Federal Disability Retirement Representation: Substance and Process

In any bureaucratic, lengthy administrative process, one can become embroiled in the procedural aspects of an endeavor, and overlook the substantive elements which form the foundation of any case.  Conversely, one can make the mistake of approaching a case and declare to one’s self, “This is so obviously a good case,” and take shortcuts in the process of putting together an effective and persuasive case.

Either approach is one fraught with grave errors, and for Federal employees and Postal workers who are beginning the process of preparing, formulating and filing for Federal Disability Medical benefits, first through one’s own agency (if still on the rolls of the Federal agency or the U.S. Postal Service or, if separated, for not more than 31 days), and ultimately submitted to the U.S. Office of Personnel Management in Boyers, Pennsylvania (directly, if the Federal employee or U.S. Postal worker has been separated from Federal service for more than 31 days), it is important to keep the balance between the substance of a case, and the process of the case.

Substantive issues involve everything from the factual, informational content required on all standard forms (SF 3107, along with Schedules A, B & C, and the required attachment of one’s DD 214 showing prior active military service; SF 2801 for CSRS employees; and the substantive content of the description of one’s medical conditions to be considered, as required in SF 3112A, etc.), as well as the medical documentation needed to provide the evidentiary support for one’s case.

“Process” issues involve the timeframe in filing a case, the administrative procedures of where the disability application must be submitted through, as well as the myriad of sequential steps required for satisfaction of accommodation issues with one’s agency.

Substance and process — they are the necessary sides of a single, inseparable currency of an administrative reality known as Federal OPM Disability Retirement, and both must be attended to in order to reach the heights of efficacy mandated for a successful outcome in the preparation, formulation and submission of an OPM Medical Retirement application.

Sincerely,

Robert R. McGill, Esquire

 

Disability Retirement for Federal Government Employees: Confusion & Disarray

A state of confusion and disarray can work in either direction; either the confused state of affairs can lead to a successful outcome (resulting from the inability to make a logically correct decision, but where a favorable outcome may randomly occur); or the state of disarray can result in a detrimental consequence, also arising from the state of confusion.  The former is often random in scope; the latter is more predictable.

Reliance on the potentiality that it “may come out right” is normally not the best course of action to take.  As such, if one is confused about a subject, an issue, etc., it is often a wise step to take to consult with someone who can unravel the layers of obfuscation surrounding an issue or circumstance.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, a repetitive thread of frustration heard throughout the process — both in a procedural sense, as well as the underlying substantive approach to completion — is the confusion of the forms themselves, the information needed to prove one’s case, and the necessity of coordination in matters of bureaucratic steps.

The obstacle of confusion and disarray is not one which is merely felt by any unique individual; it is pervasive, and you are “not alone” in the matter.  The fact is, the entire administrative process of preparing, formulating and filing for Federal Disability Retirement benefits is indeed a confusing one, and one fraught with a state of disarray.

It is thus important to approach the entire process with a logical, sequential methodology, in order to find one’s way out of the darkness of a black hole.  The universe may well have all sorts of unexplainable phenomena and voids; the Federal process of filing for Federal Disability Retirement benefits may well be one of them.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Administrative Process

Ultimately, Federal Disability Retirement must be viewed as a “process“, as opposed to a singular procedure whereby a triggering mechanism automatically allows for receipt of benefits.  The former requires an affirmative approach which involves submission of proof, argumentation, an expectation of resistance (in many cases), and an analysis by the U.S. Office of Personnel Management as to whether or not all of the legal criteria have been met.  The latter is merely a formality of filing.

As a process, filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management has various steps, procedures, and Stages for appeals.  There is, first and foremost, the initial application Stage, where one has the opportunity and right to submit proof of eligibility, and make legal arguments for entitlement.  If one’s Federal Disability Retirement application is denied at the first Stage of the process, then one has a right to have it “reconsidered” by filing a “Request for Reconsideration” within 30 days of the date of denial, or receipt of the letter of denial from OPM, whichever is later.  If denied a second time, then the Federal or Postal employee who is filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management has a right to file an Appeal to the U.S. Merit Systems Protection Board.

There are, in addition to the 3 stages described, two (2) additional stages of appeal, but the three main stages of filing are what have been previously described.

With such a “process” in mind, it is wise to prepare for the long haul.  An expectation of a quick and easy approval, even if obtained, should not be embraced at the outset, precisely because one must take into consideration the potential length of time which the entire process may take, and prepare accordingly.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for US Government Employees: Basic Approaches

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, it is always best to begin the formulation and preparation of a case by attending to the basic approaches.

