CSRS & FERS Disability Retirement: The First Denial

Your Federal disability retirement application was well-prepared:  perhaps it was prepared with the help of an attorney; the medical documentation seemed solidly unequivocal; the doctor made the necessary connections between one’s medical conditions and the type of essential elements of one’s job; the packet, by all accounts, should have been approved, and by all expectations, the approval should have been reasonably expected. 

Instead, you receive a letter stating that your disability retirement application was disapproved, and a “Discussion” section follows, explaining why the Office of Personnel Management denied your application.  Why did this happen?  There are multiple reasons why such a denial can occur:  the OPM specialist could be a person who lacks a clear understanding of the applicable laws governing disability retirement applications (more often than not, this is the case, and what you actually get in the so-called “Discussion” Section of the denial letter is merely a regurgitation of the statutory criteria for eligibility for disability retirement, without a recognition of the interpretation of such criteria by Federal Judges for the Federal Court of Appeals or by Administrative Judges from the Merit Systems Protection Board); it could be as simple as the OPM representative selectively choosing to read the medical reports and records, and disregarding or ignoring supportive portions of the medical records and reports; or it could be that additional medical reports and records need to be obtained in order to “shore up” the application. 

In any event, whatever the reason for the denial, one should not panic.  It is merely one step in a long, administrative process.  The mere fact that OPM denies your disability retirement application does not mean that they are “right” in doing so; indeed, in my opinion, they are rarely right.  That is why one has the right to have it “reconsidered”, and the opportunity to make further legal arguments, and obtain further medical documentation in support of your claim.  And, beyond that, you have the right to file an appeal to the Merit Systems Protection Board — and beyond.  Never give up; always take it to the next step.  In most cases, it will prove that OPM was in error, and in fighting the denial, you will have secured some semblence of financial security for your future.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Affirmative Approach

The road which leads to one’s future financial security is irreversibly tied to the extent of how affirmatively one takes one’s future into one’s own hand (now, that was indeed a mouthful).  By this, I mean merely that, in preparing an application for Federal Disability Retirement, there are going to be all sorts of “outside forces” which pull you towards every different direction.  Friends will tell you one thing; your Agency will tell you something else; your coworkers will give you stories (both good and bad); your Human Resources Department may give you advice; ultimately, you must take an affirmative approach and make sure that your application is coherent, logically structured, and medically supported. 

By way of example, an Agency’s Human Resources Department will often insist that the Physician’s Statement, SF 3112C, is a “required” form.  It is not.  They will often give you the form with the return address of the Agency stamped in the upper blank box, for the medical report and records to be returned to the H.R. Department.  Upon receipt, the H.R. Department simply includes the medical documentation (without review or determination that it is helpful to your case), and forwards the packet to the Office of Personnel Management.  This would be the “non-affirmative” approach of doing things. 

To take the affirmative approach would be:  Make sure that the medical documentation you submit to OPM is the extent, type, and quality that you want to submit.  Remember:  the applicant has the burden of proof, by a preponderance of the evidence, to show that you are entitled to Federal Disability Retirement benefits.  Don’t let third parties (i.e., friends, coworkers, Agency, H.R. Department personnel, etc.) make the decisions for you.  Take the affirmative approach — either by yourself, or through your attorney.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: the Bruner Presumption – Agency Actions II

One must never misunderstand the law and its application.  This is true in any legal arena of every area of law; when it comes to Federal Disability Retirement law, the misunderstanding of an application of law can have direct and irreparable consequences:  the failure to secure disability retirement benefits and, therefore, the financial security for one’s future.  The “Bruner Presumption” is one such application of law which is often misunderstood.  Without revealing all of its proper applications, it can (and is) often misunderstood to be equivalent to a “presumption of innocence” — but that would be wrong.  The Bruner Presumption comes about as a result of an Agency Action — of removal based upon the employee’s medical inability to perform one or more of the essential elements of the job.  With or without the Bruner Presumption in Federal Disability Retirement law, the “Burden of Production” — i.e., of the medical documentation, the factual establishment that the Agency is unable to accommodate the individual — still rests and remains with the applicant.  One must never think that the applicability of the Bruner Presumption makes a case a “slam dunk” of any sort.  This is especially so where we are talking about those medical conditions which are often viewed as “suspect” by the Office of Personnel Management — such as Fibroymyalgia, Chronic Fatigue Syndrome, Multiple Chemical Sensitivity cases, etc (by “suspect”, however, I do not mean to imply that such medical conditions make it harder for an applicant to get it approved; rather, it merely requires that the one who is preparing such an application, do it properly, thoroughly, and with legal force).  Remember that the initial, and continuing, burden of production always remains with the applicant; what the Bruner Presumption merely does is to “shift” some of the weight of the burden of proof over to OPM, and in the event of an appeal to the Merit Systems Protection Board, of placing a Federal Disability Retirement case into a more favorable light with the Administrative Judge.

Sincerely,

Robert R. McGill, Esquire