OPM Disability Retirement Application: Eligibility & Entitlement

The two concepts are often confused; for the Federal employee and the U.S. Postal Service worker filing for Federal Disability Retirement benefits, the frustration is often voiced precisely because of the misapplication of the legal import between them.

Eligibility is determined by the contingencies which must be met, the thresholds of prerequisites which must be satisfied:  The Federal or Postal employee must be either under FERS, CSRS or CSRS Offset; the minimum number of years of Federal Service must have been accrued; the Statute of Limitations must not have already passed; further, then, some age limitations need to be considered as a practical matter, to allow for pragmatic justification to even apply.

Entitlement is based upon proof.  As the law is set by statutory authority, filing for Federal Disability Retirement benefits through the U.S. Office of Personnel Management requires that the Federal or Postal applicant meet certain preset standards of acceptable proof, based upon that which constitutes sufficiency of satisfaction.

The legal standard is based upon a “preponderance of the evidence“; the evidentiary requirement provides that a tripartite nexus be established between (A) the medical condition, (B) the Federal or Postal position which the Federal or Postal employee occupies, and (C) evidence showing that as a result of A, one or more of the essential elements of B cannot be satisfied.  Further, there is the “D” component, and that involves the issue of “reasonable accommodations” and whether the Federal agency or the U.S. Postal Service can reassign the Federal or Postal employee to a similar position at the same pay or grade.

It is only upon the initial satisfaction of eligibility requirements that the Federal or Postal employee can then further investigate whether entitlement is feasible or not.  Thus, “entitlement” in this sense is not based upon meeting eligibility requirements; rather, satisfaction of eligibility prerequisites allows for entrance into the gateway of establishing entitlement.

Sincerely,

Robert R. McGill, Esquire

 

Medical Retirement Benefits for US Government Employees: Seasons

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, there is often the seasonal rhythm of individuals, which present a collective sense of predicatability as an Agency because agencies are comprised of individuals.

Thus, for instance, the month of August is predictably slower for the Office of Personnel Management than the other months of the summer, precisely because so many Federal employees take their vacation. Christmas, New Years, the Easter break, and the Memorial and Labor Day holidays all provide a rhythm of seasonal slowdowns. Such seasonal pauses, however, should be a time to utilize and increase productivity for the Federal or Postal employee who is contemplating filing for Federal Disability Retirement benefits under FERS or CSRS. Indeed, when the pace of work is slower and agencies temporarily wind down because of the seasonal slowdown, it is an opportune time for the Federal or Postal worker to attend to the medical needs by resting or recuperating and, if the critical decision-making point has arrived in terms of making a decision to file for Federal Disability Retirement benefits under FERS or CSRS, it is a time to begin to gather the necessary information as a preliminary matter.

While certain components which comprise the entire packet of a Federal Disability Retirement application may be delayed because of the seasonal slowdown (e.g., the Supervisor may be on vacation because of the season; or the doctor may be away, etc.), nevertheless, the foundational groundwork of preparing the request to the doctor or the supervisor, or submitting the request for medical records, etc., may be initiated.

Slowdowns are seasonal opportunities for preparation; preparation is the key to a successful outcome; and while a slower pace is often a time of frustratingly slow response time, it is the meticulous care that is taken in the slower period which results in the success of a venture.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: Coordinating the Various Elements

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, it is important to coordinate the various elements necessary in its core formulation and preparation, to the extent possible.

Aside from simply declaring that there is “insufficient medical documentation” to warrant an approval of a Federal Disability Retirement application, such that one’s case does not provide “compelling medical evidence”, the Office of Personnel Management will often cite various inconsistencies between the medical documents, including comparing what Doctor X stated as opposed to Doctor Y, or by noting internal inconsistencies where a particular medical note states “improvement” on a specific date, and contrasting that singular note with the body of the narrative report which the doctor has submitted for purposes of Federal Disability Retirement; or with the lack of performance deficiencies, or in comparison with what the Supervisor stated, etc.  

The problem with attempting to correct all inconsistencies, whether apparent, minor, or substantive, is that most issues in life contain inconsistencies.  Think about it — in normal situations of everyday life, do people act and speak in perfect narratives, where everything and everybody is coordinated in speech, action and motive?  Or are there always some inexplicable inconsistencies where one simply throws up one’s hands and says, Nevertheless, that is what happened?  Yet, the Office of Personnel Management will focus upon such inconsistencies and attempt to compare, contrast, and form the basis for a substantive denial.  

At the Reconsideration Level, of course, the Federal or Postal employee is given the opportunity to explain or to unravel such inconsistencies; but to the extent possible, the effort to coordinate between all of the various elements should be engaged in at the outset.  However, such coordination should be real, and one should never force an artificial coordination of efforts.  

Truth must always be the guide; but that the Office of Personnel Management, in reviewing a Federal Disability Retirement application under FERS or CSRS, would also be guided by the same criteria, as well as by a balanced approach of fairness.

Sincerely,

Robert R. McGill, Esquire