CSRS & FERS Disability Retirement: Complexity in the Hidden Background

To prove one’s eligibility for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether one is under FERS or CSRS, is seemingly an uncomplicated matter.

As one’s medical condition impacts the ability to perform one or more of the essential element of one’s job, it is up to the treating doctor to establish the nexus and provide an opinion as to the connecting bridge between the medical condition and the positional requirements of one’s Federal or Postal job.

How does one do that? Must it be comprised of a 1-to-1 ratio between job elements and medical conditions? How important and prominent are “symptoms” considered, as opposed to the mere clinical declaration of the diagnosis, in persuading the U.S. Office of Personnel Management that a particular medical condition should qualify for Federal Disability Retirement benefits? To what extent is one’s own statement of disability, as described on Standard Form 3112A, important in establishing the foothold towards gaining an approval from OPM?

Also, what algorithm or comparative analysis does OPM use in evaluating a case, and how does one enhance the chances of success at the First Stage of the process? If denied at the First Stage of the Federal Disability Retirement process, does the basis of the denial (often characterized by a plethora of multiple reasons given) require a point-by-point refutation, and is the Reconsideration Division at OPM using the same standard of review, or a different application of laws in evaluating the additional evidence submitted at the next stage?

If one watches a gymnast, a ballerina, or even a mathematician at work in solving or unraveling a complex problem or exercise, one is immediately struck by the ease with which the feat is performed. But it is almost always the unseen preparation which has preceded the actual performance that sets the stage of an uncomplicated presentation.

It is that mystery of the uncomplicated, which tends to trip us all, and that is no different in the preparation, formulation and submission of a Federal Disability Retirement application, applied through the U.S. Office of Personnel Management, whether you are under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

Federal Worker Disability Retirement: Algorithms & Human Peculiarities

In maneuvering through the process of filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, there are potentially multiple stages that one may encounter:  The First Stage of the process — the initial filing; if denied, one has a right to have the denial “reconsidered” by filing a Request for Reconsideration within thirty (30) days of the denial; if denied by OPM a second time, then one has a right to file an appeal to the U.S. Merit Systems Protection Board, before an Administrative Judge.

There are, beyond the three stages identified, additional appellate stages of the process, including a Petition for Full Review before a 3-Judge panel of the MSPB, as well as an appeal to the Federal Circuit Court of Appeals.

At each stage of the process, the Federal Disability Retirement application is reviewed and evaluated for sufficiency of proof and satisfaction of the statutory criteria for eligibility; and, moreover, a different person looks at the application at each stage of the bureaucratic process.

Thus, there is no singular algorithm — no application of a computer model which is identical across the board — in the evaluation of one’s Federal Disability Retirement application.  Instead, a different person reviews and evaluates the Federal Disability Retirement application at each stage.  This is probably a positive approach, and one which would be deemed “fair” by any objective standard.  For, while an application of a standard algorithm may be deemed objectively impersonal and unbiased, whereas human beings, in their inherently fallible nature may indeed possess biases and inclinations; nevertheless, it is the peculiarities of human imperfections which are still the trusted traits for procedural determinations.

That is why there is such a hue and cry over the increasing use of video replays and electronic line judges in sports; for some reason, we still trust in the human perspective, as opposed to the cold hardware of computers.  Perhaps, in our collective childhoods, we all became paranoid from watching HAL 9000 in Kubrick’s 2001:  A Space Odyssey.  A shivering thought.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Burden of Proof

In preparing, formulating and filing a Federal Disability Retirement application under FERS & CSRS, one is often asked (and should also ask of one’s self) the following question:  What does it take to be eligible?  What proof proves my case?  How much proof must I submit (quantity) and is the proof I submit sufficient (quality)?  All of these questions fall under a generic rubric in law, termed as “burden of proof“. 

Every legal process — and filing for Federal Disability Retirement benefits under FERS or CSRS is no different — applies a legal standard:  a set of criteria in determining whether or not a Federal or Postal Worker is eligible for — qualifies for — Federal Disability Retirement benefits under FERS or CSRS. 

In applying a statutory set of criteria, there is the general application of what constitutes, or meets the needs of, the evidence, documents, and proof that is submitted for review.  The overriding standard that is supposed to be applied for determining the process, is a standard of law called, “Preponderance of the evidence.”  It is a relatively low standard used in civil law — where, if the proof submitted shows that it is more likely so than not so, then one has met “by a preponderance of the evidence” that a Federal or Postal employee is entitled to Federal Disability Retirement benefits. 

Does this standard apply at the administrative level — at the Office of Personnel Management?  The answer is “Yes”, but not necessarily consciously.  One only effectively argues that the standard of proof has been met when one encounters a Judge — at the Merit Systems Protection Board.  But, nevertheless, OPM is supposed to follow “the law” and the burden of proof, and it is simply one more argument that one can, and should, make to the Office of Personnel Management when filing for Federal Disability Retirement benefits under either FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire