Tag Archives: do you need to hire an attorney when opm denies your claim?

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

OPM Disability Retirement: Discretion in a Response

When a Federal Disability Retirement applicant under FERS or CSRS receives an unfavorable response from the Office of Personnel Management (translated:  an initial Denial), you have the right (which must be asserted in order to move forward in the future, i.e., to the MSPB and beyond) to file a Request for Reconsideration.  If you receive a second denial, then the only response required (and which should and must be asserted) is an appeal to the Merit Systems Protection Board.  A response to the initial denial, however, should include a reply to the (often) detailed “discussion” section of the denial letter. 

Normally, when I file a response (in addition to obtaining additional medical documentation from the doctors, and any other substantiating documentation which may be relevant), I normally write up a 5 – 7 page responsive legal memorandum rebutting the denial letter.  Now, this is where “discretion” is necessary.  Upon an initial reading of a denial letter, one’s first response is normally not that which one should act upon, because it is often a reaction of, “What???”   Discretion is a virtue to follow; there must be a proper balance between responding to every single criticism from OPM (not a good idea), to ignoring everything in the denial letter (also not a good idea), to choosing two or three of the more substantive issues brought up and addressing those issues.  How to address them, with what tone, what manner & style, etc., is what an attorney is for.

Sincerely,

Robert R. McGill, Esquire