Federal Employee’s Medical Retirement Programs: Propriety of Sequence

Propriety is not a concept which is much discussed, anymore.  That which is socially or morally “proper” has been discarded, precisely because convention is no longer accepted as a standard to follow.  But when the consistent pursuance of the opposite of X becomes the acceptable standard, does it not then become the convention itself?

Further, some levels of propriety follow upon the thoughtful order of things, and are imposed not because they are artificial societal creations mandated through a history of traditions; rather, it is so because of common sense.  For example, while having a urinal right beside each table in a restaurant may be the most naturally convenient place for utilitarian purposes, the propriety of such placement defies the convention of modesty and privacy concerns; and so it goes.

Sequential propriety is often the best example of logically-imposed events, and failing to follow the linear approach may have unforeseen consequences erupting with problems down the road.  Thus, teaching a child to stop, look, listen — then to cross the road, is both logical, of utility, and linear, with a rational foundation for following upon the sequence of actions.

For Federal and Postal employees contemplating the preparation of a Federal Disability Retirement application, whether one is under FERS or CSRS, the propriety of sequential formulation of one’s Federal Disability Retirement application is important before proceeding. When should the Federal or Postal employee’s Statement of Disability be prepared? When should the Supervisor be approached to complete the Supervisor’s Statement? What should be the sequence and priority of listing of the medical conditions which make up the core of one’s Federal Disability Retirement application?

Sequence of propriety is often a combination of naturally-imposed events, as well as logically sound determinations.  Throwing out convention is fine for the unthinking; but there have been many a thoughtless child who, like the symbolism in the well-known story of Holden Caulfield, comes too near the edge of a cliff in a field of rye to deserve comfort of thought and actions.

Sincerely,

Robert R. McGill, Esquire

 

Disability Retirement for Federal Workers: Necessary Connections

Necessity is determined by how one defines and confines the parameters required to reach the requisite conclusion; if the criteria governing the roadmap to a successful outcome is replete with heightened qualitative specifications, greater care and effort may be mandated; conversely, if a looser, more informal measure is imposed, the tendency is to respond accordingly.

But what determines the response — outside influences, or one’s own standard of excellence? In Hume’s argument concerning causality, of course, the prerequisites defined were instituted at the outset to defeat the argument for causality; by setting up the requirement of what constitutes a “necessary connection” in order to establish a causal connection, he allowed for no amount of evidence which would satisfy his rule; thus, it was already a self-contained tautology from the outset.

For preparing, formulating and filing for Federal Disability Retirement benefits, whether the Federal or Postal employee is under FERS or CSRS, the question becomes: Does the medical condition itself determine the extent of groundwork necessary for a successful approval from the U.S. Office of Personnel Management, or should the identical set of stringent prerequisites be satisfied regardless of the seriousness of the medical condition?  The obvious answer, of course, should always ascribe to the latter, as acceptance of the former entails potential pitfalls which may result in lost time and unnecessary efforts expended for satisfaction of additional stages in the administrative process.

Necessary connections in a Federal Disability Retirement application must be proven and established at all levels; for, as the age-old adage reminds us, it is the weakest link in the chain of arguments which will ultimately defeat the entire structure of an otherwise solid case.

It is the U.S. Office of Personnel Management, through statutory impositions and regulatory requirements, which has “pre-set” the necessary connections to be made in proving eligibility for Federal Disability Retirement benefits; it is up to the applicant (you) to make sure that all such causal connections are established, proven, confirmed and supported, in order to ensure the best chances for success in an administrative process fraught with human frailties and foibles.

Sincerely,

Robert R. McGill, Esquire

 

Federal and Postal Disability Retirement: Sufficiency of Evidence

At what point is the sufficiency test satisfied?  Who determines when the bathtub is full enough in order to bathe?  What constitutes the threshold of being gluttonous on Thanksgiving, as opposed to having had a hearty meal? And, for a FERS or CSRS Disability Retirement application, what standard determines whether or not a person has submitted evidence sufficient to meet the preponderance of the evidence test, in order to persuade the U.S. Office of Personnel Management that a Federal Disability Retirement application has met its burden, and that the Federal or Postal employee is therefore eligible and entitled to receive an approval and a subsequent annuity?

Clearly, it cannot be mere volume of medical reports and records; for, otherwise, cases with barely a dozen pages of a report, diagnostic test results and some office notes would not pass through the scrutiny of the OPM Caseworker.  If not volume, then is it the quality of the report and records?  Here, too, while a well-documented file may generally meet the sufficiency test, there are times when OPM will insist upon treatment notes for the past 18 – 24 months before considering a case for approval.

The sufficiency test is often an admixture of quality, quantity, and a compendium of selectively highlighted documentation which, in their totality, prove an OPM Federal Disability Retirement case.  There are no two cases alike, though similarities may abound.  Each case must be seen in its own unique light, and within that context, a case must be carefully constructed and compiled.  Only in this manner and approach will the sufficiency test be met, and only after a careful and thorough review of the facts, issues and particular uniqueness of a given case — somewhat in a reflectively similar manner as OPM will do in reviewing the submitted case.

Sincerely,

Robert R. McGill, Esquire

 

OPM Disability Retirement: The Non-nexus

Meeting an adequacy test may constitute sufficiency for some purposes, but not for others.  Thus, it may be enough in completing an FMLA form to have a diagnosis, along with answers to other questions on WH-380-E.  But mere identification of a medical condition via a diagnosis, along with a description of symptomatologies will not be enough to meet the sufficiency test in a Federal Disability Retirement application.

