal Disability Reconsiderations & Additional Medical Information

The denial comes in the mail; it is a further delay, a negation of prior efforts; for many, it undermines and constitutes a condemnation of sorts, and a refusal of an affirmation sought in places and from people where none is offered.  It is, after all, another piece of correspondence which negates the negative:  the medical condition itself and the loss of one’s ability to perform one or more of the essential elements of one’s job, represented the first foundation of negation; now, a denial from the U.S. Office of Personnel Management merely confirms, via a second negation, the loss of positive forces inherent in failure and Federal bureaucracies.

But all things in life must be kept in their proper perspective, and a reaction of disproportionate magnitude must be kept in check; life is often a series of mishaps; yes, it just seems that such unfortunate events happen to certain individuals, and as the old adage goes, when it rains, it pours.  Once the initial shock of the denial is withstood, then the trepidation and cautious perusal, followed by an obsessively careful scrutiny, of the reasons for the denial issued by the U.S. Office of Personnel Management, is engaged; but the futility of such efforts will become apparent.

The monotony and disinterested voice behind the volume of verbiage and almost bellicose verbosity becomes more than apparent: either the administrative specialist at the U.S. Office of Personnel Management did not read the medical file or, more likely, selectively chose to extrapolate statements and findings out of context in order to justify the denial of one’s Federal Disability Retirement application.

At this Second Stage of the process of trying to obtain Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether the Federal employee is under FERS or CSRS, it matters not what the words say with respect to the denial issued by OPM; the file is immediately transferred to a general, unassigned file, awaiting further instructions from the person to whom the denial has been issued:  if left unanswered, the file will disappear within the cauldrons of bureaucratic warehouses; if a Request for Reconsideration is timely filed, then it will ultimately be assigned to someone in the Reconsideration Division at OPM; but, in either case, it is no longer the responsibility of the OPM representative who issued the denial, and no amount of phone calls, venting or sending of additional information to that person will make a whit of difference, until (a) the Request for Reconsideration is timely filed, and (b) the Federal or Postal employee addresses some of the concerns brought up in the denial itself.

The Reconsideration process itself is fraught with dangers and potential pitfalls; it confirms that perhaps the Federal or Postal employee should have sought the advice, counsel and guidance of an attorney who specializes in Federal Disability Retirement law, but moreover, as most mistakes are correctable, it may be a wise avenue of choice to seek legal assistance, finally.

In any event, time factors must be considered, and the time lost today by extension of a denial, further confirms the oldest adage of all, that being penny wise is to be pound foolish,  a saying that is often attributed to Benjamin Franklin, but can be traced to those earlier.

Sincerely,

Robert R. McGill, Esquire

 

OPM Disability Retirement: The Response to the Denial & Properly Reading the Signs

Responding to an OPM Disability Retirement application denial is fraught with dangers of addressing the right issue; whether such a response does so adequately; and the determination of the extent of what constitutes “adequacy” in such a response.  Properly reading the “road signs” is the key to a successful response.  For, to begin with, cogency and brevity are not characteristics which are common in an OPM Disability Retirement denial.

The U.S. Office of Personnel Management utilizes multiple templates in referring to the sufficiency of legal and documentary proof, and will often shift arbitrarily in declaring why, and to what extent, a Federal or Postal disability retirement application did not meet the standard of proof required, which is governed by a “preponderance of the evidence”.  They will, of course, often cite various legal “criteria”, and number them accordingly, as in:  “You did not meet Criteria Number 4 in that…”

In responding, it is important to address the critical issues which OPM regards as central to its decision, and as all roads lead back to Rome, so it is with a response to a denial from the U.S. Office of Personnel Management in a Federal Disability Retirement case: All roads lead back to the original nexus of whether a Federal or Postal employee can perform all of the essential elements of one’s job within the context of the severity and extent of one’s medical conditions, and to the issue of whether or not a “reasonable” accommodation could have been provided by the individual’s agency.

Broken down into its foundational components, the pathways can be ultimately discerned, and the proverbial fork-in-the-road leading one to the right way back to Rome will often depend upon how the traveler interprets the signs.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: Proper Responses

A receipt of a denial from the Office of Personnel Management to a Federal Disability Retirement application under either FERS or CSRS is always an event which is upsetting to a Federal or Postal employee, but it is “part of the process” which occurs often enough.  

If it is a second denial (where a Request for Reconsideration has already been accomplished, and the Office of Personnel Management has denied it again), then the only appropriate response is to file an appeal to the Merit Systems Protection Board (no response is required, or even appropriate, to OPM, as it is out of their jurisdictional purview upon denying it a second time).  

If it is a “first denial“, then a “Request for Reconsideration” must be filed within thirty (30) days of the date of the denial letter (one can argue that the 30 days should be counted from the date of receipt, but it is always better to be on the safe side), and if requested, an additional thirty (30) days is automatically granted in order to have sufficient time to gather and submit further documentation to rebut and answer the denial from the Office of Personnel Management.

Submission of the Request for Reconsideration, and participation in the process of having the Office of Personnel Management reconsider the initial denial, is mandatory, not elective.  By this is meant the following:  You cannot bypass or skip the Reconsideration Stage and jump directly to the MSPB; you must first get a decision on the Request for Reconsideration before the Merit Systems Protection Board will consider your case.  

