Federal Disability Retirement: Reconsideration Selectivity

Perceptual selectivity is an adaptive process of some evolutionary benefits; otherwise, the voluminous extent of bombarding stimuli would be too much to process and digest. We naturally focus upon certain perceptual activities; perhaps it is the brighter colors, the more aggressive movements, the objects which seem to portend potential threats, etc.  In modern societies, where attacking cougars and lions are merely mythological stories of the past (except perhaps out West, where such events still abound), selective excision occurs more often in the context of linguistic extraction.

U.S. Office of Personnel Management - Disability, Reconsideration and Appeals Group

U.S. Office of Personnel Management:  Disability, Reconsideration and Appeals Group

For Federal and Postal Workers who file for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether the Federal or Postal employee is under FERS or CSRS, the process of selective extrapolation and argumentation can be a frustrating encounter when a denial of one’s Federal Disability Retirement application is issued by the U.S. Office of Personnel Management at the initial stage of the process (and even at the Reconsideration Stage).

It is indicative of the decision-maker’s mindset, and not necessarily as a consequence of the proof submitted.  There may be quotations extracted from medical reports and records seemingly supportive of a denial, while all the time ignoring countervailing wording and opinions which contradict or otherwise reverse the unsupportive statements.

Selectivity in the endeavor to find support for one’s position is simply something that people do.  You may cry out, “But where is the objectivity which is supposed to exist?” Objectivity is a learned process, achieved through discipline and intellectually rigorous self-effacement; selective bias, on the other hand, is the natural default position resulting from the evolutionary vestiges of man’s former state of existence. The residue of man’s natural state will always remain; but with the camouflage of sophistication presented in modern society, selectivity of purpose can mask our former state of brutish behavior.

For those encountering such selective processes in a denial from the U.S. Office of Personnel Management, the road to counter it is to argue the compendium of fact, law and full context of medical opinions, in preparing a full counterattack representing a viable refutation. In the end, the attempt at selectivity of facts and the law can easily be rebutted; but it often takes an awakening of the other’s evolutionary tendencies — of a potential threat of stimuli through the aggressive use of the law — which will result in a victory via an award of one’s Federal Disability Retirement benefits from the U.S. Office of Personnel Management.

Sincerely,

 

Robert R. McGill, Esquire

 

 

CSRS & FERS Medical Disability Retirement: The Treating Doctor

There is efficacy and motivational bias.  Sometimes, unintended consequences result in the coalescence of both, but where the result is unaffected by the underlying reason for acting upon an event.

In OWCP cases, the motivational bias almost always includes the intent of the Department of Labor to try and save money, and to steer the injured worker to undergo treatment (if one can call it that) and oversight with one of “the company” doctors who can quickly declare a person to be healed and ready for return to full-time duty, despite protestations of pain, discomfort and limitation of movement, all to the contrary.

It is no accident that the ever-present Worker’s Comp Nurse who infringes upon the patient-doctor relationship by imposing her presence upon each visit, agrees whole-heartedly with any such assessment of full recovery, and ignores the pleas of the patient/OWCP benefit-recipient.

By contrast, those who are filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, are encouraged to speak with their longstanding treating doctors, as opposed to merely going to a doctor whose motivational bias may stem from the source of one’s payment.

Treating doctors who have a long tenure of doctor-patient relationships have little underlying motivation to do anything but look out for the best interests of the patient.  If Disability Retirement is the best course, then that will be what the treating doctor will support.  It is ultimately the relationship that has been established over the many years, which makes for all the difference.  And that difference is worth its incalculable weight in gold.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: Conceptual Constraints

Within the world of biology, the distinction between an unicellular eukaryote and a prokaryote is one defined by the absence of a distinct, membrane-bound nucleus.  The latter is thus without a homunculus, constrained by a parameter and protected as the central seat of control.  One would assume that, because of this, the former would be easier to genetically manipulate, while the former would be more difficult.

Similarly, while widespread dissemination of responsibility and delegation of authority may have the positive effect of getting much work done, the corollary negative impact may also become uncontrollably representative of an organization:  loss of qualitative control.

Upon reading a denial letter from the U.S. Office of Personnel Management, whether under FERS or CSRS, from the U.S. Office of Personnel Management, one may begin to suspect that you are dealing with a prokaryote-type of entity:  for anything may be said, and what may be stated may not even remotely be the law of the case.

Being unconstrained by a membrane may have its advantages for survival; being unconcerned by the constraints of language will have its definite impact upon a Federal or Postal employee attempting to obtain Federal Disability Retirement benefits from the U.S. Office of Personnel Management: confusion for the Federal or Postal Worker, or worse, surrender and retreat.  But there are ways to counter such an untethered approach — but one which must use all of the legal tools available to the Federal or Postal applicant.

The key is to build a membrane and change the prokaryote into an eukaryote.  In order to do this, however, one must know the law, apply the law, and force the law upon the organism — thereby effectuating the genetic modification.  Thus does science, logic and law coalesce into a unified, rational whole.  Go figure.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for US Government Employees: Insufficiency Test

The validity of an allegation that there is an insufficiency of X is partly determined by an objective standard, and partly (if not mostly) derived from a judgment as to the nexus between X and the standard to be applied.  

In Federal Disability Retirement cases, whether under FERS or CSRS, the basis of most Federal Disability Retirement denials is that there is an insufficiency of proof, whether as to issues of accommodation, medical opinion, medical documentation; questions about deficiency of service; and multiple other specified areas — but all will ultimately be determined to have a “lack” of something such that it fails to meet a “sufficiency” test.  But sufficiency can only be determined by comparing what exists (i.e., what has been previously submitted to the U.S. Office of Personnel Management) to what the legal standard of proof requires.  

Further, since the overriding legal standard is based upon a “preponderance of the evidence“, which requires that something be ‘more likely than not’, the narrow gap between human involvement in the judgement of sufficiency, and a truly objective basis for such insufficiency, is susceptible to human error.  Because of this, appearance of quantity in addition to quality is often what is required.  

As decisions by OPM are rendered by a wide range of people whose judgment, competence and approach in evaluating a case differ greatly, it is unfortunately necessary to take into consideration the foibles of human error.  Until a precise algorithm is invented which applies fairly and accurately in all cases across the board, we must continue to deal with human beings, the their errors of judgment.

Sincerely,

Robert R. McGill, Esquire

Federal Worker Disability Retirement: The Reason for the Law’s Complexity

The growing complexity of any body of law often reflects the unintended consequences of a poorly-written statute which first created the access to a right, a benefit, or a legal assertion.  Complications and expansion of issues, clarifications of previously-obfuscated matters of law, evolve over time and begin to take on a life of its own.  

For Federal Disability Retirement law, there is the appearance of a simple process:  one only has to look at the Standard Forms which are made available to all Federal and Postal employees who are contemplating filing for Federal Disability Retirement benefits, whether under FERS or CSRS, to recognize that, at least on the surface, the administrative process seems simple enough.  

The SF 3107 series (for FERS Federal and Postal employees) and SF 2801 series (for CSRS Federal and Postal employees) requests basic information of a factual nature.  The “other” series of Standard Forms — the SF 3112 series (both for FERS and CSRS Federal and Postal employees) requests information directly impacting one’s Federal Disability Retirement application.  

The questions asked are quite simple, and appear somewhat innocuous; the body of law which has grown behind each question is comprised by years and decades of litigation, questioning, judicial decisions and case-law.  It is like the proverbial stranger who discovers what appears to be a tuft of hair (perhaps a mouse?) sticking out from behind a bush, reaches down and pulls, only to hear the roar of a lion for having yanked its tail.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: Complexity & the Law

The complaint heard most prevalent is that the “law” is deliberately complicated for the benefit of lawyers, and to the detriment of the lay person.  That is the one of the points which Dickens makes in his work, Bleak House — a lengthy work which meticulously follows the probate of a contested will, where the lawyers involved appear to be the only beneficiaries of the central litigation. But that only tells one side of a story.  

Complexities in any issue surface because of lack of clarity; and lack of clarity manifests itself as each case brings to the forefront questions and concerns previously unspoken or uncontested.  As an example — the issue in Stephenson v. OPM, where the U.S. Office of Personnel Management refused to recalculate one’s FERS Disability Retirement annuity even though the annuitant was no longer receiving SSDI benefits, because OPM interpreted the word “entitled” in a unique and perverse manner — could have been left alone without litigation, and therefore allowed to remain a simple matter.  

This had been going on for decades.  But somebody — Mr. Stephenson in particular — decided that OPM’s actions were unfair, and that it needed to be litigated.  Did it complicate matters?  Complexity is an inherent part of the law, and as issues become contested, the evolution of a body of law can expand into a compendium of complexity.  

It is no different with Federal Disability Retirement.  Yes, Federal Disability Retirement law is a complex body of administrative issues; it requires expertise; but if it was left alone, you can be assured that OPM would step over, on, and around many more Federal and Postal Workers who are otherwise eligible and entitled to Federal Disability Retirement benefits. That is why complexity can go both ways — for the agency, but also for the Federal or Postal employee.

Sincerely,

Robert R. McGill, Esquire

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

Whether fair or not; whether consistent or a lack thereof; the one who holds the power of determination ultimately has the authority of interpretation — until and unless a higher authority supersedes such power.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, the Federal or Postal employee can seemingly comply with all of the requirements of the laws and case-laws governing Federal Disability Retirement eligibility and entitlement, and still be denied.

The standard response on the telephone is often, “I thought I had a slam-dunk case…”  But the problem with approaching a governmental bureaucracy is that one assumes (wrongly) that application of the law will be implemented in an interpretively consistent manner.  But where individuals are involved, a multiplicity of interpretive approaches will surface.

Some OPM personnel will focus upon certain legal aspects over others; others will apply a “higher” bar of passage as to what meets the “preponderance of the evidence” test; and still others will be so obtuse as to refuse, or merely fail to, accept that when a doctor (for example) states that a condition is “permanent”, that such a statement logically entails and encapsulates the satisfaction of the requirement that a medical condition will last a “minimum of 12 months“.

How to respond to such inconsistencies? By reasserting the law; citing applicable case-law; by preemptively guiding OPM into approving one’s Federal Disability Retirement case.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for US Government Employees: Denials

Denials issued by the U.S. Office of Personnel Management in a Federal Disability Retirement application are informative in multiple ways; while based upon templates for the most part, they often make arguments which are neither based upon the legal precedents which currently prevail, nor on standards of proof which are applicable.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, the Federal or Postal employee is expected to submit a Federal Disability Retirement application based upon the standard of proof and legal requirements which are current, applicable, and relevant.

Yet, if a denial is issued by OPM — one that is based upon language which is clearly contravening the statutory standards of legal precedents — that requires things which are not truly required, then what does one do?

It is tantamount to proving a negative:  how does one prove that a murder did not occur?  Or that a man did not say something asserted to have been stated?  Or that one’s Federal Disability Retirement application does not contain “compelling” medical evidence, or here’s a better one:  “According to AMA Guidelines, you do not have more than a 5% permanent disability rating…”  What?  For OWCP purposes, that may hold some meaning or relevance, but for a Federal Disability Retirement application, it means absolutely nothing.

The answer to the question, What does one do?  What one must — go to the next level, with the proper legal tools in hand, to answer such nonsense.  Or, better yet, start at the first level with some preemptive legal arguments.

Sincerely,

Robert R. McGill, Esquire

Postal and Federal Disability Retirement: Selective Extrapolation

The game of selective extrapolation is played by many; there was a time when such a methodology — otherwise known as taking something “out of context” — was with simplicity and bluntness identified for what it is:  dishonest.  But in this day and age, it has come to be accepted, and even applauded, for such characteristics as “aggressiveness” and “smart play”.

Once, in an age where integrity and fidelity were upheld as character traits worthy of emulating, there was an affirmative duty to “tell the whole story” — that if X quoted from a document in fragmented form, it was one’s duty to provide the entirety of the context in order to be “fair”.  Perhaps it is the adversarial nature of the legal arena which allowed for this standard to change; or perhaps it is just part of the greater deterioration of the culture; in any event, in modern times, it is an accepted practice to merely take sentences, words, concepts and phrases out of context, and twist and mangle them to whatever form and usage will gain one’s advantage.

In Federal Disability Retirement law, especially in the context of a denial issued by the U.S. Office of Personnel Management, one will often find the use of selective extrapolation — of taking a lengthy, comprehensive medical report of a doctor, and choosing to quote an almost-irrelevant statement which seems to support a negative or opposite conclusion from that which the doctor has stated.  At first glance, one merely scratches one’s head with puzzlement; but after the initial shock, it must be recognized for what it is:  an attempt to merely justify the denial of a Federal Disability Retirement application.

How to rebut it?  Fortunately, the rebuttal is not made to the same individual who played the game of selective extrapolation; that would obviously be an act of futility.  The rebuttal must be forceful and head-on; call it for what it is, and provide the correct content and context.

In Federal Disability Retirement law with the U.S. Office of Personnel Management, whether under FERS or CSRS, one must prove by a preponderance of the evidence that one is entitled to Federal Disability Retirement benefits.  In order to do so, one must maintain a level of integrity which reveals the sharp contrast to those who engage in such games.

It is sometimes difficult to refrain from playing the other person’s game; but in the end, let’s hope that age-old standards of integrity and fair play will continue to win out.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Unequivocal Doesn’t Mean That One Is “Right”

In a denial letter from the Office of Personnel Management, the Claims Specialist/Representative will often make statements in confident, unequivocal terms.  “You have not…”   “The medical evidence fails to show…”    “Your doctor never…”   “The law requires that you…”  Such a voice of unequivocal confidence often leaves the impression that there is no room for argument; that the case is lost; that there really is no point in even attempting to argue with the Office of Personnel Management.  Nothing could be further from the truth. 

Merely because an individual makes statements in an unequivocal manner, is not a basis for determining the truth or falsity of his or her argument.  In a Federal Disability Retirement application under FERS or CSRS, there is almost always room for disagreement.  We are speaking about interpretation of medical documents, the significance of what is said, etc.  We are talking about the different and proper application of the OPM Disability law, and the multitude of case-law which would be applicable.  Don’t let the voice of a statement fool you as to the validity of the statement.  In a Federal Disability Retirement case, the Office of Personnel Management is rarely right; they just like to sound like they are.

Sincerely,

Robert R. McGill, Esquire