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: Qualifying

The concept of “qualifying” is both peculiar as well as interesting; for, one questions whether one can “qualify” for a sports event (often, this encompasses issues of age, physical ability, whether gender may disqualify you, etc.); and then there are “qualifying events”, where you must pass certain levels of “test” activities in order to get to the next round, as in golfing events.  In racing events, there is always talk about getting through the “qualifying” stages; and, similarly, in attempting to secure a job, the applicant is often questioned as to whether he or she has the “qualifications” for the position.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, there is also the initial question of whether a Federal or Postal worker “qualifies” for the benefit identified as “Federal Disability Retirement”. Here again, to “qualify” means that a Federal or Postal worker meets certain requirements. Thus, there are automatic dis-qualifiers, such as: If you are not a Federal or Postal worker, but work for the county or state, then you do not qualify for benefits under FERS or CSRS from the Federal system. Similarly, if a FERS individual does not have at least 18 months of Federal Service, or a CSRS Federal employee does not have at least 5 years of Federal Service (which is obviously unlikely), then you cannot “qualify” to even apply for Federal Disability Retirement benefits from the Office of Personnel Management.

Those are immediate qualifying “events”.  Then, of course, the main event — the tournament of all competitive activities for Federal Disability Retirement purposes — concerns whether or not a Federal or Postal Worker qualifies for Federal Disability Retirement benefits because of his or her medical condition.  This foundational qualification can only be answered by looking at the medical condition, the support of the treating doctor, and whether and to what extent the medical condition impacts one’s physical or psychological ability to perform the essential elements of one’s job.

For that main event, one must rise to the level akin to the professional athlete.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Qualifying Medical Condition

The question is often asked, “Does my medical condition qualify for Federal Disability Retirement?”, or some variation of that question.  

Such a question, of course, in order to “make sense” in the context of a Federal Disability Retirement application under FERS or CSRS, must be reformulated, precisely because the manner in which it is posed produces multiple sub-questions.  For, ultimately, the laws and regulations governing Federal Disability Retirement do not provide for a calculus of a mathematical correspondence, where medical condition X is considered a “qualifying” one, whereas medical condition Y fails to meet such a qualification criteria.  

The sub-questions which are immediately necessitated by the originating question, involve multiple factors:  Does the medical condition you suffer from impact your ability to perform one or more of the essential elements of your job?  In what way?  Can you describe how the medical condition impacts your ability to perform your job?  Are you being medically treated for your medical condition?  Will the doctor support you in your quest and application for Federal Disability Retirement benefits?

Take, for instance, the following “extreme” hypothetical, used for purposes of expanding upon the previous conceptual paradigm:  Question:  Does my aching right thumb qualify for Federal Disability Retirement benefits?  Answer:  Normally not.  Sub-question:  If my job requires the constant and repetitive use of my right thumb, and such use is an essential element of my job, can my aching right thumb qualify me for Federal Disability Retirement benefits under FERS or CSRS?  Answer:  In all likelihood, yes.  

Often, it is the right question asked, and not the answer to the original question, which is the important starting point of the process in preparing, formulating and filing for Federal Disability Retirement benefits, whether under FERS or CSRS, from the Office of Personnel Management.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: Miscellaneous

Some cases take months to win; others, merely a week or so.  In some Disability Retirement applications under FERS or CSRS, a half-page report of substantive medical evidence is enough; in other cases, it is the compilation of voluminous material which must be argued and persuasively emphasized, in order to convince the representative at the Office of Personnel Management that the Federal or Postal employee is entitled to Federal Disability Retirement benefits. 

Professionally, it gives me no greater satisfaction when a case takes a week, or if it is approved based upon a half-page medical report, than if it takes months or volumes of medical evidence:  an approval by any means results in the satisfaction of a client.  There a some cases in which a client “grumbles” when I am hired, paid, and am able to reverse an OPM decision within a week; but I try and explain to all clients that when you hire an attorney, you hire the attorney not only for his professional competence, knowledge and experience, but also for the reputation that an attorney brings to the forum.  I have attempted to build a reputation of integrity with the Office of Personnel Management, and there are many times when OPM will reverse their previous decision upon my entering my appearance into a case.  I share this fact with great humility, and an appreciation that one’s reputation still means something in this world.

Sincerely,

Robert R. McGill, Esquire