Medical Retirement Benefits for US Government Employees: Those Intersecting “Other” Determinations

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 useful to understand the impact — if any — provided by the approval of any of the “other” compensation programs available to all Federal and Postal employees.

Thus, inasmuch as a Federal or Postal employee filing for Federal Disability Retirement benefits under FERS must also file, sometime during the administrative and bureaucratic process, for SSDI benefits, in the off-chance that SSDI approves the application before OPM makes a decision on a Federal Disability Retirement application (which, because of OPM’s extended timeframe for making decisions, is less rare these days than one may think), can it have any impact in the Federal Disability Retirement process?  And what about OWCP/FECA?  Does the fact that a Second-Opinion doctor, or what is sometimes euphemistically referred to as a “Referee doctor”, rendering a medical opinion (and therefore a narrative report) stating that the injured Federal or Postal worker is “permanently” disabled, or that he or she is unable to go back to one’s job, relevant to a Federal Disability Retirement application?  How about a VA Disability Rating?  Does the determination provided by the Department of Veterans Affairs have any relevance to the Federal Disability Retirement application?

These are all potential “tools” to be used in preparing, formulating and filing for Federal Disability Retirement benefits, and the Federal or Postal employee should be aware of the case-laws which provide for persuasive impact — not determinative — to the Office of Personnel Management.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for US Government Employees: Interactions

Preparing, formulating and filing for Federal Disability Retirement benefits under FERS or CSRS, from the U.S. Office of Personnel Management, is a necessary step for a Federal or Postal employee who finds that he or she can no longer perform one or more of the essential elements of one’s Federal or Postal job because of a medical condition.  

In doing so, there are obviously potential interactive processes which one must consider.  If the Federal or Postal employee is under FERS, then you must file for SSDI (Social Security Disability benefits), because that is what the law requires.  

Further, one must determine how aggressively, to what extent, and to what end and purpose one needs to file in pursuing SSDI concurrently — for, if one is planning on working at another, separate job while receiving a Federal Disability Retirement annuity, then the cap imposed by SSDI as opposed to the 80% allowance for FERS Disability Retirement without SSDI, needs to be taken into consideration.  Such future planning will then determine the course of one’s actions, as to how hard one will try and obtain SSDI benefits.  

Additionally, if the medical condition arose from a work-related injury, then obviously filing a claim concurrently with the Department of Labor, Office of Workers Compensation under FECA should be contemplated.  

Then, there are those who, whether by accident or wisdom and foresight, obtained and paid for throughout the intervening years, a private disability insurance policy.  Such private disability insurance policies are essentially contracts — and whether there is an offset with Federal Disability Retirement benefits, Social Security, or OWCP depends upon the “fine print” of the contract.  

One minor note as to private disability policies:  The time to read the fine print is when the insurance agent is trying to sell you a policy — not when you need to apply for the benefits.  Private policies can be negotiated, and the terms can be amended.  

Finding a negative consequence after the fact is a costly error in judgment which can easily be mitigated by spending a few moments at the outset.

Sincerely,

Robert R. McGill, Esquire

Postal and Federal Disability Retirement: Letting Go

In preparing, formulating and filing a Federal Disability Retirement under FERS or CSRS, it is often normal to have concurrent “cases” filed — an appeal to the Merit Systems Protection Board in response to an adverse action or termination by the Agency; an EEOC case proceeding against the Agency; and other judicial and quasi-judicial forums.

At some critical point, however, there comes a time when a decision must be made — a bifurcation, an “either/or”:  Either one wants to continue litigating to get one’s job back, or the preparation of the Federal Disability Retirement application under FERS or CSRS, as an admission that one is no longer able to perform one or more of the essential elements of one’s job, must proceed.  But not both.  

For the most part, concurrent judicial proceedings can continue without a conflict between the two.  Lawyers can talk out of both sides of the mouth, and beyond — sometimes out of three or four sides of the mouth.  It is well that an attorney’s mouth is circular and not triangular, thereby failing to restrict and contain how many sides there are.  

