Tag Archives: how to win an opm disability retirement claim

OPM Disability Retirement: The Foundational Paradigm

Ultimately, Federal Disability Retirement is based upon the persuasive delineation of three primary elements:  A medical condition; impact of the medical condition upon one or more of the essential elements of one’s job; and an inability on the part of the agency to accommodate the resulting impact of the medical condition upon one’s inability to perform all of the essential elements of one’s job.

How one proceeds to “prove” the case; what “kind” of evidence one needs to provide; the qualitative nature of the proof to be submitted; the quantity and volume of the type of evidentiary submissions to be included; these are determined by necessity based upon the nature of the medical condition itself.

Thus, some medical conditions may require merely a few pages; others, extensive supporting documentation, including treatment notes, diagnostic test results, explanatory clinical encounters and narratives which show a history of treatment-resistant modalities of medical applications as well as fulfillment of such extensive attempts which validate that the patient/applicant is not a “malingerer”, but rather exhibits symptoms which defy traditional approaches both for diagnoses and treatment.

It is always upon the first of the three elements identified which forms the foundational basis of a Federal Disability Retirement application; the sequential nexus of the two following almost creates itself, like the phoenix arising from the ashes, only in this case, from the debilitating medical condition from which one suffers.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for US Government Employees: Procrastination

Someone once said that procrastination is a wonderful thing — it allows for a lag-time between the future (for those things which need to get accomplished at some point), the present (those things which require attention immediately), and the past (those things which needed to get done, but whose time has passed, and with each passing moment, the urgency of which is diminishing because it doesn’t matter, anyway).  But procrastination has a way of “catching up” — where the piling up of past non-action combined with the present need to act, finally explodes when there is no future left to wait for. 

Preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS should not be compiled based upon a paradigm of procrastination.  Waiting for the last moment, or simply putting together a voluminous box of medical records and quickly filling out an SF 3112A by listing a compendium of known or suspected medical conditions, then quickly concluding that they impact one or more of the essential elements of one’s job, will only further raise the chances of a denial from the Office of Personnel Management

When a medical condition impacts a Federal or Postal employee and his or her ability to perform the essential elements of one’s job, there is certainly a sense of urgency.  However, the urgency to quickly file a case must be weighed and balanced against the future likelihood of success.  This is a long, long, process, and the extra time it may take — weeks or months — to properly prepare, formulate and file a Federal Disability Retirement application under FERS or CSRS, will help to prevent the problems of procrastination.  

Sincerely,

Robert R. McGill, Esquire

Federal & Postal Service Disability Retirement: Differing Legal Criteria

Similar benefits, at the State, Local, Private levels, and at the Federal level, each contain differing legal criteria for eligibility. Thus, for instance, Social Security Disability benefits require one set of standards of eligibility; private disability insurance policies require a different set of standards; and state disability benefits often differ from state to state.  This is of course true of Federal Disability Retirement benefits under FERS and CSRS — where the legal standard of eligibility is different from Social Security, Worker’s Comp, and State or private disability criteria.

Often, a question is asked whether a medical narrative report which is prepared for submission to the Office of Personnel Management can be used for submission for other “similar” benefits.  The short answer is, “It all depends”, but the long answer is that, in most cases, one must be very cautious.  When I represent a Federal or Postal employee under FERS or CSRS, one of the first steps in preparing a viable case is to request of the treating doctors a detailed medical narrative report.  One must understand that the treating doctor has, generally speaking, next to no idea as to the legal criteria that must be met under FERS or CSRS.  Furthermore, the treating doctor has no legal knowledge as to the differences between private disability insurance policies, State, Social Security, OWCP or FERS & CSRS.  It is the job of the Attorney to make sure and guide the treating doctors as to the criteria which must be met as to the particular and specialized field for which the medical narrative is being prepared.  This must be done with care, and with detailed guidance.

Sincerely,

Robert R. McGill, Esquire