Postal and Federal Disability Retirement: Last Minute Filings

Waiting until the very last moment in order to file a Federal Disability Retirement application is often an inevitable reflection of the medical condition itself; whether because the thought and act of filing contributes to the exacerbation of one’s condition, or because the severity of the medical condition impedes and presents an obstacle to proceeding, are somewhat irrelevant in the end; whichever may be the case, the fact is that the admixture of medical conditions, Statute of Limitations, and the need to obtain Federal Disability Retirement benefits, do not cohere well, and something inevitably suffers as a consequence.  But the law is impervious to excuses of filing inaction (with some narrow and specific exceptions); and society’s view is that a limit must be imposed at some point.

Thus:  For filing a Federal Disability Retirement application through the U.S. Office of Personnel Management, whether the Federal or Postal employee is under FERS or CSRS, the Federal or Post Office employee must file the application for Federal Medical Retirement benefits within one (1) year of being separated from Federal service.  Waiting until the last minute can have some inherent and deleterious consequences, and failing to be attuned to them can come back to haunt one at a later date.

For example: Since one has waited until the last moment to file, once an OPM Disability Retirement application is filed, there will be little to no chance of amending the application (note:  “amending” is not synonymous with “supplementing”), as one no longer has the luxury of withdrawing a Federal Disability Retirement application, amending, and refiling; for, in the meantime, the Statute of Limitations has presumably come and passed.

Filing for Federal Disability Retirement benefits and waiting until the last possible moment is, unfortunately, a reality reflecting the often anxiety-filled state of affairs, both for the individual and the pressure to file on time; with that being said, it is nevertheless a reality which must be faced, and handled in the best possible manner under the given circumstances.

Sincerely,

Robert R. McGill, Esquire

 

Postal and Federal Disability Retirement: The Independence of Each Program

The disparate nature of each Federal program, with little to no intersecting coordination amongst them (with the exception of SSDI and FERS Disability Retirement benefits in the coordination of payments upon approval of each) betrays the unplanned, thoughtless creation of each program, as well as a sense that each agency wants to maintain its feudal control and assertion of independent power.

That perhaps explains, in part, why each program ignores the extent of persuasive authority the approval of another program should logically have, upon an approval and acceptance by the “other” program.  Does it make sense that being granted “unemployability” status under the Department of Veterans Affairs ascription of percentage disability ratings would only have a nominal impact upon a FERS Disability Retirement application?  Or that an SSDI approval would have, at best, a persuasive effect upon a FERS Disability Retirement?

It is somewhat more understandable that a case accepted by OWCP/Department of Labor would have minimal impact upon a FERS or CSRS Disability Retirement application, precisely because the former is set up as a program of rehabilitation in an effort to return the Federal or Postal employee back to his or her job.

The only true “coordination” of benefits occurs between SSDI and FERS — and that, only if both are approved, and payments are received concurrently; but even then, there are often overpayment problems, lack of the left hand knowing what the right hand is doing, etc.

Thus Coordination and intersection between departments, agencies and various programs rarely occurs.  Agencies tend to want to remain independent.

Such lack of coordination, however, does not mean that the FERS or CSRS Federal or Postal employee should not force a legal argument upon OPM when a significant finding is made by another agency or program.  For, in the end, it may not be the U.S. Office of Personnel Management which listens, but an administrative judge at the MSPB, or a 3-judge panel on the Federal Circuit Court of Appeals; in which case, a precedent will have been set, for all to (hopefully) follow.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement for Federal Workers: How to Use Percentage Designations

Carefully.  With discretion.  With an intelligent approach.  Not indiscriminately (a double-negative which, in common parlance, means “discriminately”).  Quantification of pain, of a medical condition, of a loss of use of one’s body functions, ability to have the manual dexterity of the use of one’s fingers, hands, arms; of the flexion and range of motion of shoulders, etc., includes a level of subjectivity at best, and at worst, possibly misrepresents the extent and severity of a disability.

Further, when quantification of the disability of a particular body part is further interpreted to represent a part of a greater whole — as in OWCP/FECA’s attempt to assign a percentage disability of the “whole person”, or when the Department of Veteran’s Affairs calculates a combined percentage rating which is not merely the addition of all lesser individual ratings — it needs some explaining.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, one should obviously utilize all of the available tools, evidence, compilation of documentary evidence, etc., all of which, in their combined entirety, could help to provide persuasive evidence in obtaining an approval from OPM in a Federal Disability Retirement application.  But use of those tools, how it is used, what is used, how it is explained, and whether the explanation is adequate, are all important keys to keep in mind.

OPM is an independent agency.  When you attempt to dictate an outcome based upon a decision of another agency, such an attempt will often appear to be a threat to the very independence of an agency; something which needs to be kept in mind.  What should be submitted is rarely an issue; how it is stated is always a concern.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Medical Support, Belief, Documentation and the Diagnosis

Ultimately, in preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, one must always remind one’s self that this is a “paper presentation” (regardless of the prevailing and inevitable march towards a paperless society) to the U.S. Office of Personnel Management (OPM).  As such, there are certain inextricable components in the presentation itself, which must be reviewed, evaluated, and decided upon before proceeding.

