Postal and Federal Disability Retirement: Denials

Denials come with an unexpected force and impact; for, in every Federal Disability Retirement case, there is the expectation that the application itself merits close scrutiny and a belief that a proper review will persuade the OPM trier of facts that the Federal Disability Retirement application should be approved.

Indeed, from the perspective of the applicant, who is suffering from the medical condition itself on a daily basis, it is often a reaction of disbelief and anger when a denial is issued by the U.S. Office of Personnel Management.  But one must understand that this administrative process identified as “Federal Disability Retirement” is one which is not an “entitlement”, but rather, an adversarial process where proof, argumentation and persistent appellate procedures must be invoked at every step of the way.

That is why, in preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, one needs to always prepare a case as if it will ultimately go to the U.S. Merit Systems Protection Board.

Further, it is understandably disappointing to read an OPM denial and find that the OPM case worker does not even mention or refer to much of the substantive medical documentation submitted, but instead blindly (and generically) issues a template of tired old phrases, such as, “You did not meet the legal criteria“; “The evidence did not show that…”

With hundreds of cases assigned to each OPM Case Worker, one must understand that denials are rarely personal; but in responding to a denial from OPM, one must be diligent, forceful, and approach it with the use of all legal tools available.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: Proof

This is a proof-based process.  It is not merely a matter of completing some forms and meeting procedural guidelines in order to obtain a benefit; rather, it is an administrative process in which evidence and documentary support from third parties must be obtained in order to meet the legal criteria imposed by statute, regulation, and ever-evolving case-laws as handed down by the Administrative Judges of the U.S. Merit Systems Protection Board, as well as the U.S. Court of Appeals for the Federal Circuit.

There are administrative processes which are “entitlements”, such as certain economic assistance programs, Social Security, Medicare, etc., where one has paid into a system, and upon reaching a certain age, or meeting income-qualification criteria, etc., such procedural guidelines are merely shown, met, and approved.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, however, it is not merely a matter of meeting procedural criteria (although that, too, is required), but moreover, one must prove by a preponderance of the evidence that one is eligible, by submission of substantial and adequate documentation that one cannot perform, because of a medical condition, one or more of the essential elements of one’s Federal or Postal job.

Proof is the lynchpin by which the standard of winning a Federal Disability Retirement case is won or lost.  Proof is a “must”.  As such, never consider filing for Federal Disability Retirement benefits as merely a matter of filling out paperwork; one must prove one’s case.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Proof, Assertion, and the Conceptual Distinction

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, it is necessary — first and foremost — to understand that the benefit of Federal Disability Retirement is not an “entitlement” under any definition of the word; there is no automatic triggering mechanism by which a Federal or Postal employee becomes a Federal Disability Annuitant, unless one proves, by a preponderance of the evidence, that one has met all of the eligibility requirements necessary to obtain the benefit.

Further, while the standard of proof established by statute is a relatively low one in comparison to others (i.e., “preponderance of the evidence” merely requires that the truth of X is more likely than not, as opposed to other, more onerous standard of proof, such as “beyond a reasonable doubt” or “clear and convincing”, etc.), nevertheless, the mere assertion of a statement of facts will not qualify the Federal or Postal employee for Federal Disability Retirement benefits.

A standard — or “burden of proof” — means exactly that:   One must prove it, and proof requires more than the mere assertion that X is so.  Specifically, in a Federal Disability Retirement application, one must prove that one is medically unable to perform one or more of the essential elements of one’s Federal or Postal position, and in order to meet that burden, medical documentation of a sufficient and persuasive nature must be submitted along with a Federal Disability Retirement application, which includes many Standard governmental forms.

Knowing and recognizing the conceptual distinction between asserting X and proving X is an important first step in preparing, formulating, and successfully filing for Federal Disability Retirement benefits.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: The Psychological Process

One of the reasons why the Federal or Postal employee contemplating filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, should view the entirety of the administrative process as just that — a “process” as opposed to an entitlement to benefits — is because (a) that is in fact what it is and (b) to fail to view it from that perspective would be to refuse to adequately prepare for the long and arduous procedural pitfalls which are inherent in each case.

This is not an entitlement where a specific trigger of an event results in the automatic calculation and issuance of compensation.  Reaching a certain age does not result in the granting of Federal Disability Retirement benefits (although it may end it and be recalculated at age 62); attaining a certain number of years of service will not qualify one for Federal disability Retirement benefits (but again, upon reaching age 62, it may result in a beneficial calculation of benefits for having a greater number of years of service).

Rather, Federal Disability Retirement is an administrative, legal process in which one must prove by a preponderance of the evidence that one is (1) eligible, in that one meets certain minimum requirements, such as 18 months of Federal Service under FERS, or 5 years under CSRS, and (2) entitled, by proving that one has met the legal requirements under the statutes, regulations and case-law.

By having the proper psychological perspective, one is better able to prepare for the long haul before starting the process of preparing, formulating and filing for Federal Disability Retirement benefits, whether under FERS or CSRS, from the U.S. Office of Personnel Management.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Reminding the Agency of the Administrative Process

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether the Federal or Postal employee is under the Federal Employee’s Retirement System (FERS) or the Civil Service Retirement System (CSRS), a reminder is often necessary to the agency which retains the Federal or Postal employee on the active rolls, that it is an administrative process, and not a singular event representing an entitlement to Federal Disability Retirement benefits.

Of course, the Agency itself has a self-interested motive in the outcome of the Federal Disability Retirement application, especially if the Federal or Postal employee continues to occupy the positional slot of the agency.  For, so long as the Federal or Postal employee continues to remain on the rolls, it cannot officially fill the empty slot.

Thus, what often happens if a Federal Disability Retirement application is denied at the First Stage of the administrative process, is that the Agency will immediately attempt to threaten the individual and demand that the Federal or Postal employee return to work by a date certain, or justify the medical basis upon which the continuing absence occurs.  By then, all FMLA rights may have been exhausted; sick leave may be depleted, etc.

At this point, the Agency Human Resources Office needs to be reminded that, as an administrative process, there are multiple levels of appeals, and the mere fact that a Federal Disability Retirement application has been denied at the First Stage is not a basis for the Agency’s demand to return to work.

Agencies tend to be hard of hearing, however, and a law unto themselves.  That’s not surprising for most Federal employees and Postal workers; indeed, you have had to endure such a perspective of self-centered attitude throughout your Federal or Postal careers, and this information is merely reinforcement of what you already knew.

Sincerely,

Robert R. McGill, Esquire