CSRS & FERS Medical Disability Retirement: Inside/Outside

Visiting another institution, community, neighborhood or business often evokes an initial response of envy or dismay; first impressions abound, and floods the channels of opinions based upon a comparison of one’s own life.

It is an interesting phenomena to view the perspective of an “outsider”, and it is always important to recognize that the private information known only by an “insider” is simply inaccessible to those who are not residents of a given community, or who have not been a member for a sufficiently long-enough period of time.  It is not so much that such information is a secret; rather, it is often the case that certain types of knowledge can only be gained through being a part of the whole.

On a microcosmic scale, then, the turmoil which an individual experiences because of a medical condition is a life which is rarely understood in full, and less so by certain types of predisposed personalities.   Sympathetic individuals have become a rarity; as we become more and more disconnected through virtual reality and the impersonal conduits of the internet, electronic mailing, etc., human capacity for empathy diminishes.

For the Federal and Postal Worker who must consider filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, the problem is further exacerbated because of the nature of a large bureaucracy.  Bureaucracies are by definition impersonal; starting off as another insider (within the Federal Sector), but in essence always remaining an outsider (because of the impersonal nature of the environment itself) often portends a lack of empathetic response by supervisors, co-workers and the organization as a whole.

Having the proper perspective throughout — of effectively and persuasively proving one’s Federal Disability Retirement case to the U.S. Office of Personnel Management — is the best and only course of success.  How to go about it often depends upon balancing the proper insider/outsider perspective, as is the case for all of us.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: To Enter the Gates Blindly

Being naive is a quality and character trait which is distinguishable from innocence; in this world where information and the opportunity to obtain wisdom is vast and limitless, retaining the former quality may be unpardonable, whereas maintaining a level of innocence may reveal a life of self-discipline, where one has deliberately placed lines of demarcation around one’s life, and insisted upon not being sullied by the world around us.

One can remain innocent, yet not be naive.  While the converse may also be possible, it is important not to deliberately avoid the harsh reality around us.

Thus, 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 important that one enters into the metaphorical gates of the U.S. Office of Personnel Management with eyes of wisdom and experience, and not be saddled with the blind naiveté of thinking that the administrative process will be one of fairness and just analysis.

Assume that OPM will attempt to selectively read medical reports and records with an eye to deny; presume that they will ignore crucial evidentiary documentation which upholds one’s case; expect that legal “triggers” such as the Bruner Presumption or the holding in Trevan will be unimpressive.

That is why that which may be implicit, needs to always be made explicit, and repetitively so.  While it may be advantageous for one to enter the proverbial pearly gates with innocence, to enter through the gates of OPM with naiveté is merely inviting a door slammed shut.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for US Government Employees: Case Development

Federal Disability Retirement is one of those areas of law where countervailing forces are always at play, and the tug-of-war against time, resistance of individuals to respond, all within a context of a hectic-pace of life, create for a havoc of systems and regularity.

Because the underlying basis of filing for Federal Disability Retirement benefits often involves a chronic, progressively deteriorating medical condition, it is often seen from the perspective of the Federal or Postal employee to be an emergency; from the viewpoint of the medical doctor whose support for the case is critical, because the opinion of the doctor is essential to formulating the foundation of a Federal Disability Retirement application, it is often seen as another administrative burden; from the Agency’s vantage point, the alleged patience over the years which it has shown in “dealing” with loss of time, less-than-stellar performance, etc., often results in a reactionary adversity of being entirely unsympathetic to the plight of the Federal or Postal employee; and, together, all of the strands of these multiple countervailing forces places an undue pressure upon the entire process.  Yet, once it gets to the Office of Personnel Management, the file sits…and sits.

The long-term perspective on every Federal Disability Retirement application must always be to accept the fact that case development is the most important point to ponder.  Quickly filing a Federal Disability Retirement application, whether under FERS or CSRS, may in the end prove to be pound-foolish, especially in a retrospective, Monday-night quarterbacking sense, if OPM denies the case anyway.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement for Federal Workers: Understanding a Differing Perspective

Sometimes, all that one can do is scratch one’s head.  That common statement — to “scratch one’s head” — is meant to convey puzzlement or disbelief over an action, statement, or occurrence which belies rational explanation.  As rationality has been the foundation of thoughtfulness and considered formulations of explainable actions, so logic and reason have been the joists which provide the bridging support for acceptable discourse.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, one assumes that there will be a fair and reasoned review of each Federal Disability Retirement application.