Complexity of a case should not be inherently obvious.  The ease with which the professional in any field of activity makes such an activity appear to the spectator, is merely an attestation of the time and preparation expended.  

If a case is so complex that the Federal or Postal employee is unable to convey the interactive bridge between the symptoms and diagnosed medical conditions, and the type of positional duties which one must be able to function at, then how is the Claims Representative at the Office of Personnel Management going to be able to comprehend such complexity which the Applicant himself/herself is unable to effectively delineate and describe?  

Extraneous complexities, outside issues, peripheral concerns, and intra-agency squabbles, including allegations of discrimination, unequal treatment, etc., are normally irrelevancies which must be forced from the center of a Federal Disability Retirement case, to a mere passing footnote, if that.

Remember that one does not want to be pigeonholed into asserting a “situational disability” claim, which is a valid basis to be denied in a Federal Disability Retirement application.  Keep things simple. Approach the case with the basics in mind.  Formulate the nexus between one’s medical conditions and one’s positional duties.  Always keep in mind the essence of a case.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for US Government Employees: Uniqueness & Comparisons

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, then submitting the presentation either through one’s agency (if one is still on the rolls of the Federal or Postal Service, or if separated, it has not yet been 31 days or more) or directly to the Office of Personnel Management (if one has been separated from Federal Service for 31 days or more), it is then the entrance into the dreaded “waiting period” where the dead zone begins of increasing anxiety, angst and upheaval of awaiting “the decision” from the Office of Personnel Management.  

During this time of waiting wasteland, it is difficult to remain productive if one is no longer working at the Agency, and it is easy to fall prey to the mentality of comparison — of attempting to obtain information on other filings, of other Federal or Postal employees, either current, fairly recent, or in the far past, and attempting to gauge the success or failure, the waiting period, whether some have been preferentially treated, etc.  

The problem with engagement in such comparisons, of course, is that it is almost impossible to recreate an apple in order to compare it to another apple.  Whether because the internal procedures of OPM have changed (which it has), and comparing it to a time passed when procedures reflected a more systematic methodology of review; or whether one attempts to figure out if there is a non-arbitrary system of review at OPM (there isn’t); or whether the case has been assigned to a more experienced case-worker as opposed to one who has newly come on board at the Office of Personnel Management; or whether the strength of one’s medical and other substantiating documentation makes the initial review for OPM to grant the case immediately — all are factors, and many more not delineated herein, which make for differences between cases which cannot be compared.  

Each case is unique; uniqueness is the differentiation between cases; the cases, because of each individual uniqueness, fails in all attempts at quanitification of comparative analysis.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Government Employees: The Approach

In the busy lives we lead, it is often a temptation to simply adopt a generic approach to each event, for purposes of ease and convenience.  It is easy to think that most distinctions in life do not contain relevant differences — at least not enough to make much of an impact.  

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, it is certainly useful to utilize the paradigm of successful past filings, and there is enough information “out there” by multiple attorneys and “specialists” (whatever that may mean) to gather a composite model of a Federal Disability Retirement application which has a good chance of becoming approved.

However, one must always remember that each individual case is unique because of the multiple factors which must interact, and the uniqueness of the approach must match and be tailored to the distinctions which are inherent in each case.  Not only are the medical conditions different; the job description, the essential elements of a job, the symptoms which manifest themselves; whether the Federal Disability Retirement application should be based upon a single medical condition or a combination of multiple conditions; whether psychiatric conditions are primary or secondary; the intersecting impact between the medical conditions and the essential duties of one’s job; and, beyond all of this, if a Federal Disability Retirement application is denied at the First Stage of the process, or even at the Reconsideration Stage, the methodology and approach of responding to such a denial is important.  

Generic approaches are sometimes useful, but in preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, it is important to recognize that most distinctions do in fact make a difference.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: “The Grab-bag”, “Volume” and the “Last Minute” Case

Procrastination leads to filing a Federal Disability Retirement application under FERS or CSRS at the last minute, which leads one to simply attach a volume of medical documentation and list a grab-bag of medical conditions. 

Sometimes, such an approach is thought to be the only way of preparing, formulating, and filing a Federal Disability Retirement application, especially when there is little or no time left in which to meet the statutory deadline for filing (a Federal or Postal employee must file within 1 year of being separated from Federal Service).  It may well be the only way to file, given that a Federal or Postal employee has only days left to submit the Federal Disability Retirement application. 

