Tag Archives: how to approach an appeal to opm after disability denial

Federal Employee Medical Retirement: Keeping it Simple

Simplicity merely covers the complexity behind the beauty of the uncomplicated.  Indeed, one only has to look upon an Apple product, or a modern automobile, to recognize the underlying complexities which went into the production of such simplicity.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, there is often a desire to respond to an OPM denial by attempting to understanding the apparent ‘complexity’ of the denial.  By ‘apparent’ is meant the following:  Most, if not all, of OPM’s denials are regurgitated templates from thousands of previous denials, and quotations of alleged legalese notwithstanding, the basic components of a Federal Disability Retirement case do not change just because the language used attempts to complicate matters.

In the end, driving a technologically advanced automobile still requires hands on the steering wheel, and a foot on the gas pedal and the brake (hopefully, not both at the same time).  All the rest are simply “whistles and horns” to make it appear worth the price tag.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for US Government Employees: Building Blocks

The analogy or metaphor in preparing, filing, and waiting (for a decision) in a Federal Disability Retirement application for FERS or CSRS employees, submitted for review before the Office of Personnel Management, is of a child with square building blocks. If at the first try, the outcome is a nod of approval, nothing further needs to be accomplished.  If, however, a third party (the Office of Personnel Management) comes along and knocks down the building blocks (analogy:  a denial from OPM), then the child must rearrange the building blocks anew, and perhaps add one or two more for reinforcement.

Thus, depending upon the basis of OPM’s denial (which is often either irrelevant or self-contradictory, or both), one may want to reinforce that which was already gathered and organized, for a re-presentation of both the original evidence, and additional medical or other supporting evidence.  Again, if a third party (OPM) knocks down the second set of building blocks (a second denial at the Reconsideration Stage of the process), then it will be time for further reorganization, and for gathering of additional supporting building blocks.

When it gets to the Third Level of the process, the Merit Systems Protection Board, remember that all of the original building blocks of the process will still be there for the Administrative Judge to review.  That is the point of having the perspective of the entire process as one of “building blocks” — that the entire foundation is still there to be added to and reviewed, in the end, by an Administrative Judge.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: An Additional Problem with Answering an OPM Denial

Spring and summer are finally upon us; the warmth of the sun finally brings some hope that the multiple series of snowstorms may be finally behind us (now that I have said it, the chances are exponentially multiplied that we will accumulate an additional 20 inches of snow in March).  Thoughts of the beach will soon become visually real, as opposed to virtually experienced.  Sand.  The metaphor of the “shifting sand” is one which is applicable to the Office of Personnel Management in its denial of a Federal Disability Retirement application under FERS or CSRS.  Those of you who have followed my stream of consciousness on the issue of templates, denial letters and the arbitrary nature of OPM’s decision-making process, will not find it surprising to find that OPM merely shifts, changes positions, and dances around (albeit, not always gracefully) any attempt to “corner” the argument which purportedly is the basis for a denial of a Federal or Postal Disability Retirement application

Do not, however, underestimate the importance of properly, directly, and clearly answering the concerns of an OPM denial.  It is not enough to gather more medical documentation and sending them in.  It is not enough to address, point by point, the basis of a denial letter.  One must corner, clarify, and clearly define the basis of an OPM denial, then refute them.  This way, if it is denied a second time, and the case goes before an Administrative Judge at the Merit Systems Protection Board, the AJ will see that the issues previously brought forth by OPM have already been addressed, and that any necessity for a Hearing may be avoided by clarifying any remaining concerns which the OPM representative may need to search for and articulate. 

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: OPM & the Template Approach

Starting from a template is not necessarily a bad thing.  One should not have to repetitively reinvent the wheel in any endeavor.  It is when one uses a template blindly, without carefully reviewing and evaluating the facts and circumstances of a particular case, that the problem arises. 

Each case in a Federal Disability Retirement case under FERS or CSRS is unique, not so much because a specific medical condition is unique (although, obviously, it is “unique” to the individual suffering from it); and not so much because of the type of job that a particular Federal or Postal employee works in.  Rather, the uniqueness of the particular case normally arises in the combination of the two — the symptoms manifesting from a particular medical condition, and how it impacts the ability or inability to work at a particular kind of job. That, in essence, is the core of a Federal Disability Retirement case under FERS or CSRS — the combining and clashing of the medical condition with a particular kind of Federal or Postal job, and the incompatibility between the two.  How the Office of Personnel Management reviews that combination is what is often at issue — and, because templates are generic treatments without regard to particular and unique facts and circumstances, that is precisely the reason why they fail to address the uniqueness of a particular case.  (Next:  How OPM’s template is often predictable and ultimately ineffective in a Federal Disability Retirement case)

Sincerely,

Robert R. McGill, Esquire

Federal Employee Disability Retirement: Discretion in a Response II

In responding to an initial denial of a Federal Disability Retirement application before the Office of Personnel Management, it is important to remain professional, and not to “overload” the response with unnecessary or otherwise irrelevant responses.  Initial anger and disbelief over the selective criticisms contained in an OPM denial letter should not be reflected in a response to the denial.  Why not?  Because there is a good possibility that the case may be denied a second time, and it may appear before the Administrative Judge at the Merit Systems Protection Board.  Don’t write things to OPM that you will regret having an Administrative Judge — one who may be deciding your case — look at and read.  Thus, the “first rule”:  never write an immediate response back, because your anger and emotional disbelief will show itself.  If you need to “get rid” of your anger and expiate the emotionalism, then write your emotional response on a separate piece of paper, then set it aside.  Your “real” response will come later — when you can with a rational perspective, review the unfair and selectively biased denial letter, and begin to compose the serious response that your case deserves.  Or, better yet, get your attorney to do it.

Sincerely,

Robert R. McGill, Esquire