OPM Disability Retirement: The Responsibility of the Office of Personnel Management

Perhaps it is an anomaly to even speak about the issue of “the responsibility” of the Office of Personnel Management — at least, from the general consensus of experiences as told by countless individuals who have filed for disability retirement benefits from the Office of Personnel Management, especially in recent years, one might conclude that OPM is slow to respond, or often refuses to respond at all.  However, to be fair, OPM — as with all other Federal Agencies — is made up of individuals; and the “good” or “bad” of an Agency is entirely dependent upon such individuals. 

Most of the disability retirement specialists at OPM are, in my opinion, of the “good” sort.  Without naming names, there are a few of the “bad” sort.  Of course, that says very little, because such a generalized statement could be true of all Federal Agencies. 

Moreover, OPM is presently short-staffed, overworked, and way behind on the processing of disability retirement claims.  What used to be a 60-day wait at the initial application stage is taking 90 – 120 days; and at the Reconsideration (2nd) Stage, what used to take 90 days is now taking 120 – 150 days, in many cases.   More than the “time” it takes, however, just remember that the primary responsibility of OPM is to take a careful and serious look at your disability retirement application/packet.  Also, remember that those disability retirement packets which are streamlined, logically constructed, and coherently argued, are the ones which will likely be quickly processed.  Don’t just strap a volume of medical records onto an application and hope for approval; in this day and age, it might be a wise investment to hire an attorney to “streamline” your packet.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Merit Systems Protection Board

An appeal to the Merit Systems Protection Board in a Federal Disability Retirement case means that the disability retirement application has been denied twice by the Office of Personnel Management:  at the initial application stage, then at the Reconsideration Stage.  This is often considered to be the third and last try — of convincing an administrative judge (an “AJ”) that you are entitled and eligible for disability retirement.  There are, of course, two additional stages — an appeal to the Full Board and to the Federal Circuit Court — but such avenues present only the right to reverse a decision of the Merit Systems Protection Board, and no new evidence can be presented.

Thus, one might consider the Merit Systems Protection Board as the “last stop” in the administrative process.  Do not think, however, that the process must necessarily be won before the Administrative Judge in a hearing — much work and persuasive argumentation should be made to the OPM representative who is handling the case at this MSPB Stage.  The OPM representative at the Third Stage of the process is usually an attorney; they are competent; they are versed in the case-law — and thus open to be persuaded by legal argumentation.  While the administrative stages (the Initial Stage and the Reconsideration Stage) involved OPM representatives who are non-attorneys, the MSPB Stage involves seasoned attorneys who present an opportunity for persuasion and argumentation, and thus a golden opportunity to convince OPM to reverse their own decision before coming to a Hearing.  Such an opportunity should never be missed, and every effort should be made by the applicant’s attorney to have multiple contacts with the OPM representative prior to the date of the Hearing.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability: End of Year

The New Year is upcoming. For those who are anxiously awaiting a decision on their Federal Disability Retirement applications, remember that this is a continuing process. Thus, whether or not the application gets approved or denied prior to the coming New Year, the process of then having the Agency provide the necessary payroll information in order for interim payments to begin, will still take some time. Unfortunately, the Office of Personnel Management is a bureaucracy. Within each bureacracy, as with all such gigantic entities, there are individuals who are competent in what they do; others, less so. Once a disability retirement application has been approved, the best thing which can be done to expedite payment on an approved claim, is to be persistent (on a daily basis, and some times on an hourly basis); be cordial and professional with each person you speak with, but be firm; get the name, telephone number, and write down any “promises” which an OPM person makes or proposes to make; then get a firm date as to when the promise will be fulfilled. Also, it is helpful, if possible, to get a supervisor’s direct number. Remember, good manners and courtesy will get you a long way; “befriending” an individual will get you even further; and gaining a sympathetic ear will get you the farthest. Be persistent, patient, and a pain-in-the-behind — all at once.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: Thanksgiving