Given that, however, there often comes a time when a Federal or Postal employee cannot credibly state that the Agency had no right to terminate one’s employment, yet claim with the Office of Personnel Management that one can no longer perform one or more of the essential elements of one’s job.  

Indeed, as a practical matter, it is often a good negotiating point — of persuading the agency that the Federal or Postal employee will be willing to drop the adversarial proceedings in return for the Agency restating the basis of the removal, based upon one’s medical inability to perform the essential elements of one’s job.  Furthermore, it is often a pragmatic “health reason” — to let go of the adversarial proceedings, and allow for a Federal Disability Retirement application to get approved, so that one may begin the process of recuperating one’s health.  Just some thoughts.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for US Government Employees: The Issue of Discretion

A Federal or Postal employee who is filing for Federal Disability Retirement benefits under FERS or CSRS may also be undergoing concurrent disciplinary proceedings, or engaged in corollary grievances, EEO Complaints, or involved in a lawsuit in a separate forum, either in the Federal Circuit Courts or at the Merit Systems Protection Board.  

In either event, the question often comes to the fore as to whether such collateral issues should be brought up in the Applicant’s Statement of Disability (SF 3112A) or perhaps in a legal memorandum or cover letter which argues the merits of the case, the legal basis for eligibility, etc.  The answer to the question as to whether, how and where is one of discretionary choice, and there is never a singular answer.  

A separate question to be asked of one’s self (with no obvious answer) is whether or not, if the applicant who is filing for Federal Disability Retirement benefits under FERS or CSRS does not bring up the fact of a collateral issue being litigated in a separate forum, will the Agency bring it up and discuss it in a way detrimental to the Applicant, and further, will the fact that the issues was not brought up make it appear as if the Applicant is somehow trying to hide the issue?  As with all such hypotheticals, the answer to all of the above is:  It all depends…  

Often, not mentioning a potential “red flag” until and unless it becomes a red flag is the best approach.  Sometimes, making a passing reference to the collateral issue may be appropriate.  In all instances, unless a connection can be made between the collateral issue and the issues central to a Federal Disability Retirement application — the medical basis and the impact upon one’s medical inability to perform the essential elements of one’s job — it is normally best to leave it alone.  In any case, such discretionary decisions should be made with the advice of an attorney.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Quantification v. Symptom Delineation

Different systems and processes require different standards of proof, criteria, and elements of qualifying evidence in order to be eligible and entitled.  Applying for, and getting approved, a Federal Disability Retirement application under either FERS or CSRS, requires that certain legal criteria be met. 

Quantification of a medical condition, although sometimes helpful in further expanding a descriptive narrative of a specific medical condition, is normally rather irrelevant in a Federal Disability Retirement case.  By “quantification” is meant the assigning of a number — of rating a person’s specific medical condition or relative to the “whole body”. 

Thus, in OWCP and VA Claims, there will often be a number assigned — 10% for X medical condition; a “combined” rating of 80%, etc.  One would expect that a high quantification of a medical condition would translate into a more serious appraisal of that medical condition, but various factors need to be considered when attempting to utilize such numbers in preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS.  Thus, for instance, a 10% rating upon a person’s foot may seem relatively insignificant when applied to a sedentary job, but for a person who must be on his or her feet all day, with requirements of constant standing, walking, etc., it becomes not only “significant”, but potentially a singularly viable basis for filing a Federal Disability Retirement application under FERS or CSRS. 

