Federal Employee Medical Retirement: Describing One’s Medical Conditions

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS from the Office of Personnel Management, the conundrum which one faces immediately is to attempt to overcome the seeming inability of third parties (OPM Personnel included) to understand, comprehend, relate to, and ultimately “feel” a sense of empathy and compassion for the particular genre of medical conditions a Federal or Postal worker suffers from.  

While the entire administrative process of filing for Federal Disability Retirement benefits is based upon a legal criteria, with a standard of proof set by law — that of “preponderance of the evidence” (which, simply put, means that one must prove that something is “more likely” the case than not — a relatively low standard of proof in the potential options of applying various legal standards) — it nevertheless comes down to having a fellow human being review, analyze, assess and evaluate one’s Federal Disability Retirement application at the Office of Personnel Management.  

Yes, there is an applicable legal criteria which is applied by the Office of Personnel Management.  Yes, there is a set of conforming documentation which must be submitted.  Yes, there are Standard Forms to be completed.  Yet, as with all processes of review, no evaluative process can be merely characterized as an objective calculus; otherwise, the eligibility requirement of a Federal Disability Retirement application should be able to be determined by a computer program.  

While such a possibility may well occur in the not-too-distant future, for the present, an actual person (although this is sometimes questioned, also, based upon the unresponsiveness of OPM and the voicemail messages one encounters) at the Office of Personnel Management must review, evaluate, and determine the viability of a Federal Disability Retirement application.  As such, part of the key to the success of the administrative process must be in the descriptive narrative of one’s medical conditions, their impact upon one’s ability/inability to perform one or more of the essential elements of one’s job, and the qualitative and quantitative impact, direct or otherwise, upon one’s life.  

Here again, a cold, objective calculus should not be the only approach.  The “human factor” should be included — and to do so, one must extrapolate and apply all of the descriptive tools available in the English language.  

Sincerely,

Robert R. McGill, Esquire

Medical Retirement for Federal Workers: Filing in Time

All of the work which goes into preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS becomes a nullity unless the deadline for filing the application has been met.  

Remember the fundamental rule:  While there are certain restrictions on amending or adding to a Federal Disability Retirement application once it has been filed (i.e., one cannot add a new medical condition  beyond what has been stated in the Applicant’s Statement of Disability — but there is always some flexibility in arguing whether or not additional medical documentation which one later supplements merely expounds upon previously-identified medical conditions or symptoms, as opposed to “adding” a “new” medical condition), one cannot even begin to make an argument about a particular medical condition, its impact upon a particular job and ability to work at a job, etc., unless and until one has met the foundational statutory prerequisite of timely filing.  One is estopped from making any argument at all unless one first files, and files within one (1) year of being separated from Federal Service.  

Thus, remember the basic rule:  If the time is fast approaching, file first.  Further arguments may be made later, but one cannot make any arguments at all, unless the Federal or Postal worker files the Federal Disability Retirement application under FERS or CSRS in a timely manner.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Symptoms & Diagnoses

In filing for Federal Disability Retirement benefits under FERS or CSRS, it is not that a formal diagnosis is unimportant; rather, it is that the diagnosis itself is merely a starting point and does not reveal the story which must be told in order to be eligible for Federal Disability Retirement benefits under FERS or CSRS.  

From a medical viewpoint, for treatment purposes and from the perspective of the treating doctor, identifying the source of the pain, entertaining the various treatment options, considering which treatment modalities will be most effective, etc., all play into identifying the proper source of the symptoms.  Thus, from a treatment perspective, identifying the medical condition by ascribing the proper diagnosis is of paramount importance.  A doctor often cannot begin the proper course of treatment unless and until formal identification is established. To that extent, it is also the beginning point for the treating doctor, in that once a source of pain or origin of symptoms is diagnosed, then various treatment modalities can be considered.  

For purposes of becoming eligible for Federal Disability Retirement benefits under FERS or CSRS, it is also merely a starting point.  As the Office of Personnel Management often likes to point out, “The mere existence of a medical condition does not mean that a person is disabled from performing one or more of the essential elements of one’s job.”  While quoting OPM as the source of legal authority is normally unwise, nevertheless one must grant that this particular statement is true within its limited context, and must be kept in mind when preparing a Federal Disability Retirement application under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: Using an Agency’s Action

Agencies will often act in predictable fashion; they act based upon prior actions engaged in; they act as an organic constituent of procedures and policies previously followed (often blindly and without thought) in the past; they act in self-interest, and often with a very narrow, myopic path and goal.

