Federal Disability Retirement Representation: Substance and Process

In any bureaucratic, lengthy administrative process, one can become embroiled in the procedural aspects of an endeavor, and overlook the substantive elements which form the foundation of any case.  Conversely, one can make the mistake of approaching a case and declare to one’s self, “This is so obviously a good case,” and take shortcuts in the process of putting together an effective and persuasive case.

Either approach is one fraught with grave errors, and for Federal employees and Postal workers who are beginning the process of preparing, formulating and filing for Federal Disability Medical benefits, first through one’s own agency (if still on the rolls of the Federal agency or the U.S. Postal Service or, if separated, for not more than 31 days), and ultimately submitted to the U.S. Office of Personnel Management in Boyers, Pennsylvania (directly, if the Federal employee or U.S. Postal worker has been separated from Federal service for more than 31 days), it is important to keep the balance between the substance of a case, and the process of the case.

Substantive issues involve everything from the factual, informational content required on all standard forms (SF 3107, along with Schedules A, B & C, and the required attachment of one’s DD 214 showing prior active military service; SF 2801 for CSRS employees; and the substantive content of the description of one’s medical conditions to be considered, as required in SF 3112A, etc.), as well as the medical documentation needed to provide the evidentiary support for one’s case.

“Process” issues involve the timeframe in filing a case, the administrative procedures of where the disability application must be submitted through, as well as the myriad of sequential steps required for satisfaction of accommodation issues with one’s agency.

Substance and process — they are the necessary sides of a single, inseparable currency of an administrative reality known as Federal OPM Disability Retirement, and both must be attended to in order to reach the heights of efficacy mandated for a successful outcome in the preparation, formulation and submission of an OPM Medical Retirement application.

Sincerely,

Robert R. McGill, Esquire

 

OPM Disability Retirement: The Administrative Process

Ultimately, Federal Disability Retirement must be viewed as a “process“, as opposed to a singular procedure whereby a triggering mechanism automatically allows for receipt of benefits.  The former requires an affirmative approach which involves submission of proof, argumentation, an expectation of resistance (in many cases), and an analysis by the U.S. Office of Personnel Management as to whether or not all of the legal criteria have been met.  The latter is merely a formality of filing.

As a process, filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management has various steps, procedures, and Stages for appeals.  There is, first and foremost, the initial application Stage, where one has the opportunity and right to submit proof of eligibility, and make legal arguments for entitlement.  If one’s Federal Disability Retirement application is denied at the first Stage of the process, then one has a right to have it “reconsidered” by filing a “Request for Reconsideration” within 30 days of the date of denial, or receipt of the letter of denial from OPM, whichever is later.  If denied a second time, then the Federal or Postal employee who is filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management has a right to file an Appeal to the U.S. Merit Systems Protection Board.

There are, in addition to the 3 stages described, two (2) additional stages of appeal, but the three main stages of filing are what have been previously described.

With such a “process” in mind, it is wise to prepare for the long haul.  An expectation of a quick and easy approval, even if obtained, should not be embraced at the outset, precisely because one must take into consideration the potential length of time which the entire process may take, and prepare accordingly.

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

CSRS & FERS Medical Disability Retirement: The Psychological Process

One of the reasons why the Federal or Postal employee contemplating filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, should view the entirety of the administrative process as just that — a “process” as opposed to an entitlement to benefits — is because (a) that is in fact what it is and (b) to fail to view it from that perspective would be to refuse to adequately prepare for the long and arduous procedural pitfalls which are inherent in each case.

This is not an entitlement where a specific trigger of an event results in the automatic calculation and issuance of compensation.  Reaching a certain age does not result in the granting of Federal Disability Retirement benefits (although it may end it and be recalculated at age 62); attaining a certain number of years of service will not qualify one for Federal disability Retirement benefits (but again, upon reaching age 62, it may result in a beneficial calculation of benefits for having a greater number of years of service).