This year has seen a tremendous amount of changes: a seeming meltdown of the economy; a coming change of the Presidency; vulnerability of the Big Three Automakers; a housing market downward spiral; a volatile stock market which seems to take two steps back for each day of upward trading; and on and on. In the midst of such turmoil and change, when a medical condition impacts a Federal or Postal employee on top of it all, it makes any potential perspective for a bright outlook to the future look bleak. Remember, however, that this is a week of Thanksgiving. It does well for the soul to pause and reflect upon one’s blessings. Yes, disability retirement benefits may not pay enough, but it is a benefit which is granted by a Federal government which has a compassionate understanding that such a benefit is necessary to allow loyal employees to have an opportunity to receive a financial “base amount” — and hopefully be able to be productive in some other capacity or career. I hope that everyone takes a moment this week and spends time with “the family”. Happy Thanksgiving.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Physician II

This blog is written in response to a question posed: in the event that an individual is unable to have a medical report written by a treating physician for circumstances beyond his or her control (i.e., such as death of a treating physician; uncooperativeness of a doctor; need to move to a different locality and need to switch to another doctor for whatever reason, etc.), would or can a physician’s medical narrative report written by a doctor of “short tenure” still be effective? The answer is, of course, as with all legal questions, “It Depends”.

Think about it this way: Disability retirement has to do with proving that, because of a medical condition, an employee of the Federal Government is no longer able to perform one or more of the essential elements of his/her job. This simple statement, when broken down, actually has a number of limitless components: What is the job? What are the specific elements? What are the medical conditions? What are the symptoms? How do the symptoms impact the person? Does it require medications? Does it require surgery? Are there other treatment modalities? What specific symptoms impact which specific job elements? And on and on.

Thus, these questions and the answers to such questions can normally be answered only by a treating physician — one who has, over the course of a long tenure of treatment, come to intimately know the patient. At the same time, think of the following issue: A doctor whose primary source of income being to write up “disability determinations” for individuals, and whose name repetitively appears in the Office of Personnel Management — that doctor’s reputation will quickly become questioned. The issue of an effective medical narrative has an inherent component: The credibility of the writer (the doctor), and credibility is usually determined by the tenure of the patient-doctor relationship. Are there exceptions? Absolutely. As with everything else in life, credibility can always be established with the truth — for instance, if a recent change in doctors occurred because of a move, the doctor can simply state that fact, refer to prior medical records reviewed, and move on to the substance of the opinion. Alas, credibility is what always counts.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: Other Stories of Success

There are obviously many, many pitfalls in the attempt to obtain disability retirement benefits from the Office of Personnel Management. Sometimes, I get calls from individuals who tell me that they “heard from a friend” that another employee prepared the disability retirement packet him/herself, and got it through within ___ months (you can fill in the blank with an unbelievably low number — say, 1, 2 or 3), and that there was no need for an attorney, and so why should anyone need an attorney?  I really have no response for such an inquiry; I am always suspicious of such “too good to be true” stories, but on the other hand, inasmuch as I don’t have any facts to refute or otherwise disbelieve such stories, I cannot comment on them.  I can only convey facts, circumstances, and experiences which I have with my own clients (don’t worry — all information received from and on behalf of my clients is protected by attorney-client confidentiality, and I never — ever — divulge personal information; I relate such experiences only in a generic sense, with no names ever mentioned), and indeed, each case is different and unique, and I try and treat each case based upon the specific facts, circumstances, and individual complexities inherent in each.  I really cannot comment on “that other story” that is heard through a chain of mouths and ears, only to be transformed into an unidentifiable success story.

People who come to me and ask for my legal guidance and expertise know that, to the extent I am able, I will answer each question based upon my professional experience; that I try to give a realistic assessment of each case, without embellishment; and my clients remain my clients for life.  Indeed, I get calls almost every week from people who I represented many, many years ago.  If a Medical Questionnaire is received, I am here to guide the recipient so that he/she will be able to retain the disability retirement benefits we fought so hard to obtain.  I have no idea about those “other success stories”; my goal is to satisfy the legal needs of my clients — those who have entrusted their cases in me, and for whom I have a special care and trust for.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement & the Economy

I have been asked, via multiple emails, of my opinion concerning the right time to file for disability retirement, given the state of the current economy. I am not an economist; I am an attorney who specializes in obtaining disability retirement benefits for Federal and Postal employees under FERS & CSRS. With that prefatory caution, let me state that I am an optimist, and always see the glass as “half full” as opposed to “half empty”.

