CSRS & FERS Disability Disability Retirement: The "Process"

In my last writing, I briefly discussed why filing for Federal Disability Retirement benefits is, and must be looked upon as, a “process” as opposed to a mere “filing” with an expectation of an “automatic” approval.  This is because there is a legal standard of proof to be met, based upon a statutory scheme which was passed by Congress, and based upon a voluminous body of “case-law” handed down by the Merit Systems Protection Board and the Federal Circuit Court of Appeals.  With this in mind, it is wise to consider that, because it is a “process” with two administrative “stages” to the process, as well as an Appeal to an Administrative Judge at the Merit Systems Protection Board, then potentially to the Full Board via a Petition for Review, and finally to the Federal Circuit Court of Appeals — as such, each “step” in the process would naturally have a different and “higher” level of the laws governing Federal Disability Retirement. 

Because of this, it is often a frustrating experience for applicants, because a rejection or denial at the First Stage of the process often reveals the utter lack of knowledge by the OPM representative of the larger compendium of case-laws that govern and dictate how disability retirement applications are to be evaluated and decided upon.  Often, the so-called “discussion” of a denial letter is poorly written, meandering in thoughtlessness, and self-contradictory and with unjustifiable selectivity of statements from a medical report or record.  Such poor writing reflects a first-level decision-making process, and can be a frustrating experience upon reading the denial letter.  It is good to keep in mind, however, that the entire application procedure is a “process”, and each level is designed to have a greater level of competency and knowledge in the law.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Argument by Analogy

Attorneys argue “by analogy” all of the time; cases and decisions from the Merit Systems Protection Board, and language from the Federal Circuit Court of Appeals, provide the fertile fodder for such argumentation.  Thus, such issues as to whether the Bruner Presumption should apply in the case; whether a case is similar to previously-decided Federal Disability Retirement cases; the similarity of fact-scenarios and legal applications — they are all open to argument by analogy.  That is why case-citations are important — even in arguing a Federal Disability Retirement case to the Office of Personnel Management.  Whether and how much influence such legal argumentation can have at the first two stages of the disability retirement application process, may be open to dispute; but cases should never be compiled and prepared for the first or second stage alone; all disability retirement applications should be prepared “as if” it will be denied and will be presented on appeal to the Merit Systems Protection Board.  Such careful preparation serves two (2) purposes:  First, for the Office of Personnel Management, to let them know that if they deny it and it goes on appeal to the Merit Systems Protection Board, they will have to answer to the scrutiny of the Administrative Law Judge; and Second, for the Administrative Law Judge at the Merit Systems Protection Board, to let him or her know that you did indeed prepare the case well, and that your particular Federal Disability Retirement application conforms to the law, and should therefore be approved.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: The First Denial

Your Federal disability retirement application was well-prepared:  perhaps it was prepared with the help of an attorney; the medical documentation seemed solidly unequivocal; the doctor made the necessary connections between one’s medical conditions and the type of essential elements of one’s job; the packet, by all accounts, should have been approved, and by all expectations, the approval should have been reasonably expected. 

Instead, you receive a letter stating that your disability retirement application was disapproved, and a “Discussion” section follows, explaining why the Office of Personnel Management denied your application.  Why did this happen?  There are multiple reasons why such a denial can occur:  the OPM specialist could be a person who lacks a clear understanding of the applicable laws governing disability retirement applications (more often than not, this is the case, and what you actually get in the so-called “Discussion” Section of the denial letter is merely a regurgitation of the statutory criteria for eligibility for disability retirement, without a recognition of the interpretation of such criteria by Federal Judges for the Federal Court of Appeals or by Administrative Judges from the Merit Systems Protection Board); it could be as simple as the OPM representative selectively choosing to read the medical reports and records, and disregarding or ignoring supportive portions of the medical records and reports; or it could be that additional medical reports and records need to be obtained in order to “shore up” the application. 

In any event, whatever the reason for the denial, one should not panic.  It is merely one step in a long, administrative process.  The mere fact that OPM denies your disability retirement application does not mean that they are “right” in doing so; indeed, in my opinion, they are rarely right.  That is why one has the right to have it “reconsidered”, and the opportunity to make further legal arguments, and obtain further medical documentation in support of your claim.  And, beyond that, you have the right to file an appeal to the Merit Systems Protection Board — and beyond.  Never give up; always take it to the next step.  In most cases, it will prove that OPM was in error, and in fighting the denial, you will have secured some semblence of financial security for your future.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Merit Systems Protection Board

An appeal to the Merit Systems Protection Board in a Federal Disability Retirement case means that the disability retirement application has been denied twice by the Office of Personnel Management:  at the initial application stage, then at the Reconsideration Stage.  This is often considered to be the third and last try — of convincing an administrative judge (an “AJ”) that you are entitled and eligible for disability retirement.  There are, of course, two additional stages — an appeal to the Full Board and to the Federal Circuit Court — but such avenues present only the right to reverse a decision of the Merit Systems Protection Board, and no new evidence can be presented.

Thus, one might consider the Merit Systems Protection Board as the “last stop” in the administrative process.  Do not think, however, that the process must necessarily be won before the Administrative Judge in a hearing — much work and persuasive argumentation should be made to the OPM representative who is handling the case at this MSPB Stage.  The OPM representative at the Third Stage of the process is usually an attorney; they are competent; they are versed in the case-law — and thus open to be persuaded by legal argumentation.  While the administrative stages (the Initial Stage and the Reconsideration Stage) involved OPM representatives who are non-attorneys, the MSPB Stage involves seasoned attorneys who present an opportunity for persuasion and argumentation, and thus a golden opportunity to convince OPM to reverse their own decision before coming to a Hearing.  Such an opportunity should never be missed, and every effort should be made by the applicant’s attorney to have multiple contacts with the OPM representative prior to the date of the Hearing.

