Medical Retirement for Federal Workers: The Changed Standard

Lawyers are trained to engage in linguistic gymnastics; that is precisely why Plato railed against rhetoricians of his day, as they used language to distort the fullness of being (as Heidegger would say).  For, the malleability of language allows for a spectrum of purposive and mischievous play upon words; only an abiding sense of integrity in the face of a world which has abandoned parameters and boundaries of what constitutes “fair play” in the arena of linguistic word games, would save the original foundation of the correspondence theory of truth.

In this postmodern world where objective truth can no longer be argued for, subtlety in playing a language game is no longer necessary; one can simply, deliberately and without conscience switch one word for another, and maintain a straight face.

So, in a Federal or Postal Disability Retirement case, when the U.S. Office of Personnel Management inserts words which clearly do not reflect the legal standard as presently existing, what does one do?  When the standard is raised to require “disability which precludes you from the workplace”, or evidence of a medical condition which is “compelling”, how does one respond?

Such unwarranted and baseless legal applications are inserted in many denials from the U.S. Office of Personnel Management, requiring a Request for Reconsideration or an appeal to the Merit Systems Protection Board.  In the end, in order to properly respond, one must first recognize the malleability of language; then to identify the proper legal standard to be applied; then to selectively address such improper legal standards.

In a Federal Disability Retirement case, whether under FERS or CSRS, the ultimate problem is that one is dealing with a Leviathan of an agency — the U.S. Office of Personnel Management — and one which has the power to engage in rhetorical flourishes with unfettered abandon.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for US Government Employees: Insufficiency Test

The validity of allegation that there is an insufficiency of X is partly determined by an objective standard, and partly (if not mostly) derived from a judgment as to the nexus between X and the standard to be applied.

In Federal Disability Retirement cases the basis of most Federal Disability Retirement denials is that there is an insufficiency of proof, whether as to issues of light duty or accommodation, medical opinion, medical documentation; questions about deficiency of service; and multiple other specified areas — but all will ultimately be determined to have a “lack” of something such that it fails to meet a “sufficiency” test.  But sufficiency can only be determined by comparing what exists (i.e., what has been previously submitted to the Office of Personnel Management) to what the legal standard of proof requires.

Further, since the overriding legal standard is based upon a “preponderance of the evidence”, which requires that something be ‘more likely than not’, the narrow gap between human involvement in the judgement of sufficiency, and a truly objective basis for such insufficiency, is susceptible to human error.  Because of this, appearance of quantity in addition to quality is often what is required.

As decisions by OPM are rendered by a wide range of people whose judgment, competence and approach in evaluating a case differ greatly, it is unfortunately necessary to take into consideration the foibles of human error.  Until a precise algorithm is invented which applies fairly and accurately in all cases across the board, we must continue to deal with human beings, the their errors of judgment.

Sincerely,

Robert R. McGill
FERS Disability Lawyer

 

Federal Employee’s Disability Retirement: The Non-standard Approach to Standard Forms

Standard Forms are created, produced and promulgated precisely for their stated and intended purpose:  to streamline and conventionalize (yes, that is really a proper word, and spellcheck did not put a red line beneath it) the formatted receipt of information by an agency of the Federal Government.  Without Standard Forms, there would be no confining methodology of what to say, how to say it, and how much to say it.

The theory behind standard government forms is simple:  By providing the space, the questions and the apparent limitations, ease of processing will be expedited.

Of course, in pragmatic terms, the reality behind the theory is that Standard Forms create an intended limitation on space, as well as the content of what a person states or desires to state.  Yet, by self-confining the answers and information provided, the applicant for Federal Disability Retirement is essentially depending upon government lawyers to properly interpret what the statute for eligibility for Federal Disability Retirement requires.

