Tag Archives: legal help after first application denial

Federal and Postal Disability Retirement: Responding to Stupidity

Sometimes, one’s initial reaction in a situation — professional setting, social discourse, event gathering, etc. — requires a momentary pause; and it is precisely that couple of seconds of gathering one’s thoughts which saves one from further putting fuel upon a potential fire.

Perhaps you have every right to have responded with a drip of sarcasm; or others would have approved of the lashing back; and still others would say that the response was appropriate and deservedly given.  But the greater question should always be:  how effective was the response; did it evoke the necessary end; and for whose benefit was the aggressive retort given — for the benefit of truth, or for one’s own satisfaction?

In a professional context, of course, it is probably never appropriate to respond in an unprofessional way, if merely by definition alone.  Similarly, in a FERS or CSRS Federal Disability Retirement context, when one receives a denial from the U.S. Office of Personnel Management, there are statements made — whether one pertaining to mis-application or mis-statement of the law; or perhaps a wrong reference to a medical report; or even more egregious, a selective use of a statement from a medical report or record taken out of context — which can deservedly provoke a response involving sarcasm, a deluge of epithets, or worse, a barrage of ad hominem attacks — and in each case, it would be neither appropriately given, nor proper in a professional sense.

Fortunately, paper presentations and paper responses have the advantage of time over social discourse and person-to-person contact.

Holding one’s breath and counting 3 seconds, or 10, or perhaps an eternity, is an effective way of avoiding catastrophe.  Writing a diatribe of what one wants to say, then trashing it, is also acceptable.  On the other hand, beware of that “send” button; and, moreover, never push that “send to all” button.

That would indeed be unprofessional.

Sincerely,

Robert R. McGill, Esquire

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
Postal & Federal Employee Attorney

 

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

Medical Retirement Benefits for US Government Employees: Denials

Denials issued by the U.S. Office of Personnel Management in a Federal Disability Retirement application are informative in multiple ways; while based upon templates for the most part, they often make arguments which are neither based upon the legal precedents which currently prevail, nor on standards of proof which are applicable.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, the Federal or Postal employee is expected to submit a Federal Disability Retirement application based upon the standard of proof and legal requirements which are current, applicable, and relevant.

Yet, if a denial is issued by OPM — one that is based upon language which is clearly contravening the statutory standards of legal precedents — that requires things which are not truly required, then what does one do?

It is tantamount to proving a negative:  how does one prove that a murder did not occur?  Or that a man did not say something asserted to have been stated?  Or that one’s Federal Disability Retirement application does not contain “compelling” medical evidence, or here’s a better one:  “According to AMA Guidelines, you do not have more than a 5% permanent disability rating…”  What?  For OWCP purposes, that may hold some meaning or relevance, but for a Federal Disability Retirement application, it means absolutely nothing.

The answer to the question, What does one do?  What one must — go to the next level, with the proper legal tools in hand, to answer such nonsense.  Or, better yet, start at the first level with some preemptive legal arguments.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Government Employees: Refiling

For various reasons, it is necessary to refile a case.  Sometimes, an individual who has received a denial from the U.S. Office of Personnel Management, has allowed the 30-day time period to lapse, and therefore has lost the right to file for Reconsideration, or to file an appeal to the U.S. Merit Systems Protection Board.

As long as the Federal or Postal employee who has allowed for such lapse has not been separated from Federal Service, or from the U.S. Postal Service, for more than one (1) year, such refiling is perfectly acceptable.  However, if a Federal or Postal employee who has been separated from Federal Service, has:  (A)  been separated from Federal Service for more than one (1) year, and (B) has allowed for a denial from the U.S. Office of Personnel Management to lapse for more than thirty (30) days, then such a Federal or Postal employee has forever lost his or her right to refile, precisely because the Statute of Limitations would preclude the Federal or Postal employee from refiling.

In determining whether or not to refile because the Federal or Postal employee still continues to retain the right to file again, the identical questions which one should ask in the original filing of a Federal Disability Retirement application would prevail:  Do I have a supportive medical doctor?  Does my medical condition prevent me from performing one or more of the essential elements of my job?  Will my doctor help me prove that I can no longer perform one or more of the essential elements of my job?

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, the questions for an original filing, or in refiling, remain the same; the only change is the time that lapses, making each of us a day older, but hopefully, that much wiser.