As a “presentation” which is meant to be persuasive — i.e., proving by a preponderance of the evidence that one is entitled to the Federal Disability Retirement benefit, whether under FERS or CSRS — it must obviously have the essence of the proof itself:  Medical Support.  Without the medical support, one need not consider moving forward at all.

Once the Federal or Postal employee has ascertained that he or she has the medical support to proceed, then the question is one of obtaining the documentation which confirms such support.  For, a pat on the back and a wonderful smile from the doctor will not be persuasive to OPM; the doctor must be willing to document, in detailed format, the support which is expressed.

Next, in sequential order, the medical documentation must reveal, convey, and persuasively reflect, a level of belief which will be tested in the event that the Federal Disability Retirement application is denied at the First Stage of the Process, and further tested if it is denied at the Second, or Reconsideration Stage, of the process.  Thus, in short, the treating or supporting doctor must possess a level of belief in one’s case, and be willing to support that belief throughout the entire administrative process.

Finally, the doctor must be able to make a diagnosis, but more than that, to support the diagnosis, and be willing to make the “nexus” between the diagnosis, the patient’s physical, emotional and cognitive capabilities, and to relate them to one’s positional duties of one’s job.  It is through this process of connecting the dots, where the end-goal is achieved:  of obtaining one’s Federal Disability Retirement benefits.

Sincerely,

Robert R. McGill, Esquire

Postal and Federal Disability Retirement: Supporting the Concept

In preparing, formulating and filing a FERS or CSRS Federal Disability Retirement application, the important first step in the “preparation” phase — or, one might even term it conceptually as the “pre-preparation phase” — is to engage the treating doctor with the conceptual framework of what Federal Disability Retirement entails and encompasses.  

As has been repeated many times previously in other blogs, doctors are not administrators, and ultimately detest the need to annotate, narrate, write reports, etc.  The legal system has forced doctors to keep records, if only for their self-protection in the event of a question of malpractice, and the requirement of keeping office records and notes has had the positive corollary effect of forcing doctors to “think through” the procedural steps of what it is that they are “doing”.  

Requesting the treating doctor to support a Federal Disability Retirement application has the identical positive result of forcing the doctor into an admission that one’s medical condition has come to a crossroads:  prior treatment modalities have not proven to be effective; the chronic and progressively deteriorating nature of the physical or psychiatric condition has shown to be “treatment-resistant”; the time has come to acknowledge that a different mind-set must be embraced — one which includes a period of rest, restorative time, and a stage of recuperation away from the activities which the Federal or Postal employee spends on average 40 – 50% of the time at:  one’s job.  

Speaking to the doctor about his or her support and role in preparing a Federal Disability Retirement application is the first, necessary, and vital step in the preparation, formulation and filing of a Federal Disability Retirement application under either FERS or CSRS.  How best to approach the doctor, the timing, the words and concepts to use, etc., are all part of that preparation.  

If it is time for the Federal or Postal worker to recognize that one’s medical conditions are preventing the Federal or Postal worker from performing one or more of the essential elements of one’s job, it is time to think about pre-preparing the treating doctor.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Agency Actions and the Bruner Presumption

Agency actions separating a Federal or Postal employee from Federal Service often contain language which comes close to allowing for a Federal or Postal employee to assert the “Bruner Presumption” (that legal presumption which essentially states that the declaration and admission by the Agency triggers a legal presumption that a Federal or Postal employee is entitled to, by a matter of law, to Federal Disability Retirement benefits under FERS or CSRS), but not close enough.  

Such language will instead be couched in references to medical documentation which has been previously reviewed by the Agency; will embrace an acknowledgement that the Federal or Postal employee has a “medical condition”; and will sometimes even entertain verbiage evincing sympathy for the Federal or Postal Worker’s “situation” — but still will base the removal upon other considerations, such as “excessive absences”, “failure to maintain a regular work schedule”, etc.  

The question ultimately then becomes:  Is it important, leaving aside relevance, to fight the agency to amend or otherwise re-characterize the original proposal to remove, in order to obtain the Bruner Presumption?  

The Bruner Presumption is a legal mechanism which gains greater weight and importance when a Federal Disability Retirement application has been denied twice by the Office of Personnel Management (both at the Initial Stage of the process, than at the Reconsideration Stage), and one therefore finds one’s self before an Administrative Judge at the Merit Systems Protection Board.  But such appearance before the MSPB presumably means that there are other problems with a case — most often, insufficient medical documentation.  

The Bruner Presumption aside, the Federal or Postal employee must still prove, by a preponderance of the evidence, one’s case, by submitting sufficient medical documentation.  The Bruner Presumption is simply that “extra” ingredient that may be helpful if all other factors have been met in proving a Federal Disability Retirement case.