While staying somewhat within the confines of what the Standard Forms request is a “good” thing (for Federal Disability Retirement purposes, SF 3107 series for FERS applicants; SF 2801 series for CSRS applicants; SF 3112A, SF 3112B, SF 3112C, SF 3112D, and SF 3112E for both FERS and CSRS applicants), it should not limit or otherwise prevent the submission of relevant information.  “Relevancy”, of course, is a relative term, and should be noted and applied by those who understand the statutory underpinnings of the legal requirements for a successful Federal Disability Retirement application.

Ultimately, one should approach the standardization of the administrative process called “Federal Disability Retirement” as merely a piece of the larger puzzle, and not be precluded from submitting non-standardized information in an effort to prevail in the preparation, formulation and filing of a Federal Disability Retirement application, whether under FERS or CSRS, from the U.S. Office of Personnel Management.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Workers: Defining Complexity Down

The complexity of a Federal Disability Retirement case is made all the more so, in exponential fashion, when the inherent issues concerning the medical condition and its impact upon one or more of the essential elements of one’s job are difficult and involved.

The administrative process of preparing, formulating and filing for Federal Disability Retirement benefits, whether under FERS or CSRS, from the U.S. Office of Personnel Management, is in and of itself a complex process — if only for the sheer volume of Standard government forms which must be completed — and is compounded in multiple ways when the variegated medical conditions are included.  Indeed, sometimes it is the combination of multiple medical conditions which, in the totality of interconnected and intersecting symptomatologies, constitute the entirety of the medical impact in preventing one from performing a particular kind of job.

It is the job of the applicant for Federal Disability Retirement benefits — the Federal or Postal employee under FERS or CSRS — who must define the complexity down to its basic, comprehensible and coherent, cogent presentation, in order for the reviewing clerks at the U.S. Office of Personnel Management to analyze and ultimately approve the Federal Disability Retirement application.

A simple rule of thumb:  If you cannot explain it, how will OPM make heads or tails of it? The solution:  If you cannot do it, obtain the services of someone who can; normally, this would involve an attorney.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: Process

The engagement of preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, is a “process” both on a macro as well as a micro level.

On a macro level, the ability to consolidate the variety and complexity of information; of understanding that there are multiple levels in the administrative labyrinth of a Federal Disability Retirement application, beginning with the initial stage of the process; then, if denied, the Second, or Reconsideration Stage of the process; then, if denied a second time, an appeal to the U.S. Merit Systems Protection Board; then a potential filing of a Petition for Full Review; and, finally, an appeal to the U.S. Court of Appeals for the Federal Circuit; all told, the aggregate of all of the procedural hurdles can be characterized as a “process”, precisely because of the complexity of each stage building upon the previous one.

On a micro level, it is similarly a process, but in a different sense.  The “pieces of the puzzle” must be gathered, and the best way to do so is in a methodologically sequential manner, one which reflects a logical structure, as opposed to a haphazard compilation of facts, tidbits, arguments and rants strung together into a barely coherent whole.

Remember that putting together a Federal Disability Retirement application must reflect an argument with a purpose — of proving one’s case by a preponderance of the evidence.  As such, understanding the “process” of such an endeavor is important in the very preparation of one’s case.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Standards

The existence of a standard constitutes an irrelevancy if the application of it is based upon an unknowable, incalculable methodology.  Standards represent a paradigm which, if implemented, provide for stability and consistency, precisely because one can rely upon the same application in all instances, and indeed, that is what is often defined as “fairness”.

Thus, in sports — if the referee makes all calls based upon a known standard, there is very little to argue with respect to the “rules”; one may, of course, challenge the interpretation of the “facts” and charge that the referee is blind and did not see the play as reality reflected; but no one can argue the minutiae of the standard itself.  In society, and in a civilization governed by rules and accepted procedures of administration, if a standard is disagreed upon, then a democratic method of change is normally considered an appropriate methodology of redefining the lines previously demarcated by the “old” standard.

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 assumed that the standard which would constitute “fair play” will be one of “preponderance of the evidence”, but the actual implementation of such a legal standard will necessarily depend upon whether the Case Worker at OPM actually understands what that standard means.

