OPM FERS/CSRS Disability Retirement: Approaching a Reconsideration

The proverbial definition of insanity is to engage in the same repetitive activity with the expectation of receiving a different result.  While such a definition may not provide a clinically accurate or legally acceptable formulation, it does implicate the chaotic character and the futile act of responding in a particularly fruitless manner.

For Federal and Postal employees who have attempted to file for Federal Disability Retirement benefits through the U.S. Office of Personnel Management, whether under FERS or CSRS, and have received an initial denial, the process of having OPM reconsider one’s case must be approached in a 2-tier manner:  First, one must meet the “deadline” of filing for Reconsideration with OPM within thirty (30) days of the denial, or upon receipt of the denial (although, to be on the safe side, it is best to use the former date as opposed to the latter);  next, with the box checked to indicate submission of additional medical documentation, to then gather, prepare, compile and submit additional medical evidence within thirty (30) days thereafter, unless a further extension is needed and requested.

However, one should also understand that in an OPM Reconsideration case, it will not be the same Case Worker who will review the case, but it will be reviewed thoroughly by someone else as if it had never been previously reviewed. As such, there is the confounding conundrum of a dual anomaly: The First Case Worker who issued the denial based the denial upon certain specific points; yet, what the First Case Worker denied the case upon, may have no bearing upon what the Second, Reconsideration Case Worker will evaluate the case upon.

What does one do? Whatever one’s answer is to this complex conundrum, do not engage in the proverbial act of insanity; better to get some legal guidance than to spin one’s wheels in an insane world of futility.

Sincerely,

Robert R. McGill, Esquire

U.S. Postal and Federal Disability Retirement: The Proper Mental Approach

One must always have the proper mental preparation before engaging the administrative process of Federal Disability Retirement benefits through the U.S. Office of Personnel Management, whether under FERS or CSRS.

First, one must understand that it is a benefit which is not an automatic entitlement, but rather a potential eligibility benefit — and, as such, one must prove by a preponderance of the evidence that one meets the entirety of the legal criteria for such eligibility.  It is not a benefit where there is a simple trigger mechanism — e.g., one’s age, particular factual circumstances, etc. — which then automatically grants the entitlement to the benefit itself.

Second, as an administrative process, one must prepare for the full procedures involved — from the initial application stage, to a possible denial and a request for reconsideration; to a second denial, and an appeal to the U.S. Merit Systems Protection Board (which, by the way, happens to be shut down because of the budget impasse but that may change today); and, beyond the initial appeal, an appeal to the Full Board of the MSPB, and even beyond that (for extraordinary cases), to the Federal Circuit Court of Appeals.  Unless one is prepared to embrace the full administrative process, the ups-and-downs of emotional turmoil and lack of preparedness will wear you down.

And, finally, mental preparation must entail financial considerations — of what to do in order to survive during the long and arduous process.  For, as an administrative benefit which must be proven, one should always understand that one must fight every step of the way.

Only with the proper mental preparedness will one be able to engage the fight to earn the right to such a benefit.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: Preparing for the Process

Every endeavor or activity requires preparation — if merely a thought, but more than likely, the gathering of proper materials, a logistical and strategic plan of action, etc.  There is nothing more frustrating than to begin a project, only to find that one lacks the proper materials and tools, and must delay any further action because of such lack.

Similarly, in preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, it is important for the Federal or Postal employee to understand that “having a medical condition” is not enough to endeavor to begin the administrative process (some would instead insert the term, “nightmare” for the word “process”).

While the suffering of the chronic or debilitating medical condition may “feel” like it should be enough, filing for a bureaucratic benefit requires proof which meets a set standard of evidentiary documentation.  In other words, one must establish a “nexus”, or a connection, between the medical condition which one suffers from, and the job which one is positioned for, and moreover, one must always keep in mind that this is a “medical retirement“, and as such, it must be established that one is no longer able to perform one or more of the essential elements of one’s job from a medical standpoint.

It is indeed the preparatory phase of the journey into Federal Disability Retirement which will provide the foundation for ultimate success in the endeavor.

Just as you don’t want to build a house without first having the appropriate construction materials; so you don’t want to go down the path of Federal Disability Retirement without having the requisite medical and legal tools in hand.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: Responding to the Template Approach

While the Office of Personnel Management issues template approvals and denials, what must the individual applicant who receives such a template denial, do?  Obviously, it cannot be a “template” response, because any response by an individual applicant is going to be an individualized response.  Often, however, OPM’s response takes a shot-gun approach in denying a Federal Disability Retirement application — it uses every device in its template, touching upon every issue and sub-issue, without any apparent (or obvious) rhyme or reason.  Whether purposeful or not, the extent and quantity of reasons for denial become almost insurmountable, and unable to “sort out”. 

One thing that a Federal Disability Retirement applicant should not do, is to take the denial letter to his or her doctor to respond to.  It will only confuse the doctor.  Instead, the denial letter must be reduced to a comprehensible set of criteria which can be answered.  Sub-sets of issues need to be identified and consolidated; the minor (but often irritating) references to peripheral issues, often touched upon but of no real consequence, must be ignored; and the focus must be placed upon the central 2 or 3 issues which seem to be the overriding concerns in the denial letter.  In other words, the denial letter must be deciphered and extracted to be “made sense of”.  Only then can OPM’s template denial letter be answered — with reason, aggressive attack, and a rational grounding in the law.  In other words, irrationality must be met with clarity of mind.

Sincerely,

Robert R. McGill, Esquire