If a Federal Disability Retirement application is approved, then of course the level of rational discourse need not be extensive — for, implicit in the approval itself is an acknowledgement that the legal nexus between the medical conditions described and the statutory criteria required to be met, have been adequately constructed.  But in a denial, one would expect a well-reasoned discourse of “why”, as opposed to a standard template of identifying various documents submitted, and multiple declarative statements (with barely a rational explanation) of, “You do not meet criteria No. X”.

Often, it is a waste of time to try and understand the perspective of OPM.  The Office of Personnel Management is an agency which is busy and overwhelmed with a volume of cases.  Time constraints often betray the proper application of the law.  It is well that the old saying did not refer to scratching one’s back; for, there are many places where one simply cannot reach in order to scratch, and that is the sense one is left with in reading some of OPM’s denials.

Sincerely,

Robert R. McGill, Esquire

Federal Worker Disability Retirement: Creating a Meaningful Bridge

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, it is obviously important to construct an effective bridge, or nexus, between one’s identified medical conditions and the type of positional duties which one performs at the Federal Agency or the U.S. Postal Service.  

In doing so, one should keep in mind certain essential points, each from the perspective of the Office of Personnel Management (which is the agency which will determine whether the Federal or Postal employee/applicant’s Federal Disability Retirement application will be approved or denied).  

For instance, the Office of Personnel Management (OPM) will only consider those medical conditions which are identified in the Applicant’s Statement of Disability (SF 3112A).  Once a CSA Number (an administrative identifier which is assigned by OPM — an eight-digit number beginning with “4” for CSRS employees and ending with a “0”; and for FERS employees, beginning with an “8” and ending with a “0”) is assigned to an application, the Federal or Postal employee is no longer able to add any further medical conditions without withdrawing the application completely, and re-submitting it anew.

Further, while the Office of Personnel Management will consider specific duties and descriptions of duties which are delineated and expanded upon in the narrative portion of SF 3112A, it is the “official” position description which will ultimately be controlling. Thus, a logical variance from the official position description as to what a Federal or Postal employee does, will not make any difference.  However, if what the Federal or Postal employee states that he or she is doing, is completely at odds with what the positional description states that he or she should be doing, then the controlling default will be the official position description.  

It is wise to keep these two perspectives in mind, in creating an effective bridge for a Federal Disability Retirement application.  For, ultimately, it is the perspective from the “other side” which matters, and as such, OPM’s perspective of how a Federal Disability Retirement application is reviewed and considered, is an important aspect in preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement for Federal Workers: The Office of Personnel Management

The Office of Personnel Management (OPM) , located in Washington, D.C., is the agency which makes the decision on all Federal Disability Retirement applications, whether under FERS, CSRS or CSRS-Offset.  They are the responsible agency for the first two “stages” of the process of attempting to show eligibility and entitlement to a Federal Disability Retirement annuity.  By “stages” is merely meant the initial application stage of the process, as well as the second, “Reconsideration” stage of the process — where a Federal or Postal employee has the right to, within 30 days of an initial denial of a Federal Disability Retirement application, request that his or her case be “reconsidered”, and further have the right to submit any additional medical or other supporting documentation for review and consideration. 

If the case is denied a second time by the Office of Personnel Management, then the Federal or Postal employee who has filed the Federal Disability Retirement application, or the attorney representing the Federal or Postal employee, has a right to file an appeal to the Merit Systems Protection Board.  The Office of Personnel Management is taking quite a long time in making a decision on a Federal Disability Retirement application, and although they are attempting to get caught up with their workload, the volume of cases filed and received by OPM on a weekly basis has made such an attempt difficult.  As has been stated by this author many times, Patience is a virtue, and as such, Federal and Postal employees must be the most virtuous of all, because patience is what is needed to endure and survive the process.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Reasons & Conclusions

In a denial letter from the Office of Personnel Management for a Federal Disability Retirement application filed under FERS or CSRS (which, if received, a Federal or Postal employee must file a Request for Reconsideration within 30 days of the date of the denial letter), the connection between the reasonings given, and the conclusions arrived at, will often be missing.  

