OPM FERS/CSRS Disability Retirement: Approaching a Reconsideration

The proverbial definition of insanity is to engage in the same repetitive activity with the expectation of receiving a different result.  While such a definition may not provide a clinically accurate or legally acceptable formulation, it does implicate the chaotic character and the futile act of responding in a particularly fruitless manner.

For Federal and Postal employees who have attempted to file for Federal Disability Retirement benefits through the U.S. Office of Personnel Management, whether under FERS or CSRS, and have received an initial denial, the process of having OPM reconsider one’s case must be approached in a 2-tier manner:  First, one must meet the “deadline” of filing for Reconsideration with OPM within thirty (30) days of the denial, or upon receipt of the denial (although, to be on the safe side, it is best to use the former date as opposed to the latter);  next, with the box checked to indicate submission of additional medical documentation, to then gather, prepare, compile and submit additional medical evidence within thirty (30) days thereafter, unless a further extension is needed and requested.

However, one should also understand that in an OPM Reconsideration case, it will not be the same Case Worker who will review the case, but it will be reviewed thoroughly by someone else as if it had never been previously reviewed. As such, there is the confounding conundrum of a dual anomaly: The First Case Worker who issued the denial based the denial upon certain specific points; yet, what the First Case Worker denied the case upon, may have no bearing upon what the Second, Reconsideration Case Worker will evaluate the case upon.

What does one do? Whatever one’s answer is to this complex conundrum, do not engage in the proverbial act of insanity; better to get some legal guidance than to spin one’s wheels in an insane world of futility.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: The Crucial Reconsideration Stage

In engaging the U.S. Office of Personnel Management for Federal or Postal Disability Retirement benefits, whether under FERS or CSRS, it is important to recognize the differences between the administrative and legal stages involved.

There is, of course, the initial application stage; one cannot overemphasize the importance of proper preparation and compelling formulation of one’s Federal Disability Retirement packet, for the First Stage of the process.  However, regardless of the adequacy of one’s Federal Disability Retirement submission at this initial stage, there are going to be a certain percentage which are denied, and which therefore must be propelled into the Second Stage of the Administrative process.

This next step is often identified as the “Reconsideration Stage” in the process of attempting to prove one’s eligibility for Federal Disability Retirement benefits.  It is known as such, because at this stage, one has the right to have one’s case “Reconsidered”; in order to do that, however, you must notify the U.S. Office of Personnel Management within thirty days of the date of their denial letter, or within receipt — but one should be cautious of the latter timeframe, as it can be rather tricky, and thereby one should proceed on the assumption that the 30-day timeframe begins from the date of denial as reflected on the Letter of Denial, just to be on the “safe side” of things.  To ensure compliance, the undersigned attorney always requests the reconsideration via a trackable delivery device, so that proof of delivery can be shown if necessary.

This Second Stage of the process in attempting to become eligible for Federal Disability Retirement benefits is a crucial stage in the process, because if it is denied again at this stage, then one must file an appeal to the U.S. Merit Systems Protection Board, and put on one’s case before an Administrative Judge — a complex process which takes it out of the hands of the U.S. Office of Personnel Management and places it in an entirely separate determining entity.

While each stage of any bureaucratic process can be deemed “crucial”, it is this point of differentiation which makes the Reconsideration Stage unique:  it is the last chance before entering into the complex arena of legalese.  Thus, for those already confounded by the complexities of the administrative process, the land mines to be confronted at the Merit Systems Protection Board will only be exponentially multiplied.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: Proper Responses

A receipt of a denial from the Office of Personnel Management to a Federal Disability Retirement application under either FERS or CSRS is always an event which is upsetting to a Federal or Postal employee, but it is “part of the process” which occurs often enough.  

If it is a second denial (where a Request for Reconsideration has already been accomplished, and the Office of Personnel Management has denied it again), then the only appropriate response is to file an appeal to the Merit Systems Protection Board (no response is required, or even appropriate, to OPM, as it is out of their jurisdictional purview upon denying it a second time).  

If it is a “first denial“, then a “Request for Reconsideration” must be filed within thirty (30) days of the date of the denial letter (one can argue that the 30 days should be counted from the date of receipt, but it is always better to be on the safe side), and if requested, an additional thirty (30) days is automatically granted in order to have sufficient time to gather and submit further documentation to rebut and answer the denial from the Office of Personnel Management.

Submission of the Request for Reconsideration, and participation in the process of having the Office of Personnel Management reconsider the initial denial, is mandatory, not elective.  By this is meant the following:  You cannot bypass or skip the Reconsideration Stage and jump directly to the MSPB; you must first get a decision on the Request for Reconsideration before the Merit Systems Protection Board will consider your case.  

You cannot get angry or reactive and declare, “I will just file an appeal to the MSPB and have an Administrative Judge look at my case”.  You must patiently go through the proper channels of justice, and respond accordingly.

