Tag Archives: how to handle the reconsideration stage

Federal Disability Retirement: Reconsideration Selectivity

Perceptual selectivity is an adaptive process of some evolutionary benefits; otherwise, the voluminous extent of bombarding stimuli would be too much to process and digest. We naturally focus upon certain perceptual activities; perhaps it is the brighter colors, the more aggressive movements, the objects which seem to portend potential threats, etc.  In modern societies, where attacking cougars and lions are merely mythological stories of the past (except perhaps out West, where such events still abound), selective excision occurs more often in the context of linguistic extraction.

U.S. Office of Personnel Management - Disability, Reconsideration and Appeals Group

U.S. Office of Personnel Management:  Disability, Reconsideration and Appeals Group

For Federal and Postal Workers who file for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether the Federal or Postal employee is under FERS or CSRS, the process of selective extrapolation and argumentation can be a frustrating encounter when a denial of one’s Federal Disability Retirement application is issued by the U.S. Office of Personnel Management at the initial stage of the process (and even at the Reconsideration Stage).

It is indicative of the decision-maker’s mindset, and not necessarily as a consequence of the proof submitted.  There may be quotations extracted from medical reports and records seemingly supportive of a denial, while all the time ignoring countervailing wording and opinions which contradict or otherwise reverse the unsupportive statements.

Selectivity in the endeavor to find support for one’s position is simply something that people do.  You may cry out, “But where is the objectivity which is supposed to exist?” Objectivity is a learned process, achieved through discipline and intellectually rigorous self-effacement; selective bias, on the other hand, is the natural default position resulting from the evolutionary vestiges of man’s former state of existence. The residue of man’s natural state will always remain; but with the camouflage of sophistication presented in modern society, selectivity of purpose can mask our former state of brutish behavior.

For those encountering such selective processes in a denial from the U.S. Office of Personnel Management, the road to counter it is to argue the compendium of fact, law and full context of medical opinions, in preparing a full counterattack representing a viable refutation. In the end, the attempt at selectivity of facts and the law can easily be rebutted; but it often takes an awakening of the other’s evolutionary tendencies — of a potential threat of stimuli through the aggressive use of the law — which will result in a victory via an award of one’s Federal Disability Retirement benefits from the U.S. Office of Personnel Management.

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

Disability Retirement for Federal Government Employees: Someone Else’s Argument

Have you ever sat with company at a dinner table, and engaged in a conversation where it appears as if you are continuing someone else’s conversation?  Or your presence is merely a substitute for an extension of a previous debate or discussion?  Where a topic is brought up, and immediately a barrage of critical attacks — of arguments you have never made, and of statements you don’t recall disseminating (and where this is only 5 minutes into the salad and you’ve barely tasted the first glass of wine)?

The problem with unfinished business is that the transference of what one wanted to say is normally unloaded upon the wrong subject.  Conversations, debates, forums of intellectual exercises in linguistic battles — it is a rare person who has been able to convey the full force of one’s collective thoughts and beliefs on the matter, and it is more often the case that one leaves with the regretful remorse of, “I wish I had brought that point up…”  But rarely do second chances present themselves in a satisfactory follow-up forum; unless you are the unfortunate object for an unexpected dinner invitation.

In responding to a denial of a Federal Disability Retirement application with the U.S. Office of Personnel Management, whether under FERS or CSRS, the applicant — through his or her Federal Disability Retirement attorney — needs to understand that the person who issues the denial will not be the same person who will review any additional submissions or legal arguments at the Reconsideration Stage.

It will be reviewed, in legal parlance, de novo.  As such, while the basis of the denial as issued by the Caseworker at OPM at the First Level should be taken into consideration, one should approach the case in light of the following question: To what extent will the Reconsideration Branch care as to the original basis of the denial of the first caseworker?  If it is being reviewed de novo, the approach should be to go over all of the elements — and to reinforce and amend those weak points, some of which may overlap what the first caseworker pointed out, others which may not.

It may not be the best approach to argue to a dinner guest who wasn’t present at the first round of arguments; the points you are trying to make may not be heard because the bell has already rung, and the fighter in the second round has been replaced with someone upon whom you have never previously landed a punch.

Sincerely,

Robert R. McGill, Esquire 
FERS Disability Retirement Lawyer

   

Postal and Federal Disability Retirement: Selective Extrapolation

The game of selective extrapolation is played by many; there was a time when such a methodology — otherwise known as taking something “out of context” — was with simplicity and bluntness identified for what it is:  dishonest.  But in this day and age, it has come to be accepted, and even applauded, for such characteristics as “aggressiveness” and “smart play”.