One must be careful in playing the “numbers game” in formulating, preparing and filing a Federal Disability Retirement application under FERS or CSRS.  Numbers never tell the full story, but they can be used to help describe and delineate the necessary requirements to be approved for a Federal Disability Retirement application by the Office of Personnel Management.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Conflicts & Peripheral Issues

Man is the only animal who has more than one side on his mouth, and the lawyer is a special species of the animal who, unlike the limitation of the cat who only has nine lives, possesses an infinite number of geometric sides of a mouth.  Lawyers make concurrent and conflicting arguments all the time, but as long as the arguments are bifurcated and the issues kept separate and do not directly conflict or contradict, there is certainly nothing wrong with that.

In a Federal Disability Retirement case, if a Federal or Postal employee wants to pursue a collateral issue in another forum while concomitantly filing for Federal Disability Retirement benefits, there is normally no conflict or problem which arises.  But in the limited instance where a Federal or Postal employee is attempting to reverse a termination and regain a position, at some point in the process the two issues may come to a direct conflict.

Normally, however, the issue involves merely changing the underlying reasons which the Agency proposed for the termination, and it is a legitimate argument to litigate with the Agency to change the terms of the termination.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement Benefits for Federal & Postal Employees: Peripheral Issues

The reason why it is important to keep the peripheral issues where they belong — outside of the primary focus of a Federal Disability Retirement application, and not inject such issues, complaints or narratives — is because they can have multiple unintended consequences.

If a Federal or Postal employee is engaged in collateral litigation, complaints, grievances or other outstanding administrative filings, including EEOC Complaints, lawsuits, formal grievances, MSPB appeals, etc., while for the most part such collateral filings will not directly or indirectly impact a Federal Disability Retirement application, they can if you directly inject such issues into the application for Federal Disability Retirement.

In other words, if in the Applicant’s Statement of Disability (SF 3112A) , you refer directly to an outstanding EEOC Complaint, then it may spring forth a red flag that your case is one of “situational disability“.  Just a thought.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement for Federal and Postal Employees: Legal Citations

Some question whether or not legal citations are necessary in filing a Federal Disability Retirement application under FERS or CSRS.  Certainly, as an administrative process in applying for a benefit from the Office of Personnel Management, there are individuals who attempt to obtain the benefit of Federal or Postal Disability Retirement benefits without the representation or assistance of an Attorney, and such “self-represented” individuals rarely refer to legal authorities or citations in such an application.

Are legal citations — or references to legal authorities, statutes or case-laws — “necessary” when filing an application for Federal Disability Retirement benefits under FERS or CSRS?  If by “necessary” is meant, is it a requirement in order to be eligible for obtaining OPM Disability Retirement benefits, then the obvious answer is “no”.

However, the purpose in referring to legal authorities is quite simple, and logically based:  As the Office of Personnel Management is required to apply the legal criteria in determining one’s eligibility for Federal Disability Retirement benefits, it makes sense to support one’s application by citing the legal authorities which reinforce and explain the legal basis for eligibility.

As such, while citing legal authorities is not a necessary condition in applying for Federal Disability Retirement benefits, it may be a condition precedent which may need to be sufficiently satisfied in order to favorably “weight” the successful outcome which is sought after.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: Decisions during the Process

In making decisions during the process of filing for Federal Disability Retirement benefits under FERS or CSRS, it is obviously important to make the “right decision” at each stage of the process.  Thus, for example, if a person files for Federal Disability Retirement, at the first stage it is important to determine which medical conditions to identify and base the application upon; at the Second, Reconsideration Stage, it is important to first identify what substantive concerns which the Office of Personnel Management is proposing (in any given denial of a Federal Disability Retirement case, it is often not that obvious what the OPM Representative is actually stating), and how to go about rebutting and answering the concerns (as opposed to taking a “shotgun approach” and trying to answer each and every concern expressed by the OPM Representative), and further, at the Merit Systems Protection Board, it is vitally important to place all evidence, legal precedents, arguments and objections on the record, so that if the Administrative Judge in the case denies your claim, you have a legal basis to file an appeal.  As always, it is important to see the entire application submission, from beginning to end, as a “process”.

Sincerely,

Robert R. McGill, Esquire