People often assume that having a medical condition in and of itself sufficiently explains the severity of one’s condition, and any implied “blank spaces” can be filled in by the mere existence of such a medical condition.  But Federal Disability Retirement, whether under FERS or CSRS, filed through, reviewed by, and approved or disapproved by the U.S. Office of Personnel Management, must be proven by a preponderance of the evidence that the medical condition itself prevents the Federal or Postal employee from performing one or more of the essential elements of one’s positional duties.

As such, the identification and description of a medical condition fails to comply with the adequacy standards in proving eligibility for Federal Disability Retirement benefits.  One must establish, through the conduit of a medical professional, the “nexus” or “connection” between one’s identified medical condition and the inability to perform one or more of the essential elements of one’s job.

The weight of the proof is upon the Federal or Postal applicant.

The foundation of such evidence begins with the identified medical condition, but in and of itself, it is a non-nexus — until it is squarely placed in the context of one’s official position and the duties required by one’s duties.  Thus, the non-nexus become the nexus-point when combined with the identification and description of one’s positional duties.

It is this realization of the step-by-step sequence of proof which constitutes adequacy and sufficiency of evidence, and one of which the Federal or Postal applicant for OPM Disability Retirement benefits must be aware.

Sincerely,

Robert R. McGill, Esquire

Postal and Federal Disability Retirement: The Beast of Burden

The burden is undertaken by those have little choice in the matter, but who willingly submit to the responsibility and obligation.  Traditionally, the “beast of burden” (other than being a Rolling Stone song) refers to a somewhat-domesticated animal, perhaps a donkey or an ox, who must bear the weight of man’s work.

In law, the “burden” is one of proof — of the affirmative obligation to present one’s facts, persuasive argumentation based upon such facts, and the application of the relevant law which supports both the facts and the arguments.  The “other side” in the litigation has no burden at all, and can simply sit and do nothing, if he or she so chooses, and see whether or not the plaintiff, the appellant or the Federal Disability Retirement applicant has submitted sufficient proof such that he or she has met his/her burden of proof.

As the weight placed upon a beast of burden is often heavy and demanding, so in a similar vein the litigant who has the burden of proof should always expect to exceed what is “necessary” in any given case.  For the Federal or Postal employee who is filing for Federal Disability Retirement benefits through the U.S. Office of Personnel Management, whether under FERS or CSRS, it is indeed a heavy burden to bear in order to meet the legal criteria of a Federal bureaucracy who has the unmitigated power and authority to approve or deny.

The burden of proof — it is as heavy as that which we place upon a beast of burden, and the weight of such responsibility can overwhelm us, lest we have the reserve of strength to plod onward.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Independent Entities

If Federal agencies were created with the proverbial single “stroke of the pen”, all at once, in unison and coordinated intersections of thoughtful complexities, then of course there would be a lack of overlap, duplication and repetition. The essence of efficiency is precisely to limit duplicative efforts. But then, some would perhaps say that it is an inherent self-contradiction to assert that Federal agencies can both be coordinated as well as efficient.

In the disability compensatory systems impacting Federal and Postal workers, there are multiple “pockets” which the Federal and Postal worker can be eligible for, given the right qualifications and by meeting certain threshold criteria. Under FERS, the system of retirement and disability retirement was fairly well-planned (and, again, some would say that such planning was a historical first, in many ways), in that it envisioned a coordination of benefits between the retirement system and Social Security. That is precisely why, in filing for Federal Disability Retirement benefits under FERS, the Federal or Postal employee must also file for Social Security Disability Insurance benefits sometime during the process.

Then, of course, there are a multitude of other programs and agencies, such as VA benefits (for Veterans of the military services) and OWCP/FECA, for “on-the-job” injuries. Each are independent entities, created for specific purposes, goals and targeted personnel.

Over the years, the Courts, and specifically the U.S. Merit Systems Protection Board, have somewhat “clarified” the interconnecting impact of a decision from one independent agency upon the decision-making process of another, and such decisions should be used in arguing one’s Federal Disability Retirement case.

Benefit coordination, offsets and simultaneous filings aside, how one utilizes the decision of one administrative agency in preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, is an important component in reaching the goal of a successful Federal Disability Retirement application.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for US Government Employees: Insufficiency Test

The validity of allegation that there is an insufficiency of X is partly determined by an objective standard, and partly (if not mostly) derived from a judgment as to the nexus between X and the standard to be applied.

In Federal Disability Retirement cases the basis of most Federal Disability Retirement denials is that there is an insufficiency of proof, whether as to issues of light duty or accommodation, medical opinion, medical documentation; questions about deficiency of service; and multiple other specified areas — but all will ultimately be determined to have a “lack” of something such that it fails to meet a “sufficiency” test.  But sufficiency can only be determined by comparing what exists (i.e., what has been previously submitted to the Office of Personnel Management) to what the legal standard of proof requires.

Further, since the overriding legal standard is based upon a “preponderance of the evidence”, which requires that something be ‘more likely than not’, the narrow gap between human involvement in the judgement of sufficiency, and a truly objective basis for such insufficiency, is susceptible to human error.  Because of this, appearance of quantity in addition to quality is often what is required.

As decisions by OPM are rendered by a wide range of people whose judgment, competence and approach in evaluating a case differ greatly, it is unfortunately necessary to take into consideration the foibles of human error.  Until a precise algorithm is invented which applies fairly and accurately in all cases across the board, we must continue to deal with human beings, the their errors of judgment.

Sincerely,

Robert R. McGill
FERS Disability Lawyer