First, if a Federal or Postal employee can no longer perform the essential elements of one’s job, then it is probably time to file for disability retirement. Second, while disability retirement does not pay a great amount of money, it is a base annuity which allows one to go out and start a “second career”, and make up to 80% of what a person’s former position presently pays, on top of the disability annuity. Further, because disability retirement allows one to retain one’s health insurance benefits, such an individual can be an attractive candidate to a private employer, because of the lack of need to insure the person in the course of his/her the second career. Third, in a tough economy, part-time employment is often more available, and so it is often a good economy for individuals who have a base annuity to rely upon, and who are looking for supplemental income. In any event, one should always look at disability retirement benefits as an opportunity to preserve one’s deteriorating health, and move on to pursue other avenues of opportunities.

Sincerely,

Robert R. McGill, Esquire

Patience During the FERS & CSRS Disability Retirement Process

It is now post-Labor Day Weekend. Summer is essentially over. The Office of Personnel Management will be back in “full force”. The inclination will be to call up OPM and impatiently — imprudently — demand that one’s disability retirement application be reviewed, because it has been sitting on Mr or Ms. X’s desk for the last 90 days. Be cautious of what you request, or demand — because you may get your wish, but with an outcome you do not desire — a denial. I often remark to my clients that if patience is a virtue, then Federal and Postal Workers must be the most virtuous people in the world, because you are the ones who must be most patient — during the years of service you have given, during the process of dealing with a demanding public, and finally, during the process when you need the Federal Government to act quickly — the disability retirement process. Be patient; thereby, be virtuous. Unfortunately, OPM does not have a statutory mandate during the administrative process. If you must call OPM, be courteous in your inquiry, and inquire only if necessary.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: What It Means to Have the “Burden of Proof”

Remember that the applicant who is requesting disability retirement benefits from the Office of Personnel Management always has the burden of proving, by a preponderance of the evidence, that he or she is entitled and eligible for disability retirement benefits.  Even if the Agency proposes and effectuates a removal based upon one’s medical inability to perform the essential elements of one’s job (thereby invoking the “Bruner Presumption”); nevertheless, the burden of persuasion always remains with the applicant.

Never assume anything; yes, the Bruner Presumption is nice to have, but don’t ever rely upon it to have your disability retirement benefits handed to you, because it won’t be.  The Bruner Presumption “can be rebutted if adequate evidence is identified in the record to establish that the appellant actually is not entitled to disability retirement; even with the rebuttable presumption, the appellant retains the burden of persuasion at all times to establish his entitlement to disability retirement” (See Morton v. Office of Personnel Management, 88 M.S.P.R. 691 (2001). Remember:  you always have the burden to prove your entitlement to disability retirement benefits; you must prove it; you must work tirelessly to show it.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: Symptoms Versus Diagnosis

If disability retirement were merely a matter of determining the proper diagnosis of a medical condition, and having a doctor ascribe a percentage rating of disability, then the process of disability retirement would substantively be altered, and perhaps there would be far fewer cases to adjudicate at the Merit Systems Protection Board level. For, if the criteria were that ‘cut and dry’, there would be little for OPM and the applicant & the applicant’s lawyer to argue over. However, it rarely is that ‘cut and dry’ — because the major battle is rarely over the diagnosis; it is rarely over an issue concerning a percentage ascription of disability; rather, it is over the symptoms manifested, the significance of such symptoms upon the type of work one does, and in the impact such symptoms have upon the essential elements of one’s job.

That is why descriptive terms are important in disability retirement law. It is not so important ‘what it is’, as opposed to ‘how it is characterized’. From this perspective, it is important for a disability retirement attorney to be more of a poet than to be cold and analytical — although, the best approach would be to have a little bit of both. Remember to always know the context — the applicant will not be standing in front of an OPM representative showing how terrible the applicant’s medical condition is; there will be no visual presentation; everything is based upon a narrative — the applicant’s statement, the medical documentation, the legal memorandum of the attorney, etc. Thus, it is all-important for the attorney who represents a disability retirement applicant to have a good command of the English language.

Sincerely,

Robert R. McGill, Esquire