Tag Archives: claim for disabling condition non-work related compensation

OPM Disability Retirement: The Three Pockets

In discussing Federal Disability Retirement benefits under FERS or CSRS, it is important to keep in mind the conceptual distinction between the three “pockets” of compensatory programs or resources (and, not to confuse the issue further, but these three pockets are separate and apart from the 3-legs of the retirement stool envisioned under FERS — the FERS Retirement annuity, Social Security, and TSP).

The three primary pockets of compensatory programs include:  CSRS & FERS Disability Retirement (and its companion hybrid, the CSRS-Offset)  — all of which get recalculated at age 62 to regular retirement; SSDI (Social Security Disability which, under FERS, one must file for automatically as part of the process of submitting for FERS Disability Retirement benefits, but under CSRS, one does not need to); and finally, Department of Labor, Office of Worker’s Compensation Program.

The former two have direct interaction, inasmuch as one who falls under FERS Disability Retirement must also file for SSDI, and if both are accepted, there is an offset of benefits between the two (100% offset the first year of benefits, 60% offset every year thereafter until age 62).  The last of the three pockets, OWCP benefits, as I have stated on many occasions, is not a retirement system, but one may file for such benefits concurrently with filing for FERS or CSRS Disability Retirement benefits (but one must elect between OWCP benefits on the one hand, and FERS or CSRS retirement benefits on the other hand), have both approved, but cannot collect both concurrently.  There is an exception — and that has to do with a “scheduled award”.

While keeping these various benefits conceptually distinct can be rather confusing, it is important to understand the distinctions when contemplating filing for Federal Disability Retirement benefits under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Approvals & Disapprovals

The Office of Personnel Management seems to have recently issued a volume of decisions on Federal Disability Retirement applications on Federal and Postal employees under FERS & CSRS.

From the calls received from non-clients, and from clients, one sometimes wonders whether or not some sort of “quota-system” isn’t being imposed at the top levels.  Yet, statistically, the percentage of disapprovals v. approvals is not noticeably different than before; it is difficult to determine in any given period of time whether or not there is a higher rate of denials/disapprovals than approvals, in comparison to other periods.

What matters is not the general rate of approvals or disapprovals; rather, each individual case must be taken on its own merit, and responded to with the Office of Personnel Management (or, if the denial is at the Reconsideration Stage, then an appeal to the Merit Systems Protection Board) in a timely fashion, and in a tailored, appropriate manner.

Each case is indeed “different”.  One cannot compare one case with “war stories” about how X filed his or her application and got it approved “within a week”.  Such rumors can never be verified, and even if it could be verified, there are always individual and unique circumstances which must be taken into account.

Comparisons between different time periods, as well as between two or more independent cases, are never helpful; instead, the focus must be to take the uniqueness of any given case, and decide on the best course of action in order to obtain the one and only outcome which is acceptable for any given OPM Disability Retirement case under FERS or CSRS:  an ultimate approval.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Creativity Is Important In the Applicant’s Statement

It is important to creatively inter-weave facts, feelings, medical impact, symptoms and conditions into a persuasive Applicant’s Statement of Disability.  It should not be overly emotional; it should not be voluminously long; it should not be preachy; it should not be written as a doctor would write it.  It is the Applicant’s Statement of Disability, and it should be from the Applicant’s perspective; but as with every writing, the “audience” to whom anything is written, must always be kept in mind.  Remember that the audience is a reviewing Office of Personnel Management representative — one who is evaluating, analyzing, and making a decision upon the application for disability retirement. 

Of course the independent attachment of medical documentation will be persuasive; of course a review of the position description will have an impact; and of course the analysis of comparing the medical condition with the type of job one has will be scrutinized and will be relevant.  It is the applicant’s statement of disability, however, which will most often be the determining factor.  That is why such a statement must creatively weave all of the various aspects of a disability retirement application — facts, emotions, job impact, medical impact, doctor’s statement, personal statement, impact statement — all in a bundle, all inter-weaving, all in a persuasive, creative description.

Sincerely,

Robert R. McGill, Esquire

OPM Decisions of Denial in FERS & CSRS Disability Retirement Case

There are two elements: competency/knowledge, on the one hand, and authority/power on the other. When the two come together, we then have the combination resulting in a reasoned decision. It is indisputable that an Agency has the authority and power to make administrative decisions. On the other hand, if the Agency makes a decision without the proper competency or knowledge, then it can become a problem.

In reviewing a denial letter from the Office of Personnel Management in disability retirement cases, what is most disturbing are the following: First, 90% of the denial letter is based upon a computer template. The references to dates, medical reports & records reviewed, etc., comprise the remainder of the 10%.

Now, that is not to complain that OPM should or must “reinvent the wheel” each time it makes a decision — indeed, the fact that much of the decision is boilerplate, template language is not that disturbing. What is, disturbing, however, is when — under the pretense of competency and knowledge, it makes blatant mis-statements of the law.

Some of the mis-statements are: “The medical documentation does not show that you are totally disabled from performing your job.” There is no requirement under the law that a person needs to be “totally disabled”. Or: “We are unable to make a determination because of the lack of objective medical evidence.” Medical evidence does not need to be “objective” as opposed to a doctor’s reasoned medical opinions. Or: “Fibromyalgia is a condition which waxes and wanes.” OPM is not a medical facility and has no business making medical determinations or declarations.

The authority and power of an Agency must always be used in the context of competency and knowledge, and the Office of Personnel Management must make its decisions based upon the prevailing case laws, statutes and regulations which govern it. It is the job of a disability retirement attorney to point out such misstatements of law.

Sincerely,

Robert R. McGill, Esquire