You cannot get angry or reactive and declare, “I will just file an appeal to the MSPB and have an Administrative Judge look at my case”.  You must patiently go through the proper channels of justice, and respond accordingly.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement for Federal Workers: The Office of Personnel Management

The Office of Personnel Management (OPM) , located in Washington, D.C., is the agency which makes the decision on all Federal Disability Retirement applications, whether under FERS, CSRS or CSRS-Offset.  They are the responsible agency for the first two “stages” of the process of attempting to show eligibility and entitlement to a Federal Disability Retirement annuity.  By “stages” is merely meant the initial application stage of the process, as well as the second, “Reconsideration” stage of the process — where a Federal or Postal employee has the right to, within 30 days of an initial denial of a Federal Disability Retirement application, request that his or her case be “reconsidered”, and further have the right to submit any additional medical or other supporting documentation for review and consideration. 

If the case is denied a second time by the Office of Personnel Management, then the Federal or Postal employee who has filed the Federal Disability Retirement application, or the attorney representing the Federal or Postal employee, has a right to file an appeal to the Merit Systems Protection Board.  The Office of Personnel Management is taking quite a long time in making a decision on a Federal Disability Retirement application, and although they are attempting to get caught up with their workload, the volume of cases filed and received by OPM on a weekly basis has made such an attempt difficult.  As has been stated by this author many times, Patience is a virtue, and as such, Federal and Postal employees must be the most virtuous of all, because patience is what is needed to endure and survive the process.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: The Denial Letter

During this Holiday Season when Federal and Postal employees who have filed for Federal Disability Retirement benefits under FERS or CSRS, who are anxiously awaiting the decision from the Office of Personnel Management, a denial letter from OPM can appear disproportionately devastating.  Christmas and the New Year tend to bring difficulties precisely because it is seen as a season of celebration, when families get together, where work continues, but an expectation of being “joyous” pervades.  At such a time, a denial of a Federal Disability Retirement application from the Office of Personnel Management can be a seeming conclusion to a long wait.  It is not.  

Do not become discouraged just because someone at OPM has “decided” that your Federal Disability Retirement application did not “meet” the legal criteria.  Set the denial letter aside for a day or two (so long as it is not nearing the 30-day period to either file for Reconsideration or an appeal).  Then, proceed to fight it.  

Don’t let the Holiday Season become confused with the right to file for, be eligible for, and be entitled to Federal Disability Retirement benefits under FERS or CSRS.  The filing of an application for Federal Disability Retirement benefits is a process which may take 6 – 8 months, or longer if it is needed to go to the Reconsideration Stage, or to the Merit Systems Protection Board.  

Do not get discouraged; instead, fight for your benefits.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Government Employees: Initial Application, Reconsideration & MSPB Appeals

Each Stage of the process in attempting to obtain a Federal Disability Retirement application under FERS or CSRS offers a distinct, yet similar, challenge.  Do not be fooled by responding to a “template” approach; while the Office of Personnel Management may respond in an indifferent, antiseptic manner, a Federal or Postal employee who must respond to OPM’s denial at each stage of the process must pinpoint what OPM is looking for, and respond appropriately.  Indeed, it is the distinction which one observes, which makes all of the difference in the case.  

Often, it is clear that OPM’s denial at the Initial Stage of the process, as well as a denial at the Reconsideration Stage of the process (which then compels an appeal to the Merit Systems Protection Board), is merely a regurgitation of thousands of previous denial letters, with some minor insertions which are meant to appear “as if” the denial letter has been tailored to a particular case.  

Thus, references to a particular physician’s letter, and even extrapolating a quotation from a doctor’s note or narrative (often something like, “Your doctor stated that you were recovering well from your surgery,” or “Your psychiatrist stated that the medications were working”) have the effect of personalizing a denial letter.  Yet, the remainder of the denial letter is in an antiseptic, template form, and it is clear that you are merely one of hundreds & thousands of responses written by OPM’s representative.  However, while OPM has the power to generate such template-driven denials, the individual Federal or Postal Worker must respond in an independent, individualistic manner.  It must be based upon one’s particular case, and thus the response must not be a “generic” one, but one based upon the uniqueness of the case.

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

FERS & CSRS Disability Retirement for Federal and USPS Workers: The Wait Seems Longer

For those waiting for their Federal Disability Retirement application under FERS or CSRS, pending before the Office of Personnel Management, the wait seems to be getting longer and longer.  Whether at the initial stage of the application process, or at the Reconsideration Stage, OPM is taking longer to make a decision on a pending application.  Everyone, of course, wants his or her application to be the next in line; and, indeed, it is all the more frustrating when an applicant is told that a decision will be made “within the next 2 weeks”, and after the 2-week period comes and passes, still no decision. 

What makes it worse is that, even after an approval, there seems to be longer delays in processing the approved application before payment is received.  Further, even after the “interim” payments begin, there appears to be a longer wait before a case is “finalized” for payment processing.  Each period of delay results in a ripple-effect throughout the system as a whole, and indeed, in these economic times of hardship, it  places an even greater burden upon those who need the financial benefit most — those who are disabled, and who rely upon the benefit of disability retirement payments for their very livelihood.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: The Strategy of Disheartening the Opposition

When Federal and Postal employees who have filed for FERS Medical Retirement benefits and have been denied at the initial stage of the process, many are sincerely disheartened.

In my initial contact with the denied applicant, there are multiple levels of reactions, including:  the denial letter points to legal criteria which they were unaware of; it refers to doctors notations which are taken completely out of context; they have completely ignored major portions of what the doctor has stated; OPM points to legal criteria which has been met, but which OPM simply denies that it has been met.

What can be done?  This is the strategy of disheartening the opposition.

In other denials, it is simply a matter of referring to a doctor’s report here, and to a medical notation there; then to simply declare:  You have not submitted sufficient medical documentation and fail to meet the legal criteria to be eligible for Federal Disability Retirement benefits.

What can be done?  No explanation; just scant references, then a unilateral declaration.  Again, this is the strategy of disheartening the opposition.  What to do?  Don’t get disheartened.  Respond.

Sincerely,

Robert R. McGill, Esquire