Rather, Federal Disability Retirement is an administrative, legal process in which one must prove by a preponderance of the evidence that one is (1) eligible, in that one meets certain minimum requirements, such as 18 months of Federal Service under FERS, or 5 years under CSRS, and (2) entitled, by proving that one has met the legal requirements under the statutes, regulations and case-law.

By having the proper psychological perspective, one is better able to prepare for the long haul before starting the process of preparing, formulating and filing for Federal Disability Retirement benefits, whether under FERS or CSRS, from the U.S. Office of Personnel Management.

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 and Postal Disability Retirement: Systematic Preparation for the Process

As has been stated many time previously, in preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS from the Office of Personnel Management, it is important to view the engagement with the entirety of the application procedure as a “process“, as opposed to a singular event.  

The multiple stages of this administrative process — from the Initial Stage of the preparation and filing; to the Reconsideration Stage (in the event of an initial denial); to the appeal to an Administrative Judge with the U.S. Merit Systems Protection Board; to an appeal with a Petition for Full Review (PFR) with the MSPB; and finally to the Federal Circuit Court of Appeals — it is a “process” because each of the forums or legal venues cannot be viewed in a vacuum.  

While it is true that a Hearing before an Administrative Judge at the Merit Systems Protection Board will receive the information, testimony, and conduct the Hearing as “de novo” — meaning, “anew” or “freshly all over again” — nevertheless, it is quite apparent that the reason why such a stage as having a Hearing before an Administrative Judge at the Merit Systems Protection Board is precisely because of the evidence filed in the prior portion of the process, and the one before that.

Thus, retrospectively, one must understand that the Federal or Postal Worker who finds himself or herself in any part of the administrative process, is there precisely because of its interdependence upon a prior, other part of the process.  Therefore, prospectively — looking forward at the start of the process — it is important to recognize this point, and to prepare and formulate one’s Federal Disability Retirement application with this in mind:  that each Stage of the administrative process identified as a Federal Disability Retirement application under FERS or CSRS cannot be viewed in a vacuum, but instead, must always be analyzed with a view from “on high” — meaning, preparing for the potentiality that it will be reviewed and heard before a judge.  

This often changes the perspective, and should give pause to the lay person who believes that his or her case is a mere “slam dunk” which will entail a singular event.  Systematic preparation for the entirety of the process is a perspective worth noting, and such notation may be the needed grammatical mark for a successful and persuasive presentation to the Office of Personnel Management.

Sincerely,

Robert R. McGill, Esquire

Early Retirement for Disabled Federal Workers: Waiting until the Very End

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, it is never a good idea to wait until the very end to obtain an attorney who specializes in Federal Disability Retirement issues.  By “the very end”, of course, is a relative term — it can mean the U.S. Court of Appeals for the Federal Circuit, or a Petition for Full Review (PFR) before a 3-Judge panel of the Merit Systems Protection Board (upon an appeal to the Merit Systems Protection Board, after a denial at the initial application stage before the Office of Personnel Management, then a denial at the Reconsideration Stage before OPM), or the hearing stage itself at the Merit Systems Protection Board.  The “very end” equates to “it is almost too late”.  Another relative concept is the term involving “almost”, as in “almost too late”.  

A recent reversal of a case was by a former Federal employee who attempted all of the initial stages on his own — the initial application stage with the Office of Personnel Management, then the Reconsideration Stage — then went to a Hearing at the Merit Systems Protection Board without an attorney.  This particular Federal employee then came to the undersigned attorney and asked if it could be reversed by an appeal to the 3-Judge panel at the Full Review Stage of the Merit Systems Protection Board.  As pointed out in an earlier blog, there were enough judicial/legal errors committed by the Administrative Judge to justify a Petition for Full Review, and indeed, the outcome was a positive one — fortunately, for the Petitioner/Appellant/Applicant.  However, it is always best not to wait until it is too late.  That is another relative concept — “too late”.  

Hope springs eternal, but such hope has an end in every administrative appeal process, and unless one begins to build the bridge properly from the very beginning, block by block, legal precedent by legal precedent, there is the danger that a collapse will ensue.  It is best to prepare well at the beginning of a process, lest the lack of preparation result in an irreversible tide of mistakes, mishaps, and misfortunes at the end of a long and arduous attempt.