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

Medical Retirement Benefits for US Government Employees: Sounds Good

There are various stages of the administrative process designated and defined as “Federal Disability Retirement” — the initial application stage of the process, where one must attempt to prove by a preponderance of the evidence that one is eligible for Federal Disability Retirement benefits; if disapproved and denied, then the Reconsideration Stage of the process (where one may submit additional medical and other documentary evidence to persuade the Office of Personnel Management to reverse themselves); an appeal to the U.S. Merit Systems Protection Board, where the Federal or Postal applicant’s Disability Retirement application is taken out of the hands of OPM and transferred to an Administrative Judge, who will hear the case anew, without regard to what OPM has decided in the past; a further appeal to the Full Board of the MSPB in the event that the Administrative Judge issues an Initial Decision which affirms and upholds OPM’s denial of the case; and a further appeal to the Federal Court of Appeals for the Federal Circuit.

Throughout this process, and especially in the administrative stages before the Office of Personnel Management, one should make a distinction between “sounding good” and “being right”.  Hopefully, the Federal or Postal employee who has filed for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, is both right and sounding good. But there is a distinction to be made.  For example, OPM will often — in their denial letter — “sound good” but be completely wrong on the law.  They will cite medical textbooks which skew the legal standard of review; creep into the discussion of a denial letter such terms as “no significant disability rating to speak of,” or that you don’t suffer from a disability which “incapacitates” you.  It all “sounds good”, but it is not true precisely because it is not the applicable standard of law to be applied.

At the initial stages of the process, OPM can get away with such nonsense, because most people don’t recognize the untrue and inapplicable standard of law being applied.  In the later stages of the process, however, when an Administrative Judge hears a case, it becomes important not only to “sound good”, but to also apply the right legal criteria.

Appearance versus reality — it is the argument of Western Civilization from the pre-Socratics onward.  As Alfred North Whitehead once observed, all of philosophy was already written by Plato and footnoted by Aristotle.  That statement both sounds good, and is indeed right on point.

Sincerely,

Robert R. McGill, Esquire

Federal Worker Disability Retirement: He Who Dictates the Law…

He who dictates the law, controls the conditions and criteria which govern a process.  Whether such dictation is an accurate reflection of the actual substance of the law, of course, is another matter.

Thus, when the Office of Personnel Management applies their 7-part criteria, they purportedly and in declarative form assert that it is based upon the substantive law which is extrapolated from the statutory authority which underlies Federal Disability Retirement laws, statutes, regulations, and expansive case-law as handed down from the U.S. Merit Systems Protection Board decisions and opinions rendered by the Federal Circuit Court of Appeals cases.

Merely asserting that a given set of legal criteria has been applied, does not constitute a verification of the proper interpretation of what the law means.  Proper interpretation requires legal analysis, an understanding of the context of how the law was applied, in what fact-scenarios the law was cited, and an argument as to whether it applies in one’s own set of factual circumstances.

Indeed, often the U.S. Office of Personnel Management will describe a linear state of a Federal or Postal employee’s set of medical reports, conditions, etc., then merely declare that the legal criteria was applied, then (without any explanatory nexus between the facts and the conclusion) make a decision stating that the medical conditions “did not satisfy the legal requirements” — without any bridging explanation as to why such a statement should be accepted as true.

Having the authority to dictate the law is one thing; such authority does not mean that one is right, or that such authority grants the agency any great insight into proper legal reasoning.  Fortunately, there are appellate procedures, such as the next step in the process — the Second Stage of the process (Reconsideration Stage), and beyond, to the U.S. Merit Systems Protection Board.

Sincerely,

Robert R. McGill, Esquire

Federal Worker Disability Retirement: Reluctance through Negation

Making mistakes is part of the entire process of going through life; receiving advice and proper counsel helps to mitigate such mistakes; the distinction between “advice” and “information” is not merely a conceptual difference, but a pragmatic one which impacts one’s actions, thoughts, and application of thoughts to actions.  

“Going it alone” in preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS is no longer the only viable option; there is much information “out there” on the internet, and other publication resources are available; but as has been written about previously, there is a conceptual distinction to be made between “information” and “knowledge”, where the former is merely a compilation of facts and perspectives upon those facts, whereas the latter is a filtered compendium of the latter based upon experience, reflection, and considered logical analysis.  

The Federal or Postal employee who is considering filing for Federal Disability Retirement, who encounters the morass of information and hesitates because of the reluctance to engage in an administrative process, complex though it may be, is making a crucial mistake.  

Most “mistakes” which result in a denial from the Office of Personnel Management in a Federal Disability Retirement application under FERS or CSRS are correctable.  Such mistakes, however, must be identified, recognized, and addressed in any subsequent appeal, either at the Reconsideration Stage of the process, or in the appeal to the Merit Systems Protection Board.  

Reluctance to begin or continue the process of preparing, formulating, and filing a Federal Disability Retirement application with the Office of Personnel Management, because of the potential negation through mistakes, while understandable, should not result in failing to file.  

The medical condition should be the determinative factor, as well as the quality of life for the Federal or Postal Worker contemplating filing for Federal Disability Retirement benefits under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire