Tag Archives: if your opm disability claim was unfairly denied

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

 

 

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

   

Federal Disability Retirement: Surprise in the Universe of Reconsiderations

Until the science of Physics can implement the ability of molecular and particle transference technology (i.e., “Beam me up, Scotty”), there is little potential of resolving the Cartesian mind/body dualism (i.e., that French Philosopher Rene Descartes, who bifurcated the world between the material and the spiritual). But such dualism in philosophical terms does not mean that we can be at two places at one time; or even attempt to be “objective” when the subjective “I” is the very same person who is attempting to appear objective.

In Federal Disability Retirement law, when the U.S. Office of Personnel Management issues a denial letter, the customary response by the denied OPM applicant, whether a Postal Worker or a non-Postal Federal Worker, is that he or she is “surprised” by the initial denial because of the strength, completeness, and thoroughness of one’s Disability Retirement packet.  But that should be a given.

No one who files with OPM should do so without meeting the requisite foundations of thoroughness or completeness.  But this is where the problem is:  the very person who determines that a Federal Disability Retirement application is sufficient, is the same person who suffers from the very medical conditions of which the application speaks about.

The subjective/objective coalescence makes for a difficult mind/body dualism, in that the one who suffers from the medical condition can hardly assess and evaluate, in an objective manner, the strength of the Federal Disability Retirement application.

Thus, the Cartesian mind/body dualism lives on, and until Captain Kirk can guide us otherwise, such bifurcated dualism will continue to pervade all Federal Disability Retirement applications, whether under FERS or CSRS, and the denials which follow will still have the familiar response of, “Surprise!

Sincerely,

Robert R. McGill, Esquire

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

Postal and Federal Disability Retirement: Denials

Denials come with an unexpected force and impact; for, in every Federal Disability Retirement case, there is the expectation that the application itself merits close scrutiny and a belief that a proper review will persuade the OPM trier of facts that the Federal Disability Retirement application should be approved.

Indeed, from the perspective of the applicant, who is suffering from the medical condition itself on a daily basis, it is often a reaction of disbelief and anger when a denial is issued by the U.S. Office of Personnel Management.  But one must understand that this administrative process identified as “Federal Disability Retirement” is one which is not an “entitlement”, but rather, an adversarial process where proof, argumentation and persistent appellate procedures must be invoked at every step of the way.

That is why, in preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, one needs to always prepare a case as if it will ultimately go to the U.S. Merit Systems Protection Board.

Further, it is understandably disappointing to read an OPM denial and find that the OPM case worker does not even mention or refer to much of the substantive medical documentation submitted, but instead blindly (and generically) issues a template of tired old phrases, such as, “You did not meet the legal criteria“; “The evidence did not show that…”

With hundreds of cases assigned to each OPM Case Worker, one must understand that denials are rarely personal; but in responding to a denial from OPM, one must be diligent, forceful, and approach it with the use of all legal tools available.

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

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

When Federal and Postal employees who have filed for FERS Medical Retirement benefits 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

Federal Employee Disability Retirement: Discretion in a Response II

In responding to an initial denial of a Federal Disability Retirement application before the Office of Personnel Management, it is important to remain professional, and not to “overload” the response with unnecessary or otherwise irrelevant responses.  Initial anger and disbelief over the selective criticisms contained in an OPM denial letter should not be reflected in a response to the denial.  Why not?  Because there is a good possibility that the case may be denied a second time, and it may appear before the Administrative Judge at the Merit Systems Protection Board.  Don’t write things to OPM that you will regret having an Administrative Judge — one who may be deciding your case — look at and read.  Thus, the “first rule”:  never write an immediate response back, because your anger and emotional disbelief will show itself.  If you need to “get rid” of your anger and expiate the emotionalism, then write your emotional response on a separate piece of paper, then set it aside.  Your “real” response will come later — when you can with a rational perspective, review the unfair and selectively biased denial letter, and begin to compose the serious response that your case deserves.  Or, better yet, get your attorney to do it.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: OPM’s Detailed Denial

Neither length nor detail constitutes legitimacy.  The spectrum of the types and styles of denial letters issued by the Office of Personnel Management in Federal Disability Retirement cases under FERS & CSRS range from a short paragraph under the “Discussion Section”, to 3 – 4 pages of apparent references to doctor’s notes, reports, etc. — with a lengthy lecture about the need for “objective” medical evidence, and about how a particular medical condition “may be” treated by X, Y or Z treatment modalities. 

Don’t be fooled.  One may think that, because OPM provides a seemingly “detailed” explanation of why a particular disability retirement application was denied, that such lengthy detail means that it is somehow “substantive”.  In fact, I often find the opposite to be true:  the shorter the denial, the greater the substance.  The lengthy denial letters contain “substance”, all right — but substance of the wrong kind.  They contain:  Mis-statements of the law; mis-statements of the criteria to be applied; inappropriate assertions of medical opinions (contrary to what one might think, the OPM representative does not normally have a medical degree, let alone a law degree), and a host of other “mis-statements”.  Sometimes, the weightier the denial, the more confusing as far as how to respond.  And, perhaps, that is one methodology as to how OPM wants to approach the case:  If it seems long and complicated, maybe the applicant will sigh, give up, and go away.  Don’t.

Sincerely,

Robert R. McGill, Esquire