It is, ultimately, a low civil “bar” to meet; and when a denial is rendered, the language contained within the denial will often reveal the extent of comprehension on the part of the OPM Case Worker.  Pointing a misapplication of the standard is sometimes a useful tool in taking the Federal Disability Retirement case to the next level — the Reconsideration Stage of the process — but unduly focusing upon the mistakes of the previous Case Worker is often a waste of time.

Balance is the key; application of the correct standard is vital to the working efficiency of a bureaucracy; pointing out a misapplication is why attorneys exist.  They are, ultimately, technicians of written standards.

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

Medical Retirement Benefits for US Government Employees: The Legal Standards

Recent decisions issued by the Full Board of the U.S. Merit Systems Protection Board — specifically, Henderson v. OPM, decided on January 31, 2012, reestablishes the two general standards of applicable evidentiary approaches in proving a Federal Disability Retirement case, whether under FERS or CSRS.  Whether or not the U.S. Office of Personnel Management will “comply” with the applicable standards as set forth by the MSPB is another question.

Often, the “trickle-down” effect of a legal opinion can take years to accomplish — and by that time, further refinements by the courts and by the MSPB may have made such legal opinions moot, irrelevant or otherwise restrictive in its practical application, anyway.  For the time being, however, the two legal approaches can be generally stated thus:  One must prove, by a preponderance of the evidence in all Federal Disability Retirement cases, either (A)  That certain specific medical conditions prevent one from performing certain specific essential elements of one’s job (somewhat like a 1 – 1 correspondence, or more generally, a medical opinion showing that medical condition X prevents job duties Y because of Z) or (B) as stated previously in Bruner and multiple other cases, there is an “inconsistency” between one’s medical condition (or multiplicity of medical conditions) and the type of positional duties one must engage in to perform the essential elements of one’s Federal or Postal job.

The former criteria to satisfy may be deemed “particularized”; the latter may be seen as a more “generalized” approach.  While there is certainly a conceptual distinction between the two, in pragmatic terms, such a distinction may be without too much difference, if only because doctors will often go back and forth between the two approaches, anyway, in writing a medical narrative report.

The conceptual distinction is not as apparent as one between “explicit” and “implicit”, but certainly the former approach encapsulates a greater specificity of detailing a connection between X and Y, whereas the latter requires the reader or reviewer (i.e., OPM or the Administrative Judge) to think through and analyze the entirety of the issue.  But that life would not be so complicated.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Burden of Proof

In preparing, formulating and filing a Federal Disability Retirement application under FERS & CSRS, one is often asked (and should also ask of one’s self) the following question:  What does it take to be eligible?  What proof proves my case?  How much proof must I submit (quantity) and is the proof I submit sufficient (quality)?  All of these questions fall under a generic rubric in law, termed as “burden of proof“. 

Every legal process — and filing for Federal Disability Retirement benefits under FERS or CSRS is no different — applies a legal standard:  a set of criteria in determining whether or not a Federal or Postal Worker is eligible for — qualifies for — Federal Disability Retirement benefits under FERS or CSRS. 

In applying a statutory set of criteria, there is the general application of what constitutes, or meets the needs of, the evidence, documents, and proof that is submitted for review.  The overriding standard that is supposed to be applied for determining the process, is a standard of law called, “Preponderance of the evidence.”  It is a relatively low standard used in civil law — where, if the proof submitted shows that it is more likely so than not so, then one has met “by a preponderance of the evidence” that a Federal or Postal employee is entitled to Federal Disability Retirement benefits. 

Does this standard apply at the administrative level — at the Office of Personnel Management?  The answer is “Yes”, but not necessarily consciously.  One only effectively argues that the standard of proof has been met when one encounters a Judge — at the Merit Systems Protection Board.  But, nevertheless, OPM is supposed to follow “the law” and the burden of proof, and it is simply one more argument that one can, and should, make to the Office of Personnel Management when filing for Federal Disability Retirement benefits under either FERS or CSRS.

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