CSRS & FERS Disability Retirement: Complexity in the Hidden Background

To prove one’s eligibility for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether one is under FERS or CSRS, is seemingly an uncomplicated matter.

As one’s medical condition impacts the ability to perform one or more of the essential element of one’s job, it is up to the treating doctor to establish the nexus and provide an opinion as to the connecting bridge between the medical condition and the positional requirements of one’s Federal or Postal job.

How does one do that? Must it be comprised of a 1-to-1 ratio between job elements and medical conditions? How important and prominent are “symptoms” considered, as opposed to the mere clinical declaration of the diagnosis, in persuading the U.S. Office of Personnel Management that a particular medical condition should qualify for Federal Disability Retirement benefits? To what extent is one’s own statement of disability, as described on Standard Form 3112A, important in establishing the foothold towards gaining an approval from OPM?

Also, what algorithm or comparative analysis does OPM use in evaluating a case, and how does one enhance the chances of success at the First Stage of the process? If denied at the First Stage of the Federal Disability Retirement process, does the basis of the denial (often characterized by a plethora of multiple reasons given) require a point-by-point refutation, and is the Reconsideration Division at OPM using the same standard of review, or a different application of laws in evaluating the additional evidence submitted at the next stage?

If one watches a gymnast, a ballerina, or even a mathematician at work in solving or unraveling a complex problem or exercise, one is immediately struck by the ease with which the feat is performed. But it is almost always the unseen preparation which has preceded the actual performance that sets the stage of an uncomplicated presentation.

It is that mystery of the uncomplicated, which tends to trip us all, and that is no different in the preparation, formulation and submission of a Federal Disability Retirement application, applied through the U.S. Office of Personnel Management, whether you are under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

Postal and Federal Disability Retirement: The Beast of Burden

The burden is undertaken by those have little choice in the matter, but who willingly submit to the responsibility and obligation.  Traditionally, the “beast of burden” (other than being a Rolling Stone song) refers to a somewhat-domesticated animal, perhaps a donkey or an ox, who must bear the weight of man’s work.

In law, the “burden” is one of proof — of the affirmative obligation to present one’s facts, persuasive argumentation based upon such facts, and the application of the relevant law which supports both the facts and the arguments.  The “other side” in the litigation has no burden at all, and can simply sit and do nothing, if he or she so chooses, and see whether or not the plaintiff, the appellant or the Federal Disability Retirement applicant has submitted sufficient proof such that he or she has met his/her burden of proof.

As the weight placed upon a beast of burden is often heavy and demanding, so in a similar vein the litigant who has the burden of proof should always expect to exceed what is “necessary” in any given case.  For the Federal or Postal employee who is filing for Federal Disability Retirement benefits through the U.S. Office of Personnel Management, whether under FERS or CSRS, it is indeed a heavy burden to bear in order to meet the legal criteria of a Federal bureaucracy who has the unmitigated power and authority to approve or deny.

The burden of proof — it is as heavy as that which we place upon a beast of burden, and the weight of such responsibility can overwhelm us, lest we have the reserve of strength to plod onward.

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

Medical Retirement for Federal Workers: The Silent Sufferer

The silent sufferer rarely gets noticed; but, of course, that is the whole point.  It is analogous in an inverse manner to the childhood adage that the squeaky wheel gets the oil.  From a purely philosophical, conceptually vacuous standpoint, how does one “show” pain?  How does one reveal the inner turmoil of Major Depression, anxiety, panic attacks, or a Bipolar Disorder?

Certainly, physical manifestations of uncontrollable tremors, trembling, etc., can be indicators; but the more complex state of psychiatric conditions which are negatively reflected to the world — of paralysis from action; of lethargy; of an overwhelming “sense” of worthlessness and hopelessness; where stamina or energy, self-motivation and initiative, cannot simply be forced; rather, one is lifeless in a world of activity and sensory overload, not because one cannot self-will movement and progress, but because one is mentally and physically unable to act upon one’s volition.

It is, ultimately, the age-old question of Appearance versus Reality.  So, in preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, the question to be answered is not whether an effective description creating a nexus of one’s medical conditions with one’s positional duties as a Federal or Postal employee should be assembled; rather, the question is how.  One must overcome the appearance of normalcy, by cracking open the reality of the underlying medical condition, and to bring forth, as Heidegger would put it, the uncovering of the reality of Being — by using selective words to reveal to the OPM Representative the starkness of one’s medical conditions.

Eligibility for Federal Disability Retirement benefits from the U.S. Office of Personnel Management must be proven; in order to prove it, one must show the reality of the Real, as opposed to the silence and concealment of that which is mere Appearance.

Sincerely,

Robert R. McGill, Esquire

Federal Worker Disability Retirement: VA Benefits

As each collateral source of disability benefits must be carefully assessed before utilizing it as a tool in filing for Federal Disability Retirement benefits under FERS & CSRS, so it is with those benefits which rely primarily upon percentage ratings. First, one should note that, if a Federal Disability Retirement application is approved under FERS or CSRS, that there is no offsetting of benefits between Federal Disability Retirement and Veterans benefits.  The two are treated as independent of one another.  

