Postal and Federal Disability Retirement: Last Minute Filings

Waiting until the very last moment in order to file a Federal Disability Retirement application is often an inevitable reflection of the medical condition itself; whether because the thought and act of filing contributes to the exacerbation of one’s condition, or because the severity of the medical condition impedes and presents an obstacle to proceeding, are somewhat irrelevant in the end; whichever may be the case, the fact is that the admixture of medical conditions, Statute of Limitations, and the need to obtain Federal Disability Retirement benefits, do not cohere well, and something inevitably suffers as a consequence.  But the law is impervious to excuses of filing inaction (with some narrow and specific exceptions); and society’s view is that a limit must be imposed at some point.

Thus:  For filing a Federal Disability Retirement application through the U.S. Office of Personnel Management, whether the Federal or Postal employee is under FERS or CSRS, the Federal or Postal employee must file the application for Federal Disability Retirement benefits within one (1) year of being separated from Federal service.  Waiting until the last minute can have some inherent and deleterious consequences, and failing to be attuned to them can come back to haunt one at a later date.  For example: Since one has waited until the last moment to file, once a Federal Disability Retirement application is filed, there will be little to no chance of amending the application (note:  “amending” is not synonymous with “supplementing“), as one no longer has the luxury of withdrawing a Federal Disability Retirement application, amending, and refiling; for, in the meantime, the Statute of Limitations has presumably come and passed.

Filing for Federal Disability Retirement benefits and waiting until the last possible moment is, unfortunately, a reality reflecting the often anxiety-filled state of affairs, both for the individual and the pressure to file on time; with that being said, it is nevertheless a reality which must be faced, and handled in the best possible manner under the given circumstances.

Sincerely,

Robert R. McGill, Esquire

OPM FERS/CSRS Disability Retirement: Approaching a Reconsideration

The proverbial definition of insanity is to engage in the same repetitive activity with the expectation of receiving a different result.  While such a definition may not provide a clinically accurate or legally acceptable formulation, it does implicate the chaotic character and the futile act of responding in a particularly fruitless manner.

For Federal and Postal employees who have attempted to file for Federal Disability Retirement benefits through the U.S. Office of Personnel Management, whether under FERS or CSRS, and have received an initial denial, the process of having OPM reconsider one’s case must be approached in a 2-tier manner:  First, one must meet the “deadline” of filing for Reconsideration with OPM within thirty (30) days of the denial, or upon receipt of the denial (although, to be on the safe side, it is best to use the former date as opposed to the latter);  next, with the box checked to indicate submission of additional medical documentation, to then gather, prepare, compile and submit additional medical evidence within thirty (30) days thereafter, unless a further extension is needed and requested.

However, one should also understand that in an OPM Reconsideration case, it will not be the same Case Worker who will review the case, but it will be reviewed thoroughly by someone else as if it had never been previously reviewed. As such, there is the confounding conundrum of a dual anomaly: The First Case Worker who issued the denial based the denial upon certain specific points; yet, what the First Case Worker denied the case upon, may have no bearing upon what the Second, Reconsideration Case Worker will evaluate the case upon.

What does one do? Whatever one’s answer is to this complex conundrum, do not engage in the proverbial act of insanity; better to get some legal guidance than to spin one’s wheels in an insane world of futility.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Government Employees: Someone Else’s Argument

Have you ever sat with company at a dinner table, and engaged in a conversation where it appears as if you are continuing someone else’s conversation?  Or your presence is merely a substitute for an extension of a previous debate or discussion?  Where a topic is brought up, and immediately a barrage of critical attacks — of arguments you have never made, and of statements you don’t recall disseminating (and where this is only 5 minutes into the salad and you’ve barely tasted the first glass of wine)?

The problem with unfinished business is that the transference of what one wanted to say is normally unloaded upon the wrong subject.  Conversations, debates, forums of intellectual exercises in linguistic battles — it is a rare person who has been able to convey the full force of one’s collective thoughts and beliefs on the matter, and it is more often the case that one leaves with the regretful remorse of, “I wish I had brought that point up…”  But rarely do second chances present themselves in a satisfactory follow-up forum; unless you are the unfortunate object for an unexpected dinner invitation.

In responding to a denial of a Federal Disability Retirement application with the U.S. Office of Personnel Management, whether under FERS or CSRS, the applicant — through his or her Federal Disability Retirement attorney — needs to understand that the person who issues the denial will not be the same person who will review any additional submissions or legal arguments at the Reconsideration Stage.

It will be reviewed, in legal parlance, de novo.  As such, while the basis of the denial as issued by the Caseworker at OPM at the First Level should be taken into consideration, one should approach the case in light of the following question: To what extent will the Reconsideration Branch care as to the original basis of the denial of the first caseworker?  If it is being reviewed de novo, the approach should be to go over all of the elements — and to reinforce and amend those weak points, some of which may overlap what the first caseworker pointed out, others which may not.

It may not be the best approach to argue to a dinner guest who wasn’t present at the first round of arguments; the points you are trying to make may not be heard because the bell has already rung, and the fighter in the second round has been replaced with someone upon whom you have never previously landed a punch.

Sincerely,

Robert R. McGill, Esquire

Postal and Federal Disability Retirement: Sparing the Legal Argument

In preparing, formulating, and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, there are multiple discretionary decisions to make.  By “discretionary decision“, is meant that there may be differing priorities of values which must be placed in the very process of deciding whether or not to include or exclude a medical document, legal argument, etc., and the prioritizing of the value placed upon such evidence is what will determine the decision itself.  There may ultimately be no “correct” decision on the matter, as opposed to an incorrect one.

Further, one may never know (or care, once an approval of a Federal Disability Retirement application is received) whether or not the Office of Personnel Management made a positive or adverse decision on the Federal Disability Retirement application (whichever the case may be at any given stage of the administrative process) based upon the same priority of values assessed upon the decision itself.

For example, sometimes the evidence itself — whether medical or non-medical documentary evidence — may be compelling enough in and of itself, that making a long and tedious legal argument may in fact detract from the prima facie strength of the evidence itself.  Or, it may be that a short sentence or annotation in a medical document may be so significant that a particular legal argument, however long and involved that may be, should be stated, and stated at length, and argued boldly.

Discretion dictates a restraining of a reactionary response; sometimes, the shorter the statement, the more effective is the presentation.  Length and verbosity alone do not constitute effectiveness in preparing, formulating and filing for Federal Disability Retirement benefits from OPM.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Disability Retirement: Discretionary Decisions

In preparing, formulating and filing for Federal Disability Retirement benefits under FERS or CSRS, there are obviously the “basics” which one must submit, in order to meet the legal standard of proof of preponderance of the evidence.  

Thus, submitting “adequate” medical documentation which formulates a nexus between the medical condition upon which the Federal Disability Retirement application is based, and the essential elements of one’s job; writing the descriptive narrative to complete the Applicant’s Statement of Disability (SF 3112A), and filling out the other standard forms in order to meet the minimum requirements, are deemed “non-discretionary”, in that one does not have the choice of filing such paperwork  — it is a requirement.  

However, certain other documentation can be designated and categorized as “discretionary” —  whether to include certain medical conditions, and therefore medical documentation which bears upon the particular medical condition; whether to include paperwork from one’s OWCP, Department of Labor filing; Veteran’s Administration ratings, findings, medical documentation; Social Security Disability paperwork; additional statements from co-workers; Private Disability Insurance paperwork, etc.  

“Discretion” implies freedom to act or not act, but the problem will often arise, “In what context”?  Discretion is a wonderful, liberating position to be in; acting effectively in a discretionary manner requires research, and knowing the relevant criteria to apply in making a proper decision; and an understanding of the laws governing Federal Disability Retirement in making the “right” discretionary decision.  

Using discretion in making discretionary decisions is the key to obtaining a positive discretionary determination from the Office of Personnel Management.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: SSDI Approval as a Special Case

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, there are multiple discretionary decisions which must be made in preparing a paper presentation to the Office of Personnel Management.  For instance, should determinations made by Second-Opinion or Referee doctors in a case which concurrently involves OWCP issues be included in the submission?  Should VA ratings be part of the packet?  Should determinations by a private disability insurance company be included? Should a determination by the Social Security Administration — which often will come about when the packet has already been submitted to the Office of Personnel Management while awaiting a decision — be forwarded to OPM?  

In proving one’s eligibility for Federal Disability Retirement benefits under FERS or CSRS, one must affirmatively prove, by a preponderance of the evidence, that one is eligible for the benefit.  That leaves much of the decision-making process regarding what information is relevant, helpful, pertinent and substantive, up to the Federal or Postal employee and/or his attorney to decide.  There are multiple details, and it is often in the minutiae and details which will win or lose a case.  Should all medical conditions be made a part of the packet?  

These are all discretionary issues to be decided, with the possible exception of Social Security.  Inasmuch as SSDI must be filed, and inasmuch as the statutory mandate is that SSDI and a FERS Disability Retirement annuity must be offset if both are approved, an approval by SSDI is a special case which is non-discretionary.  Not only must OPM be informed of its approval; under the case-law, it must be considered in the process of deciding upon a Federal Disability Retirement case.  Nevertheless, it still remains merely persuasive authority, and not determinative.

Sincerely,

Robert R. McGill, Esquire