Medical Retirement for Federal Workers: To Just Walk Away

One suspects that the U.S. Office of Personnel Management “plays the odds” and finds that a certain percentage of the population will accept at face-value the stated basis of a denial of a Federal Disability Retirement application, regardless of the lack of substantive basis for such a denial.  And, indeed, there will be a segment of the population, within the entire universe of Federal and Postal employees who submit a Federal Disability Retirement application, who will simply feel discouraged, and simply give up.

This is precisely why, in many administrative processes, there is an automatic first-level denial.

FERS & CSRS Disability Retirement is somewhat different, and one would assume that there is no internal mechanism of automatically rejecting a submission at the initial stage of the application, because the merits of each case should be determined at each stage of the process.

Nevertheless, it would be “prudent” for the U.S. Office of Personnel Management to take such an approach, if only to test the determination and seriousness of each applicant.  This is not to allege that such an approach is deliberately engaged in by OPM; rather, whether on a valid basis or not, there is nevertheless the likelihood that a certain percentage of Federal Disability Retirement applicants who are denied at the first stage, will simply walk away, not fighting for a benefit which they may well be eligible for.

And, of course, “walking away without a fight” is certainly an option for everyone; not a very viable one, and one which should not be recommended.  The sad part, of course, is that the very basis for not having “the fight” to contest an OPM denial, is often the same basis for which the Federal or Postal worker filed for Federal Disability Retirement benefits in the first place:  the medical condition itself, and the debilitating manifestations which have weakened the human spirit to persevere.

Sincerely,

Robert R. McGill, Esquire

FERS Disability Retirement for Federal and USPS Workers: Selective Reality

The problem with an unrepresented Federal or Postal employee who files for Federal Disability Retirement benefits from the Office of Personnel Management, is that because this is the one and only encounter with OPM, any response from them will be a narrow, one-dimensional perspective.

Thus, if the Office of Personnel Management denies the Federal or Postal disability retirement application, such a denial, the manner in which it is written, the content, the apparent delineation of “the law”, and the loosely-stated declarative statement while vaguely referring to the insufficiency of one’s medical documentation, will result in a narrow perspective, in a vacuum of reality created by OPM.

OPM’s denial letters are notorious for its selective reality.  Such selective reality will completely ignore all medical statements which seem to support the OPM disability retirement application, while selectively focusing upon every tidbit of medical notations which favor the denial.

Thus, be careful if on any given day, you arrive at the doctor’s office and the doctor asks you how you are feeling, and you respond with, “I’m feeling pretty good, today.”  Such a conversational statement may nullify the fact that, in its proper context, what the reality of your statement meant to convey was:  “I’m feeling better today in comparison with yesterday and the entire month before, but in no way could I perform my job even today.”  But OPM will selectively pick upon that one statement, and run with it — to a complete and total basis in denying your Federal Disability Retirement application under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: The Strategy of Disheartening the Opposition

When Federal and Postal employees who have filed for Federal Disability Retirement benefits under FERS or CSRS, and have been denied at the initial stage of the process, many are sincerely disheartened.

In my initial contact with the denied applicant, there are multiple levels of reactions, including:  the denial letter points to legal criteria which they were unaware of; it refers to doctors notations which are taken completely out of context; they have completely ignored major portions of what the doctor has stated; OPM points to legal criteria which has been met, but which OPM simply denies that it has been met.

What can be done?  This is the strategy of disheartening the opposition.  In other denials, it is simply a matter of referring to a doctor’s report here, and to a medical notation there; then to simply declare:  You have not submitted sufficient medical documentation and fail to meet the legal criteria to be eligible for Federal Disability Retirement benefits.  What can be done?  No explanation; just scant references, then a unilateral declaration.  Again, this is the strategy of disheartening the opposition.  What to do?  Don’t get disheartened.  Respond.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: The Problem with Answering an OPM Denial

A denial of a Federal Disability Retirement application under FERS or CSRS from the Office of Personnel Management always leaves the applicant and his or her attorney at a disadvantage.  This is because OPM is never answerable to any resulting consequence of a denial; at least, not directly.  Think about it this way:  In the initial application, if an OPM Disability Retirement application is properly prepared and submitted according to, and within the parameters of the laws governing Federal Disability Retirement, one would assume that it should be approved.  If it is denied, then the case is sent to the “Reconsideration” division of OPM — meaning, to another person. 

Now, taking it out of the hands of one OPM Representative into the hands of another, has both the good and the bad mixed together:  the good is that it will now be reviewed afresh by someone else; the bad is that the person who denied the original application has no further responsibility for the denial.  This is true, incidentally, with respect to the Reconsideration Stage of the process; if a second denial is issued, the person who issues the second denial also has no responsibility to answer for the basis given in the denial. 

The “light at the end of the tunnel“, however, comes when it is finally taken up by an Administrative Judge at the Merit Systems Protection Board.  While the AJ cannot hold anyone at OPM responsible for a denial which never should have been, at the very least, when the AJ reviews the record and finds that the previous denials were unfounded or rationally without legal foundation, an immediate recognition of a baseless denial can help the applicant.  Ultimately, rationality and legal integrity has a chance to prevail; it sometimes takes more than one bite at the apple.

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

OPM Disability Retirement: Denials

Denials received from the Office of Personnel Management are particularly difficult news to digest. It is not so much that the denial itself obviously represents “bad news” (that is difficult enough), but for the disability retirement applicant, it casts a long and foreboding shadow upon one’s financial and economic future. For, obviously, the income from the disability annuity is being relied upon; the applicant filed for Federal disability retirement benefits under FERS or CSRS based upon the assumption that it would be approved, and the future calculation of economic and financial stability was based upon the obvious assumption of an approval. Long-term plans are made based upon the assumption of approval. Further, it doesn’t help that the basis for the denial, as propounded by the Office of Personnel Management, is often confusing, self-contradictory, and without a rational basis. It is often as if the OPM representative just threw in a few names, referred to some doctor’s reports, and essentially denied it with a selective, almost pre-determined view towards denying the claim. This is unfortunate, because the Office of Personnel Management is under a mandate to make its decision based upon a careful and thorough review of the applicant’s supporting documention. However, when the denial is received, one must fight against the initial feelings of defeat and dismay; work is yet to be done, and a view towards the future must always be kept at the forefront. A time to give up is not now; it is time to fight onward, and to move forward.

Sincerely,

Robert R. McGill, Esquire