At the same time, however, that does not mean that you cannot utilize a VA disability rating decision in pursuance of an approval from the Office of Personnel Management, when filing for Federal Disability Retirement benefits under FERS & CSRS.  Indeed, there is case-law which states that the Office of Personnel Management, or the Merit Systems Protection Board (if it has been previously denied twice and is appealed to the MSPB) must consider such evidence in the totality of all of the evidence, in making a determination on the approval or disapproval/denial of a FERS or CSRS Disability Retirement application.  

If a VA Rating decision is used, however, in such an application, it must be done with some thought and care.  How to go about using it; what to use; whether to use; those are all discretionary questions which must be carefully considered.  In such cases, it is prudent to seek the advice and counsel of an attorney who specializes in Federal Disability Retirement law.

Sincerely,

Robert R. McGill, Esquire

Early Retirement for Disabled Federal Workers: Collateral Disability Determinations

The key to effectively using collateral sources of disability determinations in a Federal Disability Retirement application under FERS or CSRS is to tailor its relevance in each individual circumstance.  Thus, for example, because the focus upon percentages of disability, or the issue of causal connection to the workplace, is a focal point of importance in an OWCP/Department of Labor case, but not in cases of Federal Disability Retirement under FERS or CSRS, such issues should be left alone.  However, the fact that there may be an “independent medical examination” by a Second-Opinion doctor, or a referee doctor in a Worker’s Comp case, can be used to one’s advantage.  

Often, a person who has been under the agonizing scrutiny and torture of the Worker’s Comp process will miss the point, and complain that the OWCP-appointed doctor “didn’t even exam me for 2 minutes”, or “didn’t listen to a thing I said,” but all the while missing the key ingredients in the doctor’s report:  (1) that the doctor can be effectively characterized as “independent” — not from an OWCP standpoint, but certainly from a FERS or CSRS Disability Retirement standpoint, because that particular doctor has no self-interest from OPM’s viewpoint, and (2) if the doctor’s opinion is that, while the causal connection (for example) may not have been established, does he nevertheless express an opinion that the Federal or Postal employee is unable to return to perform the essential functions of his or her job?  Often, the emotional uproar in an OWCP case, or in other similar cases (SSDI & Veteran’s Department disability determinations) causes the Federal or Postal employee to miss the primary point of the process:  to use the tools effectively in getting a Federal Disability Retirement application under FERS or CSRS approved.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Other Processes

Does it make a difference to list that one’s Federal Disability Retirement case is also accepted by OWCP/Department of Labor as an “accepted case”?  Or that one has been deemed 90% disabled by the Veterans Administration — or, more to the point, that one has received a 100% unemployability rating?  How about having been approved for SSDI?  Aren’t these all “indicators” of a medical disability?  

The short, uncomplicated answer is that, yes, such acceptance and approval by other agencies and sources can be indicators of a medical disability.  The longer, more complicated issue, however, is how to divulge and inform the Office of Personnel Management about the “other” Agency, the acceptance, and the relevance of what an approval or an acceptance by another agency should mean to one’s Federal Disability Retirement application.  

Unfortunately, there is no generic or universal rule concerning OWCP-accepted claims, SSDI approvals, VA determinations, etc., with respect to their relevance to an OPM Disability Retirement application.  Each case is unique; there is case-law which is applicable to each one, independent of the other; and because the criteria which governs each is different from any other, they must be dealt with in an independent manner.  This is not a reflection upon the individual filing for Federal Disability Retirement benefits under FERS or CSRS; this is more a reflection upon the asserted independence of each Agency from each other.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: The Limitation of Agency Actions

Often, in the process of filing for Federal Disability Retirement benefits under FERS or CSRS, the client will ask the question, “Well, doesn’t that prove that I can’t do the job?”  Such a question invariably points to some action by the Agency — a letter or a memorandum; a statement which the Supervisor made, etc.  While it may be true that the Agency believes that a Federal or Postal employee is unable to perform, or is not performing, all of the essential elements of the job, remember that actions of the Agency can never replace the affirmative burden of proof that one is unable, medically, to perform the essential elements of one’s job.  

One must keep in mind that the Office of Personnel Management is a separate Agency which is not necessarily in communication with the Agency which employs the Federal or Postal employee.  The “mindset” of the Agency is not being considered by the Office of Personnel Management.  Whatever the motivations of the Agency in doing what it is or will do, is to a great extent irrelevant to OPM.  What the Agency is doing may well indicate “proof” as to other issues — i.e., inability to accommodate; acknowledgment that certain essential elements of one’s job is not being performed, etc. — but it does not prove that an individual is unable, as a result of a medical condition, to perform all of the essential elements of the job.  Only a doctor can do that.

Sincerely,

Robert R. McGill, Esquire