While helpful, it is not a certainty for an approval.  While better to have than not, one must still prove one’s case.  While triggered most effectively at the MSPB, a less-than-Bruner-trigger can still be argued at all stages of the process.  Just some thoughts.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Workers: Different Benefits

In preparing, formulating and filing a Federal Disability Retirement application under FERS and CSRS, it is often thought that medical documentation obtained for one venue of eligible benefits (e.g., Worker’s Compensation or SSDI, or VA benefits) can be utilized in the pursuit of FERS or CSRS Disability Retirement benefits.  However, because the applicable criteria which each Federal program or benefit is different, one should always take care before submitting the same, or similar, medical documentation, for multiple and varied applications.  

It is not so much that such documentation cannot be deemed relevant for multiple purposes; rather, relevance is a relative concept, and while X can be relevant for A & B, it may only meet the statutory criteria for A but not for B.

Further, every answer to a question depends upon what the question is.  For FERS & CSRS Disability Retirement, the question always involves whether or not a Federal or Postal employee’s medical condition(s) prevents one from performing one or more of the essential elements of one’s job.  The question involving SSDI, VA Benefits or OWCP is a completely different one.  

However, a particular medical document may in fact cross the boundaries of relevance and address a specific issue or aspect of a question, and for that limited purposes, may in fact be “relevant enough” to be submitted.  Such submissions crossing boundaries, however, must be done with care and deliberation; for, while it may answer one aspect of a Federal Disability Retirement application, it could potentially raise multiple other questions which might have been best to leave alone.

Sincerely,

Robert R. McGill, Esquire

Federal Worker Disability Retirement: Issues

The issues upon which the Office of Personnel Management denies a Federal Disability Retirement application under FERS or CSRS are normally rather limited.  There are recurrent themes, and some of the more prevalent ones are:  insufficient medical documentation; issues concerning accommodations and attempted accommodations by the Agency; situational disability and issues which focus upon work issues which never should have been included in the Applicant’s Statement of Disability (SF 3112A).  

These are generic designations of the types of issues which an OPM Claims Representative may argue as the primary basis of his or her denial of a Federal Disability Retirement application, and there may be multiple corollary issues which are described — but, ultimately, when all is said and done, there are limited reasons as to why an Initial Stage application for Federal Disability Retirement is denied.  

That fact, however — of the limited basis and reasons — does not mean that the issues are simple; rather, that in responding to a denial from OPM, no matter how lengthy the denial letter may appear (or how short, for that matter), the issues can be neatly “broken down” and placed into manageable categories in order to respond.  Responding to a denial properly (in addition to filing the Request for Reconsideration in a timely manner) is important; how to respond, is all the more important.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: Don’t Assume

We are all familiar with the acronym-like adage which can be extracted from the word “assume”.  In preparing a Federal Disability Retirement application under FERS or CSRS, the first question that one must ask of one’s self is:  “Do I have a supportive doctor?”  If the answer is an unequivocal “No”, then entertaining even the thought of proceeding forward with the process is a virtual act of futility.  

Now, to all unqualified statements, there are exceptions to the rule.  There are, indeed, medical conditions where the mere treatment records, office notes, etc., reveal irrefutably of a medical condition of such severity that there is no question as to its impact upon one’s ability/inability to perform the essential elements of one’s job.  But that is rare.  If the answer to the original question is:  “He may be…”  “I assume he is supportive…”  “He seems supportive because…”   While these are niceties in one’s figment of one’s imagination, and foster a sense of security and a warmth for a doctor-patient relationship, such answers all have an undercurrent of an assumption.  Don’t assume, if you are planning to go forward with a Federal Disability Retirement application.  Instead, make an appointment with your doctor and have a frank and open discussion.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Other Processes

Does it make a difference to list that one’s Federal Disability Retirement case is also accepted by OWCP/Department of Labor as an “accepted case“?  Or that one has been deemed 90% disabled by the Veterans Administration — or, more to the point, that one has received a 100% unemployability rating?  How about having been approved for Social Security Disability Insurance benefits (SSDI)?  Aren’t these all “indicators” of a medical disability?

The short, uncomplicated answer is that, yes, such acceptance and approval by other agencies and sources can be indicators of a medical disability, and these findings can help you to enhance your chances with Office of Personnel Management (OPM).  The longer, more complicated issue, however, is how to divulge and inform the OPM about the “other” Agency, the acceptance, and the relevance of what an approval or an acceptance by another agency should mean to one’s Federal and Postal Disability Retirement application.

Unfortunately, there is no generic or universal rule concerning OWCP-accepted claims, SSDI approvals, VA determinations, etc., with respect to their relevance to an OPM Disability Retirement application.  Each case is unique; there is case-law which is applicable to each one, independent of the other; and because the criteria which governs each is different from any other, they must be dealt with in an independent manner.  This is not a reflection upon the individual filing for Federal Disability Retirement benefits under FERS or CSRS; this is more a reflection upon the asserted independence of each Agency from each other.

Sincerely,

Robert R. McGill, Esquire