Once, in an age where integrity and fidelity were upheld as character traits worthy of emulating, there was an affirmative duty to “tell the whole story” — that if X quoted from a document in fragmented form, it was one’s duty to provide the entirety of the context in order to be “fair”.  Perhaps it is the adversarial nature of the legal arena which allowed for this standard to change; or perhaps it is just part of the greater deterioration of the culture; in any event, in modern times, it is an accepted practice to merely take sentences, words, concepts and phrases out of context, and twist and mangle them to whatever form and usage will gain one’s advantage.

In Federal Disability Retirement law, especially in the context of a denial issued by the U.S. Office of Personnel Management, one will often find the use of selective extrapolation — of taking a lengthy, comprehensive medical report of a doctor, and choosing to quote an almost-irrelevant statement which seems to support a negative or opposite conclusion from that which the doctor has stated.  At first glance, one merely scratches one’s head with puzzlement; but after the initial shock, it must be recognized for what it is:  an attempt to merely justify the denial of a Federal Disability Retirement application.

How to rebut it?  Fortunately, the rebuttal is not made to the same individual who played the game of selective extrapolation; that would obviously be an act of futility.  The rebuttal must be forceful and head-on; call it for what it is, and provide the correct content and context.

In Federal Disability Retirement law with the U.S. Office of Personnel Management, whether under FERS or CSRS, one must prove by a preponderance of the evidence that one is entitled to Federal Disability Retirement benefits.  In order to do so, one must maintain a level of integrity which reveals the sharp contrast to those who engage in such games.

It is sometimes difficult to refrain from playing the other person’s game; but in the end, let’s hope that age-old standards of integrity and fair play will continue to win out.

Sincerely,

Robert R. McGill, Esquire

Early Retirement for Disabled Federal Workers: Responding to an OPM Denial

Fairness” is a term which is often thrown about freely, indiscriminately, and without thought, when an individual believes that he or she has been wrongly treated.  But an objective analysis of whether or not a particular type or mode of treatment of an individual is justified or not, should be determined by the criteria which has been previously applied.  

In order to accomplish this, there obviously has to exist a “criteria” to begin with.  The necessary precondition of an application of a criteria, in order to determine “fairness” in a given circumstance, should be self-evident.  Thus, in the world of sports, a charge of “unfair play” should be easily determined by looking at the predetermined rules of the game, whether such rules were properly interpreted and applied, and coming to a conclusion based upon whether such rules were followed.  Where there are no “rules” of the game, however, it becomes more difficult — both in alleging “unfairness”, as well as in determining how to analyze a violation of — of what?  Precisely.  

In responding to a denial of a Federal Disability Retirement application from the Office of Personnel Management, whether under FERS or CSRS, there is obviously the legal criteria of eligibility which one can point to.  But if the Office of Personnel Management “adds” to the legal criteria, or otherwise includes in its denial substantive legal jargon which has no applicability in a Federal Disability Retirement case, what is one to do?  

Some denials received from the Office of Personnel Management are fairly simple and straightforward; others, however, can encompass seemingly complex reasons and rationale rising to the level of complicated incomprehension, bundled in a mass of conundrums which puzzle even a legal expert.

To make matters worse, the author of such a denial is not the one responsible for the next level of review.  Instead, the denial from OPM is kicked over to the “Reconsideration Stage” Case Worker.  This can be both a blessing as well as a curse, of course.  Whether the former or the latter, one is left with the complex conundrum of calamities — an incomprehensible denial which must nevertheless be answered.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Substantive Responses

Once a Federal Disability Retirement application has been denied at any given stage of the process (at the First Stage or at the Reconsideration Stage) by the Office of Personnel Management, a Federal or Postal employee must determine the proper response.  

As stated in the immediately preceding blog, there is first the administrative response which must be satisfied, before one even gets to the issues of a substantive response.  The administrative response takes care of the timeliness issue of satisfying the administrative requirements set forth by the law — upon a first denial, one must submit a “Request for Reconsideration” within thirty (30) days of the denial; upon a second denial, one must file an appeal to the Merit Systems Protection Board within thirty (30) days of the denial, etc.  

