Federal Disability Retirement: The Rarity of the “Clean” Case

“Clean” cases are those which need no further elucidation. Like events and documents which speak for themselves, the clean case in a Federal Disability Retirement application, as in other sectors of legal encounters and adversarial processes, requires little, if any, explanatory addendum.

It is a rarity for two primary reasons:  First, because life itself defies a linear, uninterrupted sequence of events which follows along the parallel universe of administrative rules and regulations, and second (and probably more importantly and certainly problematically) because most people are unable to distinguish between an objectively clean case, and one which — because of one’s personal and subjective involvement in one’s own case — merely appears to be less embroiled than others with potential problems.

The Federal or Postal Worker who is preparing one’s own Federal or Postal Disability Retirement application, is the same person who suffers from the pain or psychiatric illness which is the foundation and basis of one’s claim.  As such, because the private world of medical disability is the identical consciousness which must prepare, formulate and present one’s Federal Disability Retirement application, whether under FERS or CSRS, to the U.S. Office of Personnel Management, it is difficult to make an objective, unbiased assessment of one’s own case.

The one who “feels the pain”, believes that one’s own pain is in and of itself persuasive to others as to the extent and severity of that pain.  That is why the truly “clean” case is a rarity; it exists mostly in the minds of those who believe in their own suffering.  The rest of the world, however, has little empathy for the suffering of others, and the systematic, bureaucratic volume of denials in Federal Disability Retirement applications is a testament to the harsh reality of the world in which we occupy.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Non-nexus

Meeting an adequacy test may constitute sufficiency for some purposes, but not for others.  Thus, it may be enough in completing an FMLA form to have a diagnosis, along with answers to other questions on WH-380-E.  But mere identification of a medical condition via a diagnosis, along with a description of symptomatologies will not be enough to meet the sufficiency test in a Federal Disability Retirement application.

People often assume that having a medical condition in and of itself sufficiently explains the severity of one’s condition, and any implied “blank spaces” can be filled in by the mere existence of such a medical condition.  But Federal Disability Retirement, whether under FERS or CSRS, filed through, reviewed by, and approved or disapproved by the U.S. Office of Personnel Management, must be proven by a preponderance of the evidence that the medical condition itself prevents the Federal or Postal employee from performing one or more of the essential elements of one’s positional duties.

As such, the identification and description of a medical condition fails to comply with the adequacy standards in proving eligibility for Federal Disability Retirement benefits.  One must establish, through the conduit of a medical professional, the “nexus” or “connection” between one’s identified medical condition and the inability to perform one or more of the essential elements of one’s job.

The weight of the proof is upon the Federal or Postal applicant.

The foundation of such evidence begins with the identified medical condition, but in and of itself, it is a non-nexus — until it is squarely placed in the context of one’s official position and the duties required by one’s duties.  Thus, the non-nexus become the nexus-point when combined with the identification and description of one’s positional duties.

It is this realization of the step-by-step sequence of proof which constitutes adequacy and sufficiency of evidence, and one of which the Federal or Postal applicant for OPM Disability Retirement benefits must be aware.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: In Life, the Pragmatic Trumps the Theoretical

In administrative and other processes, as in life generally, there are issues which on a theoretical level would seem to work; but when tested in the “real world”, somehow the perfect paradigm suddenly disintegrates.  Thus, one may ascribe a series of seemingly logical propositions, each in their independent and isolated delineations apparently stand strong and without a flaw; but somehow, in their linear progression of dependence, one upon the previous one, the linkage itself may be the determining factor.

Thus the old adage:  An X is only as strong as the weakest link.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, the Federal or Postal employee may lay out a plan of attack which, on its face, may appear sound and credible; but as experience in anything constitutes the crux of everything, so the first-time experience of thinking that one’s own case is a “slam-dunk” case because the “pain I feel” is so excruciating that there is no way that OPM could do otherwise than to approve my case, may be that weakest link.

Think again.  OPM deals with thousands of such cases; your particular case, as the unique case singularly known by you, is essentially a mere theoretical example of countless other such cases.  The pragmatic reality of the Federal bureaucracy is what one must ultimately face; again, as in life in general, the practical aspects of an engagement rules the day.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: The Burden

Ultimately, a Federal Disability Retirement application is a paper-presentation to the U.S. Office of Personnel Management.  Yes, yes, we are entering into a “paperless” technological society, and that is fine; but by “paper presentation” is meant in a generic sense, that the proof necessary to obtain eligibility and entitlement to a Federal Disability Retirement benefit, must be presented in a format which is readable, comprehensible, and coherent — whether on a computer screen or in paper format.