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: Reconsiderations

When a Federal Disability Retirement application under FERS or CSRS is denied at the first stage of the process, a Federal or Postal worker who filed for the benefit has the administrative right to request that it be “reconsidered” by the Office of Personnel Management.  Once requested, the case file is turned over to the “Disability Reconsideration Branch” of the office, and will be reviewed and evaluated by a Disability Specialist — not the same person who reviewed it at the Initial Stage of the process. 

A person who has filed for Federal Disability Retirement benefits has thirty (30) days to Request Reconsideration.  While the 30-day period may arguably have some flexibility based upon when the applicant actually received the denial letter, it is nevertheless a good policy to adhere to the 30-day time-frame by counting the date of the denial letter as the “beginning” date.  Obviously, it is better NOT to be placed in a position of having to argue whether or not the applicant met the 30-day deadline.  Further, it is best to send it in via a means where confirmation of receipt can be shown.  OPM is a large bureaucracy, and things get lost in the morass of the volume of submissions.

Sincerely,

Robert R. McGill, Esquire

Early Retirement for Disabled Federal Workers: The Appeals

While it is often stated that a Federal Disability Retirement application has three (3) stages to the process, there are additional appellate stages which must be considered, and certain additional steps and actions must be undertaken, in order to preserve the viability of the final two stages of the process.  The initial three stages are comprised of the (A) Initial Application Stage of the process in preparing and filing for Federal Disability Retirement benefits under FERS & CSRS; then (B) if it is denied at the Initial Stage, there is the Reconsideration Stage, where one may submit additional medical documentation and legal arguments, and finally (C) an appeal to the Merit Systems Protection Board, which takes the Federal Disability Retirement application out of the control and hands of the Office of Personnel Management, and allows for an Administrative Judge at the MSPB to hold a Hearing and make a determination.  

The two additional stages of the process for Federal and Postal workers who have filed for Federal Disability Retirement benefits, are:  (1)  a Petition for Full Review (which I recommend should be taken, in the event of a further denial by the Administrative Judge at the MSPB Appeal) and (2) the U.S. Court of Appeals for the Federal Circuit (which can be filed with directly after being denied at the MSPB level, skipping over the Petition for Full Review).  The last two stages of the process — the Petition for Full Review and the U.S. Court of Appeals for the Federal Circuit — will not consider any “new evidence” (except in some rare instances), but will be a review as to whether any error of law occurred.  As such, all of the previous steps of the process would be reviewed, and that is why at each and every step, it is important to know what is important in preserving one’s right to an appeal, what is a basis for an appeal, etc.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: OPM May Say So, But…

I often wonder how many unrepresented disability retirement applicants there are who, having received a denial letter at the First Stage of the process of filing for Federal Disability Retirement benefits under FERS & CSRS, never file a Request for Reconsideration because they believe what the Office of Personnel Management stated in the Denial Letter.  Sometimes, I will get telephone calls from people who want to file, and during the course of the conversation, it will come out that they had filed a few years previously, and had been denied.  “Did you file a Request for Reconsideration, at the time?” I ask.  “No,” is the answer.  “Why not?” I ask.  The typical answer?  “Because I just thought there was no way to fight them on it.” 

I used to be amazed at such answers, but after some thought, it makes sense.  As an attorney, my first instinct (both trained and natural) is to always take something to the next level, with the firm belief that I will prevail just by pure persistence, and by using the law as “a sword” in the process of fighting for my clients.  But most people are not lawyers (some would say, thank goodness for that, we have enough lawyers in the world), and when the Office of Personnel Management writes up a denial letter, then allegedly cites “the law”, and makes bold conclusions such as, “You do not meet the eligibility criteria under the laws governing disability retirement…”  It all sounds convincing.  It all sounds like any further action will be an act of futility.  But just because OPM “says so” doesn’t make it true, doesn’t make it right, and certainly doesn’t make it unwinnable.  They may say you don’t meet the eligbility criteria; I would argue otherwise.

Sincerely,
Robert R. McGill, Esquire

OPM Disability Retirement: Discretion in a Response

When a Federal Disability Retirement applicant under FERS or CSRS receives an unfavorable response from the Office of Personnel Management (translated:  an initial Denial), you have the right (which must be asserted in order to move forward in the future, i.e., to the MSPB and beyond) to file a Request for Reconsideration.  If you receive a second denial, then the only response required (and which should and must be asserted) is an appeal to the Merit Systems Protection Board.  A response to the initial denial, however, should include a reply to the (often) detailed “discussion” section of the denial letter. 

Normally, when I file a response (in addition to obtaining additional medical documentation from the doctors, and any other substantiating documentation which may be relevant), I normally write up a 5 – 7 page responsive legal memorandum rebutting the denial letter.  Now, this is where “discretion” is necessary.  Upon an initial reading of a denial letter, one’s first response is normally not that which one should act upon, because it is often a reaction of, “What???”   Discretion is a virtue to follow; there must be a proper balance between responding to every single criticism from OPM (not a good idea), to ignoring everything in the denial letter (also not a good idea), to choosing two or three of the more substantive issues brought up and addressing those issues.  How to address them, with what tone, what manner & style, etc., is what an attorney is for.

Sincerely,

Robert R. McGill, Esquire