Often, OPM will tangentially or in a cursory manner refer to various medical documents which were submitted with the original Federal Disability Retirement packet, or actually extrapolate a selective quote from a medical report or office note, and even make it appear as if a full and complete evaluation of the submission has been performed.  Thereafter, a conclusory statement will be proposed, often with a logical pretext of:  “Therefore, your application is denied.”

However, there is a vast difference between referring to various medical reports or statements, and evaluating such reports and statements in order to arrive at a proper legal conclusion based upon the evidence submitted.  It is rare that the Office of Personnel Management engages in the proper evaluative process in determining whether or not a Federal or Postal worker’s Federal Disability Retirement application meets the applicable legal criteria.  That said, such lack of evaluative and analytical process is legally required, and there must be a logical connection between the reasons given, and the conclusions reached.  Such lack of engaging in the process must be pointed out, but it must be done in a “diplomatic” manner.  Diplomacy is best engaged in by diplomats; similarly, legal issues are best tackled by lawyers.

Sincerely, Robert R. McGill, Esquire

Medical Retirement for Federal Workers: The Office of Personnel Management

The Office of Personnel Management, the Agency which reviews, evaluates and makes determinations upon all Federal and Postal Disability Retirement applications, whether it is under FERS, CSRS or CSRS Offset, is diligently attempting to adjudicate each application for Federal Disability Retirement benefits.  

One must understand that the Office of Personnel Management (OPM) does not just handle Disability Retirement applications for Federal and Postal employees — they handle all regular retirements, early retirements, and at all levels of the process — from eligibility determinations, to benefit and annuity calculations; to ensuring that the proper offsets are put in place between Social Security and Federal annuities; and, moreover, any over-payments or errors which may have occurred in the course of establishing benefits and payments are also reviewed and handled by OPM.  

From the perspective of the individual Disability Retirement applicant or annuitant, the length of time it takes, or the lack of responsiveness, may appear as if a particular individual is being “singled out” in the long delay and lengthy wait.  From the perspectively of OPM, however, such an individual is merely one of many, many cases awaiting adjudication. Discussions with various personnel at OPM reveal that there is simply a backlog of cases, with many, many cases coming in every day.  Patience is the only solution; it is an administrative, bureaucratic process, and when one freely enters into it, one must accept the timeline of the process itself.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: Content & Substance

Form, Content & Substance.  Form is the appearance and the general approach & methodology of a Federal Disability Retirement packet; Content is the essence of that which makes up the materials in the packet; and Substance (hopefully) is the “meat” of the packet itself.  Make sure that what is stated is substantive.

OPM Representatives have multiple cases.  From the perspective of the Federal Disability Retirement applicant, it is a singular case, because it is one’s own case, and the personal nature of such a case makes it of paramount importance.  From the perspective of the OPM Representative, however, it is one of multiple cases, and it is part of his or her job.  If one has to wade through a generous amount of fluff before getting to the content of the Federal Disability Retirement application, the energy expended may be a distraction from a serious review of the substantive content.

A descriptive narrative bridging the medical condition with the type of job one performs is a necessary component; but as between a concise short story and a novella, the former is to be preferred in preparing and filing a Federal Disability Retirement application under FERS & CSRS.

Sincerely,

Robert R. McGill, Esquire

 

Federal and Postal Disability Retirement: Medical Conditions

In filing for Federal Disability Retirement benefits under FERS or CSRS, it is important to note that the Office of Personnel Management will often argue that the mere fact that a person suffers from a medical condition is not in and of itself a basis for granting disability retirement benefits.  So far as such a statement goes, the Office of Personnel Management is correct on the laws governing the eligibility criteria for Federal Disability Retirements (which is rare in and of itself).  Having a medical condition is not a sufficient cause in granting a Disability Retirement benefit.  As it is often argued in the world of philosophy, it is a necessary cause, but not a sufficient one.  In other words, one must indeed suffer from a medical condition (it is thus a “necessary cause”); however, suffering from a medical condition is not sufficient in and of itself to qualify for Federal Disability Retirement benefits under FERS or CSRS (it is not a “sufficient cause”).  One must, beyond having a necessary cause, prove that the medical condition is also the source and impact upon one’s inability to perform one’s job.  Thus, to the limited extent of its truth, suffering from a medical condition is indeed insufficient to obtain an approval from the Office of Personnel Management; it is not “proof enough” in and of itself.

Sincerely,

Robert R. McGill, Esquire