Federal Employee Medical Retirement: The Chasm between Denials

From the perspective of an individual Applicant for Federal Disability Retirement benefits under FERS & CSRS, the individual applicant does not normally observe some other person’s Federal Disability Retirement application, and therefore never has the opportunity to see the “greater process” at work, or patterns of behavior on the part of the Office of Personnel Management.  Yet, there are indeed patterns, and that is why an experienced attorney who has seen literally thousands of Federal Disability Retirement cases over numerous years, has an advantage in responding to OPM’s denials.  Experience lends itself to greater observation.  Experience over time reveals certain patterns.  And patterns of behavior can reveal important principles. 

Certain OPM Representatives provide detailed and (often) irrelevant factual references which can be ignored; others like to “cite the law” and believe that such citations appear irrefutable and authoritative; and still others give scant discussion to laws or to facts.  Thus, there often appears to be a great chasm between the types of denials.  Whether or not there are such differences, an applicant who has received a denial for his or her Federal Disability Retirement case needs to respond to any such denial with a three-pronged attack:  Medical refutation; Factual correction; Legal assertion.  Such an attack will cover any chasm which might exist between the different individuals who send out a denial letter.  More importantly, it will cover the necessary elements for winning a Federal Disability Retirement case.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for Federal & Postal Employees: Beyond the MSPB

Because filing for Federal Disability Retirement benefits under FERS & CSRS is a process which may potentially take the full stages — from the initial application stage, to the Reconsideration Stage, to the Merit Systems Protection Board; then, if denied at the MSPB, to the Petition for Full Review, and if denied there, to the Federal Circuit Court of Appeals; as a result, it is a good idea to be represented by a Federal Disability Attorney.  Remember that the last two stages of the process only allow for arguing an error of law.  To that extent, if one pauses for a moment and reflects — everything ultimately comes down to an error of law.  Very rarely is there a misinterpretation of the facts. 

In a Federal Disability Retirement case, the medical evidence is fairly straightforward.  Yes, there can be some arguments concerning the interpretation of the extent and severity of the medical conditions, but the substantive focus of disagreement between the applicant and the Office of Personnel Management normally comes down to the appropriate application of the standard of law, and whether the application has met the burden of proof and satisfied the legal criteria for eligibility.  As such, the essence of a Federal Disability Retirement application comes down to whether OPM — and subsequently the Administrative Judge — has mis-applied the law.  Thus, at each stage of the process, it is important to lay the foundation by pointing out where the error of applying the law happened — at each and every stage of the process.

Sincerely, Robert R. McGill, Esquire