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

OPM Disability Retirement: Great Expectations

The title of this blog, borrowed (of course) from Dickens’ great novel, refers to the contrast between the reality of X and the mental projection of what should be, in the mind of an individual.

What does this have to do with filing for Federal Disability Retirement benefits under FERS or CSRS?  When an application for Federal Disability Retirement benefits under FERS or CSRS is carefully prepared, meticulously gathered, painfully delineated, and thoughtfully prepared, one has the (logical) expectation that, when it is reviewed and evaluated by the Office of Personnel Management, that a certain minimal level of intellectual discourse would be engaged in.

In other words, it should not be an unrealistic expectation that, if it is denied or disapproved, that the person who is writing the letter of denial would provide some fundamental delineation of reasons; some intellectual discussion addressing certain aspects of the Federal Disability Retirement packet; even (God forbid) a revelation of some logical discourse with a legally viable basis in making an argument.

Alas, such an expectation would be too much to bear.  The great chasm between the reality of the process and the expectation which one has, is one which will lead only to disappointment.  If a denial of a Federal Disability Retirement application comes, it is a rare event that the Office of Personnel Management engages in any justifiable discussion.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Reconsideration Response — Refrain from Reflexive Response

When a denial is received for an Application for Federal or Postal Disability Retirement benefits under FERS or CSRS, sometimes they are replete with comical “errors” and omissions.  Thus, anywhere from mistaken identities, to wrong job identifications, to the wrong doctors named; from medical conditions which were never claimed, to diagnostic tests and surgeries which were never submitted; these are just some examples of errors and omissions which one might find in the body of the “Discussion” in an OPM denial letter.

The reflexive temptation is to put together a string of harangues and accuse the OPM Representative of incompetence, incoherence, ineptitude, and inability to perform the essential element of his or her job.  Such a reflexive response would be the wrong tact to take, however.  One should refrain from making such “ad hominem” attacks.

Instead, the better way to go about it would be to politely point out the major errors, the omissions of any medical or other substantiating documentation, in an understated way, then to argue the main points that need to be argued to rebut the denial letter.  While the former methodology may make you feel good, in the end, it is an approval which will prove to be of lasting elation.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Reconsideration Decisions

Types of reconsideration decisions denying an applicant his or her Federal Disability Retirement benefits under FERS or CSRS can and do span the entire spectrum, depending upon the OPM representative who writes up the decision:  from half a page (barely giving a passing, respectful review to a packet which took multiple hours to put together) to over 3 pages long (in the “Discussion Section”); from merely listing general principles of law and generalized, template-like denials to apparent detailed (but very selective) references to various medical reports submitted by the applicant as part of the disability retirement packet — they all boil down to the same thing:  a denial at the initial application stage.

Often, an initial reaction to the denial encompasses a myriad of responses, ranging from incredulity, to resignation, to anger, to indignation.  Set aside the emotionalism.  Further, there is often the reaction to that “one piece” of medical information which the applicant believes should have turned that “denial” into an “approval” — that “one piece” of medical note, statement, sentence, or paragraph which the OPM representative conveniently disregarded or chose not to reference.  Don’t ruminate over it.  It may well be that it was deliberately disregarded; it may even have been overlooked.  More than likely, the OPM representative was fully aware of it, but decided to selectively choose his or her basis as the more “important” and “substantive” evidence, forming the core rationale of the denial.  Don’t waste time.  More work is needed — both medical as well as legal.

Sincerely,

Robert R. McGill, Esquire

Federal & Postal Disability Retirement: OPM's Words

It is a frightening thought that there may be a percentage of Federal or Postal Federal Disability Retirement applicants who read an initial denial from the Office of Personnel Management, and take their words at face value.  From statements such as, “Your doctor has failed to show that your condition is amenable to further treatments” (by the way, when did the Office of Personnel Management obtain a medical degree or complete a residency requirement?) to “you have not shown that you are totally disabled from performing efficient work” (hint:  this is not Social Security, and the standard is not “total disability”), to a full spectrum of error-filled statements in between, one may suspect that there may be a knowing strategy in rendering a denial, knowing that a small percentage of the corpus of disability retirement applicants will simply walk away and not file a Request for Reconsideration. 

Further, I suspect that this occurs more often with certain more “vulnerable” medical conditions — Fibromyalgia, Chronic Fatigue Syndrome, Major Depression, PTSD, anxiety, panic attacks; Chemical Sensitivity cases, etc.  Why do I suspect these?  Mostly because such cases are attacked for “lacking objective medical evidence” (see my articles on Vanieken-Ryals v. OPM, and similar writings) and failing to provide “diagnostic test results”, etc.  There was a time, long ago, when it used to mean something when someone said, “The Government says…”  In this day and age, I would advise that you take it to an attorney to review whether or not the words of the Office of Personnel Management are true or not.

Sincerely,

Robert R. McGill, Esquire