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