OPM Disability Retirement: The Administrative "Process"

I have previously written about how a Federal Disability Retirement application should be prepared:  that it should be looked upon as an administrative “process”, and as such, it is not like taking a test for a driver’s license, or filing an application to obtain a permit — both of which are similarly “administrative” issues.  The reason why filing for Federal Disability Retirement benefits under FERS or CSRS is different, and is a “process” as opposed to merely filing an “application” for something which will be essentially rubberstamped, is that it requires proof which must meet a certain statutory legal standard — it requires that one prove, by a preponderance of the evidence, that one is entitled to receive disability retirement benefits.  

Now, wherever “proof” of eligibility is required, there can be a disagreement as to whether or not such proof met the statutory eligibility requirements.  Other applications, such as filing for a Social Security Card, may also have certain statutory requirements, but normally such administrative applications are fairly “cut and dry” — such as, certain documents will be accepted to prove X, or certain forms may need to be filled out to obtain Y.  But where a legal standard of proof must be met, differences between the Applicant and the Agency may erupt. 

OPM may state, and argue, that the medical documentation, the Supervisor’s Statement, the Agency Certification of Accommodation efforts, the comparison between the applicant’s Statement of Disability and the doctor’s statements and notes — did not rise to the level of meeting the legal standard of “preponderance of the evidence”.  This is where many people get themselves into trouble — by thinking that it is merely an “application” to file in order to obtain an administrative benefit.  Then, when it gets denied at the first level, applicants become devastated, thinking that it is the end of the world.  From the outset, it should be looked at as a “process” — one which may take going to the Merit Systems Protection Board, or even further, to the Full Board Review, and then, if necessary, to the Federal Circuit Court of Appeals.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: Reasonable Accommodation by the Agency

Often, aside from having submitted insufficient medical documentation to support a Federal Disability retirement application, the Office of Personnel Management will deny a case based upon a statement submitted by the Supervisor, normally on SF 3112B (aptly entitled, “Supervisor’s Statement”).  Now, in preparing a Federal Disability Retirement application, I rarely worry about what will be on a Supervisor’s Statement, primarily because the applicant rarely has any control over the contents of the statement, anyway, and therefore to focus upon that which one has little or no control over, is simply a waste of time.  Instead, I focus upon obtaining an overwhelmingly convincing medical narrative report from the doctor, which then essentially makes the Supervisor’s Statement — if it is viewed somewhat as “negative evidence” by the Office of Personnel Management — a moot and irrelevant point of contention.  More often than not, when the Office of Personnel Management refers to the Supervisor’s Statement as revealing some basis for denying a disability retirement application, I find that OPM has either mis-read the import of the statement, or has selectively misquoted from the Supervisor’s Statement.  Remember that the law requires that the Agency provide a “reasonable accommodation”; more often than not, what the Supervisor or the Agency has provided, is neither “reasonable”, nor an “accommodation” under the law.  In any event, whether by misquote, unfair and selective reasoning, misreading, “unreasonable”, or not an “accommodation” at all, I rarely find that the Supervisor’s Statement is helpful or unhelpful; and, certainly, I have never found that a Supervisor’s Statement contains any substance which would or should be the basis of a denial from the Office of Personnel Management.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: SSA Approval, Part II

In order for an SSA approval to have an impact upon a Federal disability retirement application, the Social Security Administration’s decision letter granting benefits must provide a detailed explanation as to the basis for the approval, delineating the medical basis, the medical conditions upon which the decision was made, etc.  Thereafter, the applicant can submit the decision letter, but this is where it is important to have an attorney provide the proper legal & foundational argument — to provide the contextual applicability.

The legal basis, to start with, is found in Trevan v. Office of Personnel Management, 69 F.3d 520, 526-27 (Fed. Cir. 1995), in which the Federal Circuit Court found that in making a determination of eligibility for disability retirement, the Board (and thus, by analogy, OPM) must consider an award of SSA disability benefits together with medical evidence provided by the appellant to OPM, and other evidence of disability.  This is when an attorney’s tools of “argument by analogy” and pointing out the significant contextual language in an SSA decision letter comes in handy.  Next:  What if an SSA decision letter is not immediately forthcoming, or does not address the same medical conditions as that applied for in one’s disability retirement application?

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: Pragmatic Considerations

Often, pragmatic judgments and decisions must be considered at different stages of a disability retirement application. For instance, whether to submit all of the medical documentation in your possession is a discretionary judgment which needs to be considered. One might wonder why an applicant may withhold some or part of the medical documentation, and the answer is quite simple: if the Office of Personnel Management requests additional medical documentation, or it is rejected at the Initial Stage and further medical documentation needs to be submitted — if the applicant does not have additional medical documentation to submit, then there is very little incentive or basis for OPM to “reconsider” their position of denial.

Now, one might wonder, If the “additional” medical documentation had been submitted in the first place, perhaps OPM would never had requested more documentation, or perhaps they would have approved it to begin with. Not necessarily so. If you have already provided sufficient medical documentation to prove by a preponderance of the evidence your case, sometimes reserving that “extra” set of office or treatment notes is a wise decision. It may be the difference between being able to respond to OPM’s request for additional medical documentation, and not being able to — and the difference between an approval or a denial, and a basis for OPM to “reconsider” their position.

Sincerely,

Robert R. McGill, Esquire