The fact is, one can only argue the merits of a case if, and only if, one has met the Statute of Limitations; if one fails to file in a timely manner, then there is simply no opportunity at all to argue the substantive basis for the Federal Disability Retirement application.  Yet, even in “Last Minute” cases, it is important to pause and attempt to streamline a case.  Why?  Because once a case has been filed, and the Statute of Limitations has passed, a Federal or Postal employee is unable to change or otherwise amend the stated and identified medical conditions, as listed on Standard Form 3112A. 

As such, even at the last minute, the grab-bag volume case should be — and can be — prepared and formulated with some thought.  In the end, it will serve the Federal or Postal employee who is filing for OPM Disability Retirement benefits under FERS or CSRS, well.

Sincerely,

Robert R. McGill, Esquire

Federal Worker Disability Retirement: The “Grab-bag” Approach

In preparing, formulating, and filing a Federal Disability Retirement application under FERS or CSRS, there is always the question of which medical conditions to include in the Applicant’s Statement of Disability (prepared on SF 3112A).  One approach which many Federal and Postal employees take (which, in my opinion is the wrong one to embrace), is to name every medical condition, symptom and suspected symptom one has suffered from, or is suffering from.  This might be characterized as the “shotgun” or “grab-bag” approach. 

One must be sympathetic to this approach, of course, if only because of the following reason:  OPM regulations and case-law supports the position that once an application for Federal Disability Retirement benefits has been filed with the Office of Personnel Management, a Federal or Postal employee cannot amend or add any further medical conditions without withdrawing the application and re-filing. 

Thus, a Federal or Postal employee who prepares and files an application for Federal Disability Retirement benefits is “locked into” what is stated on one’s SF 3112A.  Because of this, many Federal and Postal employees who prepare the application without the assistance of competent legal representation will take the “grab-bag” approach of listing every possible medical condition known to man. 

While this may seem like a reasonable, “safe” approach to take, remember that such an approach can have unintended consequences:  Upon an approval of the Federal Disability Retirement application, the approval letter may approve the Disability Retirement application based upon a minor medical condition which you no longer suffer from.  This, of course, can have negative consequences down the road.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Differing Perspectives

The old adage, “Walk in your fellow man’s shoes for a mile” is a saying which is meant essentially to teach a child (and many adults) to have a different perspective than one’s own, self-centered universe.  In practicing law, it is a good idea to attempt to obtain a perspective from the multitude of differing “shoes” — and this is especially important in putting together a Federal Disability Retirement application under FERS or CSRS. 

The gathering of such differing and different perspectives — that of the treating doctor; that of the applicant; that of the Agency (the Supervisor and the Agency in its determination that accommodation or reassignment is not available or appropriate for a given employee, given the particular medical conditions and the type of positional duties of the specific job which the Applicant must perform, as well as taking into account what constitutes “efficiency” in the Federal Service, etc.); and further, that of the Office of Personnel Management. 

It is the job of the Attorney representing a Federal or Postal employee in preparing a Federal Disability Retirement packet under FERS or CSRS, to pull together the various perspectives; write up and prepare, and gather the information from the multiple and differing perspectives; to neutralize those perspectives which may impact negatively upon the Federal disability retirement application; then to present the fullness of the different perspectives such that it meets the legal criteria and “perspective” of the Representative from the Office of Personnel Management:  that “ultimate” perspective which determines a “yes” or “no” in determining the viability of a Federal Disability Retirement Application.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: Pragmatic Considerations

Often, pragmatic judgments and decisions must be considered at different stages of a disability retirement application. For instance, whether to submit all of the medical documentation in your possession is a discretionary judgment which needs to be considered. One might wonder why an applicant may withhold some or part of the medical documentation, and the answer is quite simple: if the Office of Personnel Management requests additional medical documentation, or it is rejected at the Initial Stage and further medical documentation needs to be submitted — if the applicant does not have additional medical documentation to submit, then there is very little incentive or basis for OPM to “reconsider” their position of denial.

Now, one might wonder, If the “additional” medical documentation had been submitted in the first place, perhaps OPM would never had requested more documentation, or perhaps they would have approved it to begin with. Not necessarily so. If you have already provided sufficient medical documentation to prove by a preponderance of the evidence your case, sometimes reserving that “extra” set of office or treatment notes is a wise decision. It may be the difference between being able to respond to OPM’s request for additional medical documentation, and not being able to — and the difference between an approval or a denial, and a basis for OPM to “reconsider” their position.

Sincerely,

Robert R. McGill, Esquire