If an agency ignores the medical conditions and the documentation submitted showing the medical conditions of a Federal or Postal employee, and removes an individual from his or her Federal position based upon reasons other than one’s medical inability to perform one’s job (whether intentionally or because no one bothered to look at the medical documentation), then the resulting action can obviously impact a Federal Disability Retirement application under CSRS or FERS.  Often, the Agency’s general counsel will be the first person to finally listen to reason, and by then an appeal has been filed with the Merit Systems Protection Board, for the sole and narrow purpose — not of overturning the termination or getting one’s job back, but — of rescinding the adverse decision of removal and reissuing a removal based upon one’s medical inability to perform one’s job.

This course of action, however, is not always necessary.  Often, the adverse action, the delineation of poor performance, etc., can be directly tied to one’s progressively deteriorating medical condition, and the Agency’s own actions can be used to one’s advantage in proving a Federal Disability Retirement case.  Each case is different, and discretion in fighting for that which is helpful, and recognizing that what may “appear” to be adverse, is actually to one’s benefit, is the key to winning a Disability Retirement case under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

 

Federal and Postal Disability Retirement: Medical Conditions

In filing for Federal Disability Retirement benefits under FERS or CSRS, it is important to note that the Office of Personnel Management will often argue that the mere fact that a person suffers from a medical condition is not in and of itself a basis for granting disability retirement benefits.  So far as such a statement goes, the Office of Personnel Management is correct on the laws governing the eligibility criteria for Federal Disability Retirements (which is rare in and of itself).  Having a medical condition is not a sufficient cause in granting a Disability Retirement benefit.  As it is often argued in the world of philosophy, it is a necessary cause, but not a sufficient one.  In other words, one must indeed suffer from a medical condition (it is thus a “necessary cause”); however, suffering from a medical condition is not sufficient in and of itself to qualify for Federal Disability Retirement benefits under FERS or CSRS (it is not a “sufficient cause”).  One must, beyond having a necessary cause, prove that the medical condition is also the source and impact upon one’s inability to perform one’s job.  Thus, to the limited extent of its truth, suffering from a medical condition is indeed insufficient to obtain an approval from the Office of Personnel Management; it is not “proof enough” in and of itself.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: RIF

If a person is separated from Federal Service pursuant to a Reduction-in-Force, can he file an application for Federal Disability Retirement benefits under FERS or CSRS?  As with all such questions, “It Depends”.  If a person has a medical disability prior to the separation from service, and the doctor will state that prior to the separation, the Federal or Postal employee could no longer perform one or more of the essential elements of the job, then the answer is that he has a Federal Disability Retirement case.  Whether from a RIF or for some other reasons is ultimately irrelevant; the point is that one must ultimately show that prior to separation from Federal Service — any type of separation — the connection between the medical condition and the type of job one has, must be made.  Remember, further, that during the time of Federal Employment, if a person was receiving OWCP partial disability payments for an hour, two hours, three hours, per week or per day, that is further evidence that the Federal or Postal employee was unable to perform all of the essential elements of one’s job.  For, as with any full-time Federal sector job, being able to work 8 hours per day, 5 days per week, is part of the essential element of such a job.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Service Disability Retirement: Termination

Termination by a Federal Agency or the Postal Service can be a trying time, even if it has been a long time in expectancy.  The key is to try and begin negotiating with the agency even before the Notice of proposed termination is issued.  During that period when you know that the Agency is considering filing a Notice of Proposed Termination, is precisely the window of opportunity to try and convince & persuade the agency that the underlying basis of any proposed termination is and should be based upon your medical inability to perform one or more of the essential elements of your job.  This would be done through various means:  submission of medical documentation to your supervisor, agency & Human Resources personnel; addressing key points concerning conduct or performance with medical evidence showing a direct and causal correlation between such conduct or performance with the medical evidence, etc.  If, on the other hand, a Notice of Proposed Termination is issued but one which is not based upon one’s medical condition, that does not mean that the window of opportunity has been lost — it just may mean that the strategy and tactic to try and persuade the Agency to amend the proposed termination may have to be adapted.  The key to all of this is to make sure and aggressively attack, rebut, and answer, at all stages of any proposed termination, in order to gain an advantage for one’s medical disability retirement.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: After Separation from Service (Part 2)

