CSRS & FERS Medical Disability Retirement: Bureaucracy and the Objective Algorithm

On the one hand, objectivity can be viewed as a positive thing; for, with it, one is assured that all applications are treated equally, by the implementation of identical criteria across the board.  “Gut feelings”, personal beliefs, and that “sixth sense” is eliminated; and thus is fairness achieved by the equal treatment of all cases, and “exceptional circumstances” are not, and cannot be, considered.

What such an approach gains in large-scale application, however, may lose out in individual cases.  For, if experience and age accounts for anything, it should allow for decisions made outside of the mainstream of thought, based upon those very factors which make up the difference — wisdom from years of engaging in a particular endeavor.

The problem with the bureaucratization of a process is precisely that it fails to allow for exceptions; but concomitantly, it is precisely those unique circumstances which cry out for a carved-out exception.  In a Federal Disability Retirement application, submitted to the U.S. Office of Personnel Management, whether under FERS or CSRS, there are always cases where all of the facts and circumstances reveal eligibility; but in applying the mathematical (and thoughtless) algorithm of criteria-based analysis, there may be something missing.  Perhaps the doctor would not, or could not, say exactly X; or the test results revealed nothing particularly significant.

In some ways, the medical conditions identified as Fibromyalgia or Chronic Fatigue Syndrome represent such scenarios.  In those instances, it is important to descriptively convey the human narrative in a particularly poignant manner.

The administrative bureaucracy is here to remain among us; to rise above the level of thoughtless application of a criteria, however, one must creatively encourage the phoenix to rise from the ashes of boredom, and span its wings to include those others who deserve the benefits of Federal Disability Retirement.

Sincerely,

Robert R. McGill, Esquire

Postal and Federal Disability Retirement: Certainties and Presumptions

Life presents conundrums of certainties and presumptions; the former in order to retain sanity; the latter in order to appear sane.  A certain event is one which is expected to occur because of a natural law, a habitual repetition of reliance, or because the daily routine has engrained it upon our consciousness.  A presumption is a wish for certainty which may not even be rationally-based, but one in which we conclude will likely occur because of past events, contextual probabilities, and a sense that the present should reflect the historicity of the past.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, it is best to establish the strict bifurcation between certainties which are clearly so, and avoid presumptions.

It is certain that Federal Disability Retirement is a process which will likely require multiple stages to obtain; it is certain that the Office of Personnel Management will scrutinize each Federal and Postal employee’s application and find it deficient or inadequate; it is certain that one’s agency will likely be two-faced and feign loyalty and support but act in ways which defy such declarative embracing of the Federal or Postal employee.  Conversely, one should never presume that one’s case is a “slam-dunk”; nor that OPM will make a decision sooner than later; nor that OPM will provide a rationally-based reasoning for denying a case.

Hume and Berkeley aside, we live in a world where cause-and-effect are relied upon, and where the world does not merely depend upon our perceiving it; but certainties should always be tempered with an understanding that Federal Disability Retirement is an administrative process which must be fought for, then protected, and presuming an easy path with any Federal agency is to defy the logic which both Hume and Berkeley took to the extreme.

Sincerely,

Robert R. McGill, Esquire

Postal and Federal Disability Retirement: Never a Science

Ultimately, a Federal Disability Retirement application under FERS or CSRS is not a science, in terms of a mechanistic approach and methodology in determining the successful outcome of a case.  In law, there is always a distinction to be made between truth, evidence, and persuasive argumentation.  It used to be that the middle term (evidence) provided for the latter concept (persuasive argumentation) through the strength of the former term (truth).  

Science always relied heavily on the first two terms, believing that the strength of the first two determined the last term by logical default.  But once “science” began engaging in valuations and judgments based upon projected possibilities of future occurrences, the art of persuasive argumentation took on greater prominence in determining the truth, and the “evidence” to be presented became less important.  

Similarly, in preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, because there is not a computational calculus in determining whether or not a particular Federal Disability Retirement application meets all of the legal eligibility criteria, it is not a “perfect science” and, indeed, it is not a science at all.  

A human being at the Office of Personnel Management must determine whether or not the applicant under FERS or CSRS is eligible for Federal Disability Retirement benefits.  As such, a fair amount of subjectivity comes into play.

The “art” of submitting a persuasive Federal Disability Retirement application — where the spectrum of objectivity is greater at the medical evidence side of things, and where human emotions and descriptive delineation of the impact of the medical condition upon one’s ability/inability to perform the essential elements of one’s job will be more apparent in the Applicant’s Statement of Disability — all combine to present a totality of evidence mired in subjective/objective compendium of the whole — for a presentation of the truth.

Sincerely,

Robert R. McGill, Esquire

Federal Worker Disability Retirement: Crossing Lines

The question has been posed:  How can one Federal Agency make a determination of disability while another, separate Agency can deny a determination of disability? Contained within that question, of course, is an answer of disability from each Federal Agency, which was further preceded by multiple questions requesting the agency to make a determination of disability.