The burden of providing such proof is upon the “applicant” — the Federal or Postal employee who is attempting to obtain Federal Disability Retirement benefits.  That “burden” is both a legal one, as well as a regulatory one.  There are different levels or requirements of what constitutes proof, depending upon the requirements of what must be proven.

In a general sense, one can assert that all that is necessary in a Federal Disability Retirement case is to gather together one’s medical records, wrap them in a secure bundle, and forward them to the U.S. Office of Personnel Management.  Will such an approach “prove” one’s Federal Disability Retirement application?  It might — depending upon the seriousness of one’s medical condition, and whether the Disability Retirement Specialist assigned to such a case will take the time to infer and imply.  But to make an inference, or to expect an implication to be discerned, takes an unnecessary chance at misunderstanding, failure, and the unwanted “denial”.

Instead, the better approach is to explicitly explicate.  Always remember that in preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, there is a difference between suffering from a medical condition, and proving that the medical condition prevents one from performing one or more of the essential elements of one’s job.  It is the latter which is necessary to be approved for a Federal Disability Retirement benefit.  As to the former — while an unfortunate circumstance — it is not enough to suffer to prove one’s case.

Sincerely,

Robert R. McGill, Esquire

Postal and Federal Disability Retirement: The Easy Case

Life presents conundrums; puzzles exist to be solved, but few attempt to understand the foundational precepts which need to be discovered and applied; ergo, Aristotle remains an esoteric author of antiquity, to be rediscovered and in whom delight approaches an enduring mystery.  In every endeavor of that vast designation identified as “life”, difficulties abound, challenges confront, and obstacles confound.  One hears about the “easy” life, how X has it so “comfortable”, and the proverbial, “if only I…”

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, one often hears about the “easy” case — it proves itself; the evidence is so overwhelming that…

Take the following hypothetical:  X has an OWCP case approved; Second opinion and referee doctors all state that X cannot return to performing one or more of the essential elements of one’s job; additionally, SSDI has been granted; and on top of everything else, the agency has removed X from the Federal or Postal rolls, based upon one’s “Medical Inability to perform the essential elements of his/her job.”

As Federal Disability Retirement cases go, this may constitute and possess elements which most would consider a “sure thing”.  Easy case?  What is missing?  As to the first question, the answer is a resounding, “No”.  As to the second question, those who have inquired as to the “first principles” in Aristotelian fashion, will be able to discover the answer, and this author need not state thejavascript:; obvious.

Sincerely,

Robert R. McGill, Esquire

Postal and Federal Disability Retirement: The Danger of the Sure Thing

The danger of any “sure thing” is that, aside from the potential reversal of fortune if the assumed certainty fails to come to fruition, the acceptance of the claim of certainty in and of itself undermines the motivational factor in the very process of attempting to reach a goal.

A recent article in the New York Times told of another high school basketball prodigy who was “destined” for greatness in the NBA, only to descend into the ranks of the “has-beens” and those who had “great potential” but somehow never realized and actualized such potential greatness.  Rare is the Lebron James in any walk of life; rarer still is the one who recognizes the distinction that a “sure thing” becomes a certainty only on the precondition that one must vigilantly ascertain and safeguard such certainty of outcome.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, there is often a misguided view that one’s own particular medical condition is so serious, and so debilitating, that it is a “sure thing” in the approval process with the U.S. Office of Personnel Management.

Yes, there are rare cases where the identity of the medical condition is such that it warrants an automatic approval from OPM; but such cases are few, and that is why we refer to them as cases of certainty.  The problem often rests in the fact that the sufferer of the medical condition is the same person who attempts to be a proponent of the Federal Disability Retirement application.

Certainty is clouded by judgment; when it’s your own horse in the race, one wants to judge a certainty.  When that horse is not only one’s own, but moreover, the person himself/herself is in the race itself, then a clouded judgment becomes a misguided view of how the world operates.

Sincerely,

Robert R. McGill, Esquire