Of course, it is always the separation from service based upon reasons delineated other than medically-based reasons which give rise to concerns in a federal disability retirement case.  Understand, however, that the “Bruner Presumption” is essentially a “scale-tipper” for the Office of Personnel Management (supposedly) and for the Administrative Judge at the Merit Systems Protection Board (of somewhat greater certainty).  By this, I mean merely that, with or without the Bruner Presumption, a Federal Disability Retirement applicant under FERS or CSRS must still prove by a preponderance of the evidence that he or she is eligible and entitled to federal disability retirement benefits. “Preponderance of the evidence” is essentially proof such that it is “more likely the case than not”.  Thus, when all things are equal, the Bruner Presumption is supposed to tip the scale in favor of the federal disability retirement applicant. 

On the other hand, if an individual was removed for reasons other than medically-based reasons — i.e., as a hypothetical, let’s say he was removed “for cause” — an act of dishonesty; failure to follow certain agency procedures; or whatever the case may be.  Does such a removal tip the scale the other way?  Not necessarily; however, it makes gathering the proper medical evidence that much more important, and what I often do is to try and tie in the underlying behavior which resulted in the removal “for cause”, with the medical basis — if at all possible.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Service Disability Retirement: After Separation from Service

It should be well established for anyone who has looked into Federal Disability Retirement issues, that a person has one (1) year from the time of separation from Federal Service to file for Federal Disability retirement benefits.  Separation from Federal Service can take many different forms:  Resignation; separation for cause; administrative separation based upon one’s medical inability to perform one or more of the essential elements of one’s job; etc.  The latter of these delineated forms (separation for medical inability to perform) is obviously the most beneficial to one contemplating filing for Federal Disability Retirement (first and foremost because it allows for the Bruner Presumption to be applied). 

On the other hand, separation based upon a resignation is often neutral for issues concerning disability retirement (unless, of course, one has been foolish to put into his or her letter of resignation that the reason for the resignation is to go and become a professional poker player for the next year — but even then, if a medical condition existed prior to resignation, one might still be eligible for disability retirement benefits under FERS or CSRS); and, obviously, if the resignation was accompanied by a medical reason, and that particular medical reason was reflected in the SF 50, all the better.  Even separation for adverse actions — if there was a medical condition which existed prior to separation — can be explained away and fought for.  The point here is, regardless of the nature, reason and expressed rationale for separation from service, if a medical condition existed prior to separation from service, such that the medical condition prevented one from performing one or more of the essential elements of one’s job, there is a viable basis for filing for, and fighting for, Federal Disability Retirement benefits under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: Clarity over Question

While a compromise position on certain issues in Federal Disability Retirement for FERS & CSRS may be the best that one may hope for, obviously, clarity over question is the better course to have.  Thus, for instance, in a removal action, where a Federal or Postal employee is being removed for his or her “excessive absences,” it is best to have the proposed removal and the decision of removal to reference one or more medical conditions, or at least some acknowledgment by the Agency, that would explicate — implicitly or otherwise — that the underlying basis for the “excessive absences” were as a result of the medical condition.  There are cases which clearly state that where excessive absences are referenced by medical conditions, the Bruner Presumption would apply in a Federal Disability Retirement case. 

Now, in those cases where the removal action merely removes a Federal or Postal employee for “excessive absences”, there are other methods which may win over an Administrative Judge to apply the Bruner Presumption.  Such “other methods” may include emails or correspondence, at or near the time of the removal action, which appears to put the Agency on notice about specific medical conditions, including attachments of doctor’s reports, medical notations, etc.  Such concurrent documentation can convince an Administrative Judge that, indeed, the question as to whether the “excessive absences” were as a result of a medical condition, and whether the Agency was aware of such an underlying basis, is clarified by documents which provide a proper context within the reasonable time-frame of the issuance of the proposal to remove and the decision to remove.  It is always better, of course, to have clarity over a question, but sometimes the question can be clarified with additional and concurrent documentation.

Sincerely,

Robert R. McGill, Esquire