As for the substantive response, the worst mistake that a Federal or Postal employee can make is to immediately write an angry diatribe and submit the response.  There is time enough for a thoughtful and proper response.  The issue is whether to rebut each point which the Office of Personnel Management makes, or to selectively choose one or two main points, and to focus upon those.  Normally, the latter is preferable, if only because such an approach normally addresses all of the subset, minor points of a denial in the very process of presenting one’s case.  Remember that, throughout the process, the mere fact that OPM asserts an argument, does not mean that the argument is true, or even valid.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Template Approach

The Office of Personnel Management essentially renders both approvals and denials of a Federal Disability Retirement application with a “template” approach.  This is not surprising, but it is little noticed, and this is why:  For disabled Federal and Postal workers who file for Federal Disability Retirements benefits under FERS or CSRS, and who are not represented by a federal disability attorney, it is their “one-and-only” exposure to the Office of Personnel Management.

Thus, if an approval is received, that approval is the first and only time of having any correspondence from the Office of Personnel Management.  Similarly, if a denial is received, then that is the first exposure and contact from the Office of Personnel Management.  There would be no way of knowing whether or not the approval letter, or the denial letter, was or was not a “standard template”.  Certainly, in a denial letter from the Office of Personnel Management, there are references to submitted medical documents, or supervisor’s statement, or some other document which was part of the Federal Disability Retirement application; but the remainder of the denial letter is in “template form”. 

However, when an attorney represents a Federal or Postal worker and receives an initial denial letter, or a denial at the Reconsideration Stage, it is an obvious issue, because any attorney who specializes in Federal Disability Retirement law has viewed hundreds, if not thousands, of such letters.  Why is it important to recognize that the format is in “template” form?  For many reasons.  The type of template; from whom the template is received; the extent of the template; the issues presented in the format; these are all helpful for any experienced Federal Attorney who specializes in Federal Disability Retirement law, to successfully answer such formatted denials.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The "Process" at the Reconsideration Stage

It is important to understand that the “process” of filing for Federal Disability Retirement, when it comes to the Second, or “Reconsideration” Stage, encompasses two factual prisms:  (1)  The application has now been denied (obviously, and for whatever reason — most likely because of “insufficient medical evidence”) and (2) it is the stage in the process prior to an appeal to the Merit Systems Protection Board. 

This dual prism of the stage, while self-evident, is important to keep in mind, because it requires a duality of duties:  A.  It requires (for the Disability Retirement Applicant) a duty to show something beyond what has already been shown, while B.  It requires the Office of Personnel Management to be careful in this “process” of review, because if OPM makes a mistake at this stage, then the likelihood is great that they will be required to expend their limited resources to defend a disability retirement case before an Administrative Judge, and if it becomes obvious that the case should have been decided favorably at the Second Stage, it reflects negatively upon the Agency.  OPM is an agency made up of people (obviously); as such, just as “people” don’t like to look foolish, OPM as an Agency made up of people, does not like to look “badly” or “foolish”.  This duality of factual prisms is important to understand when entering into the Second, Reconsideration Stage of the “process”.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement & the Reconsideration Process

In the process of applying for Federal Disability retirement under FERS or CSRS, it is the “hope and wish” of each applicant that it will smoothly sail through at the initial stage of the application. However, the reality of the process is that a certain percentage of applications get denied at the initial stage (Stage 1 of the process). It is both discouraging and befuddling to receive a letter from the Office of Personnel Management informing you that your disability retirement application has been “denied”.

You are now required to Request Reconsideration of your case within thirty (30) days of the date of denial, and you must submit additional medical evidence or other supporting documentation within 30 days of requesting such reconsideration (Stage II of the process). It is, indeed, a time of disappointment to receive a denial. It is all the more so when it is unclear as to the basis for the denial. Often, a denial letter will refer to the medical evidence without much commentary beyond acknowledging the submission of a medical report, then in the last paragraph, simply make a declarative statement that the medical evidence submitted “was insufficient” to show that you are disabled. Or, more often than not, the OPM Benefits Specialist will actually mis-state the law by claiming that you have “not shown that you are so disabled as to keep you from the workplace” (no such legal standard is required under disability retirement rules, regulations or case-law).

Whatever the reasons given, it is both discouraging and disheartening to receive a denial letter from OPM. However, it is important to calmly, systematically, and with pinpoint focus reply to the letter of denial — even if it doesn’t seem to make any sense. This is done most effectively by using all of the tools required in persuading eligibility and entitlement to disability retirement benefits: the law; the medical report; the medical records; rational and legal arguments –in short, the “nexus” needed to win.

Sincerely,

Robert R. McGill, Esquire