Sincerely,

Robert R. McGill, Esquire

Early Retirement for Disabled Federal Workers: The Timeline

The timeline is an extensive one.  Beyond the period from start to finish of the initial process (6 – 8 months minimum for just the First Stage of the process, assuming everything goes “right” in receiving prompt responses from the medical providers, obtaining the records; having the agency process everything in a timely manner, etc.), there is then the possibility of a glitch in the process on the part of the Office of Personnel Management (OPM).

Filing for Federal or Postal Disability Retirement benefits from OPM must necessarily entail a recognition and acknowledgement of being prepared for a long and arduous wait.  Then, of course, if the case is denied at the First Stage of the process, one must expect a minimum of 90 – 120 days for the Reconsideration Stage of the process; if it is denied a second time by OPM, then a minimum of 120 – 150 days at the Merit Systems Protection Board.

Further, if a Petition for Full Review is filed, it can often taken 10 months  5 years.  And an appeal to the Federal Circuit Court of Appeals?  You don’t even want to consider that…

As such, when one is preparing, formulating and filing for Federal Disability Retirement benefits, the operative focus should be upon the first conceptual link in the sequence — “preparing”.  The first order of business in a disability claim is in mentally preparing for the long haul.  I will reiterate an oft-used quip:  Patience is a virtue; ergo, Federal and Postal employees filing for Federal Disability Retirement benefits under FERS must be by definition be the most virtuous of people.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Legal Arguments

Legal precedents are a necessary part of any process, and this is no less true when filing for Federal Disability Retirement benefits under FERS & CSRS.  Some argue that legal citations and references to legal precedents are less important at the Initial Stage of the process, but such a viewpoint ignores the fact that preparing, formulating and filing for Federal Disability Retirement benefits under FERS or CSRS is a “process” — not merely a one-time filing.  

Indeed, the distinction is important to note, because that is precisely why the entire administrative procedure of having an Initial Stage, a Reconsideration Stage, then an appeal to the Merit Systems Protection Board, then further appeals, is available for all Federal and Postal employees.  As a “process”, while each stage is considered in a “de novo” fashion (meaning, looked at “anew” without consideration of the prior decision), the legal precedents and citations which one refers to in order to establish one’s eligibility and entitlement to Federal Disability Retirement benefits under FERS or CSRS provide the foundational justification, no matter what stage of the process one is at.  

Thus, a legal citation argued for at the Initial Stage is valid for the Reconsideration Stage; a precedential legal reference made and argued at the Reconsideration Stage is valid for the MSPB, and so on.  As such, legal arguments provide for a continuum of arguing for one’s entitlement to a benefit which the Office of Personnel Management must justify in any denial it renders.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Mistakes Made

There is obviously an assumption to be made that if a case is denied at the initial stage of the process of filing for Federal Disability Retirement benefits under FERS or CSRS, that a “mistake” must have been made.  The mistake, then, is given an opportunity to be “corrected” at the Second, or Reconsideration Stage, of the Federal Disability Retirement process.  Further, if the mistake is not properly corrected, or corrected to the satisfaction of the Office of Personnel Management, and it is again denied — at the Reconsideration Stage of the process — then there is the cumulative assumption that further mistakes were made in the application.  Just as success distinguishes between winners and losers, the general assumption is that a denial by the Office of Personnel Management means that there was something inherently wrong with the Federal Disability Retirement application at its inception. 

Yet, if this were true at each turn, for every case, then there would never be a case where, at the Third Stage of the process, in filing an appeal to the Merit Systems Protection Board, that the Representative from the Office of Personnel Management would not reverse a denial and grant the disability retirement after listening to the legal arguments made by the attorney for the applicant.  Many times, it is the pointing out of overlooked aspects of a case which makes the difference between an approval or a denial — and not necessarily something that is inherently wrong, or that a “mistake” was made.

Sincerely,

Robert R. McGill, Esquire