A simple answer to the question posed would be:  Each Agency is independent and separate, and thus has the authority to make an independent determination.  That is what is deemed a “power” answer.  But there are further nuances of an answer which go beyond the mere authority or power of an agency to make a determination.

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, the question of another agency’s determination on disability is often asked:  How can one…?  The full answer to the question would require a complex analysis of the various laws, statutes and criteria, which would include the following:  Each Federal agency which provides a particular disability benefit is mandated by a specific statutory authority which sets out a specific set of criteria, and is different from the statutory authority defining another agency’s particular benefits; some legal criteria are based upon a determination of percentage ratings, while others are based upon employability or whether a particular kind of job can be performed.

Given all of this, one may still “cross the lines” by making arguments utilizing statements from one agency, as persuasive authority in arguing for another agency’s medical disability benefits.  In crossing such lines, however, it is important to maintain the integrity of the role, the criteria, the specific citation of the law, and what Judges actually have stated concerning the extent and authority of the influence which one agency determination may have another another.  Thus, if one attempts to cross the lines, do so with knowledge and understanding of the law.

Sincerely,

Robert R. McGill, Esquire

 

Federal and Postal Disability Retirement: Reasons & Conclusions

In a denial letter from the Office of Personnel Management for a Federal Disability Retirement application filed under FERS or CSRS (which, if received, a Federal or Postal employee must file a Request for Reconsideration within 30 days of the date of the denial letter), the connection between the reasonings given, and the conclusions arrived at, will often be missing.  

Often, OPM will tangentially or in a cursory manner refer to various medical documents which were submitted with the original Federal Disability Retirement packet, or actually extrapolate a selective quote from a medical report or office note, and even make it appear as if a full and complete evaluation of the submission has been performed.  Thereafter, a conclusory statement will be proposed, often with a logical pretext of:  “Therefore, your application is denied.”

However, there is a vast difference between referring to various medical reports or statements, and evaluating such reports and statements in order to arrive at a proper legal conclusion based upon the evidence submitted.  It is rare that the Office of Personnel Management engages in the proper evaluative process in determining whether or not a Federal or Postal worker’s Federal Disability Retirement application meets the applicable legal criteria.  That said, such lack of evaluative and analytical process is legally required, and there must be a logical connection between the reasons given, and the conclusions reached.  Such lack of engaging in the process must be pointed out, but it must be done in a “diplomatic” manner.  Diplomacy is best engaged in by diplomats; similarly, legal issues are best tackled by lawyers.

Sincerely, Robert R. McGill, Esquire

Medical Retirement Benefits for US Government Employees: Office Notes

The Office of Personnel Management will often request that a doctor’s “office” or “treatment” notes be attached for approximately the last 1 – 2 years.  What is the purpose of this request?  Normally, to compare whether or not the doctor’s treatment notes reveal the consistency with what is stated in the narrative report prepared by the doctor.  This is often unfair, of course, because the purpose of office notes is quite different from the purpose behind a narrative report requested to support a Federal Disability Retirement application under FERS or CSRS.  

Office notes often reflect a cursory overview of the type of treatment rendered, and will sometimes contain statements of the positive advances and treatment responses of the patient/applicant, including any progress made in response to therapy, surgery, treatment, and medication regimens.  Thus, statements such as, “patient is showing good progress” or “Patient comes in today feeling much better” may be used by the Office of Personnel Management to deny a Federal Disability Retirement application under FERS or CSRS, and yet such statements must always be seen within the context of treatment, and in no way are inconsistent with a medical narrative report which clearly and unequivocally shows that a Federal or Postal employee is no longer able to perform one or more of the essential elements of one’s job.  Next:  How to overcome OPM’s unwarranted focus upon the Office/Treatment notes.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: OPM’s Methodology II

When the Office of Personnel Management approves an OPM disability retirement application, as I stated in the previous article (OPM’s Methodology), they will normally choose to approve it based upon only one of the listed disabilities. This is because, from OPM’s viewpoint, if the applicant lists multiple medical disabilities, once OPM reaches any one of the listed disabilities and finds that one of them is a basis for an approval, there is no further need for OPM to review the remaining medical conditions.

This methodology requires that future applicants consider the consequences of such a method: it is essential that the applicant base a disability retirement application upon only essential, significant medical conditions, normally best to list them in the order of significance, and further, to document a case in the order of severity.

While I have not heard of a disability retirement application being approved based upon a non-essential, minor medical condition, it is wise not to rely upon the off-chance that OPM might base an approval upon a medical condition that is somewhat “thrown in” as an afterthought, into the applicant’s statement of disability. In other words, it is not a good idea to “throw in the kitchen sink” at the last moment, thinking that by multiplying the quantity of medical conditions listed, that OPM will see how “serious” one’s medical condition is. Remember, it is not the totality of many medical conditions that is important; rather, it is the list, however small, of those medical conditions that prevent one from performing one or more of the essential elements of one’s job.

Sincerely,
Robert R. McGill, Esquire