Sincerely,

Robert R. McGill, Esquire

OPM Federal Disability Retirement: The Emergency Filing

On the desk of one of the Circuit Court clerks, in an adjacent county, is a sign which reads: “The fact that you waited until today does not make it into my emergency.” Those who stand in line to file an emergency pleading, either try to ignore the prominently-displayed sign, or hope that some other clerk will attend to his or her needs. Yet, we all know that there are times when, for one reason or another — the year passed so quickly; the medical reports which we expected months ago just arrived; “life happened” and the 1-year mark for filing for disability retirement is upon us — we have a couple of weeks, or perhaps a week, or perhaps only a couple of days, to file for Federal disability retirement benefits.

When such an emergency filing becomes necessary, three things must happen: First, the three essential forms must be quickly filled out (whether they are adequately and sufficiently filled out is another matter — but just remember that if you don’t at least meet the 1-year statute of limitations for filing for Federal disability retirement benefits, you are left with no argument at all; whereas, at least by filling out the forms and filing, regardless of their adequacy or completeness, you can at least argue later that it meant x or y). Those three (3) forms are: SF 3107 Application for Immediate Retirement for FERS; SF 2801 for CSRS; Schedules A, B & C for FERS & CSRS; and SF 3112A, Applicant’s Statement of Disability for FERS & CSRS. Second, fax the three completed forms to Boyers, PA, and Express Mail or FedEx it (and get a fax confirmation sheet); and Third, follow up with a phone call to Boyers to get the name of the person who will confirm that he/she received the fax.

Every now and then, “life happens”, and emergency filings are necessary. In a perfect world, such emergencies should be unnecessary; and while the clerk in the Circuit Court in an adjacent county might look with disgust upon the lawyer or pro-se individual attempting to file an “emergency” pleading, whether it is his emergency, her emergency, or someone else’s fault, the fact still remains: It needs to be filed on time.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: Christmas Season

Christmas is upcoming. The Office of Personnel Management, along with many other Federal Agencies, is beginning to “shut down” for the Holiday Season. OPM will be making many decisions concerning pending disability retirement applications. For those who receive a denial, obviously a negative decision coming during the Holidays is unwelcoming news; for those who receive an approval, the reaction is normally that it is great news and a needed Christmas present. But a negative decision — a denial from OPM — needs to be put into its proper perspective. Yes, it is an unfortunate bit of news coming at a bad time; but those who file for disability retirement benefits, must always look upon the process as one involving 4 steps: The initial application step; if denied, the Reconsideration step; if denied a second time, an appeal to the Merit Systems Protection Board; if denied by the Administrative Judge at the MSPB, an appeal to the full Board via a Petition for Review (PFR) — and even a fifth step, to the Federal Circuit Court. Remember, Disability Retirement is a “process”; the fact that it coincides with the Holiday Season does not change the long process which it involves.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Petition for Full Review

The next step beyond the Merit Systems Protection Board, of course, is a choice: You can either file an immediate appeal to the Federal Circuit Court of Appeals, or file a Petition for Review before the Merit Systems Protection Board, where the decision of the Judge at the Merit Systems Protection Board will be reviewed by a panel of 3 Administrative Judges.

Normally, I recommend taking the latter route, only because it allows for another step to win, as opposed to putting all of one’s eggs in the proverbial “one basket”. If an individual has put on a case without being represented, by going through OPM’s procedures, then putting on a case at the MSPB, I will rarely accept a case at the Petition before the Full Board level.

My reasons are essentially as follows: First, it was not “my case”. The applicable criteria to have an MSPB case reversed by filing a Petition for Full Review, is to point out an “error of law” that the Judge made. If I put on a case before an administrative judge at the MSPB, I try and put on “my case” — one that I believe in; one that I am an advocate for; one that I am passionate about, because it is a case on behalf of a client whom I represent.

That is why I win most of my cases, both at the OPM level, as well as before the MSPB. When someone else has gone through the process, it is simply not “my case”. To nitpick for an error of law that the administrative judge had made, when it was not my case, and not the case-laws that I relied upon in putting on my case, is simply something that I have little interest in doing. That is not to say that a case cannot be won at a Petition for Full Review. I have won enough of them; it is a matter of pointing out the error of law which the administrative judge made; but a passionate argument is essential to winning such a review.

Sincerely,

Robert R. McGill, Esquire

Each Stage for CSRS/FERS Disability Retirement Must Be Approached Differently

In filing for Federal disability retirement benefits, there are essentially 3 stages — the initial application Stage; the Reconsideration Stage; and the appeal to the Merit Systems Protection Board (and, of course, additionally if you are denied at all three stages, you can go further and file a Petition for Review with the MSPB, and beyond that, file an appeal to the Federal Circuit Court). Do not approach all of the first three stages in the same way; there is a philosophical reason for the existence of each, and to approach all three stages in the same manner is often a mistake that unrepresented applicants make.

As a practical matter, for the first two administrative stages before the Office of Personnel Management, while citing applicable statutory authority and case-law is important, it is often wise to keep in mind that you are addressing non-lawyer benefits specialists at OPM. Thus, arguing the law in the first two stages should be performed quite differently from arguing the law to OPM’s representative and the MSPB administrative judge at the Merit Systems Protection Board (3rd) Stage of the process. A “cookie-cutter” approach for all three stages is the wrong methodology to undertake. Each stage in the process must be taken independently, and approached uniquely.

Sincerely,

Robert R. McGill, Esquire