FERS & CSRS Disability Retirement for Federal and USPS Workers: OWCP Dilemma

Benefits received through FECA (Federal Employees’ Compensation Act), administered through the Department of Labor and otherwise known under the acronym of OWCP, provide for temporary total disability compensation during the time that a Federal or Postal employee is injured and is unable to go back to one’s former job.

It pays well.  The problem, often, however, is that it pays well enough just to maintain a person to prevent him or her from drowning.  This dilemma is highlighted by the fact that a Federal or Postal employee who is receiving OWCP benefits (scheduled awards excepted) is unable to work at a job (with some exceptions regarding a person who had already been employed at a second job when injured at his primary vocation) or receive additional earned income.

Federal Disability Retirement benefits, on the other hand, whether under FERS or CSRS, allows for earned income up to 80% of what one’s former position currently pays.

While the Federal or Postal worker is allowed to concurrently file for, and get approved, both Federal OWCP benefits as well as FERS or CSRS Disability Retirement benefits, if both are approved, you must choose between one or the other approved benefit, and allow the unchosen one to remain inactive.

While FERS & CSRS Disability Retirement benefits, filed and obtained through the U.S. Office of Personnel Management, pays less than OWCP benefits, it is the added advantage of being able to work at another vocation which makes it more attractive.

It is like the difference between a shipwrecked victim who can hang onto a small floating device as opposed to a raft with oars; while the former allows for survival, it is the latter which will ultimately take one to the destination of final fruition.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: Dependent Contextual Information

The historical context of one’s medical condition is an issue which is mostly irrelevant for the First and Second Stages of a Federal Disability Retirement application, submitted to the U.S. Office of Personnel Management, whether under FERS or CSRS. This is because OPM is not interested — or, more accurately, the law does not recognize as relevant in analyzing the eligibility criteria applied in a Federal Disability Retirement application — of “how” or “why”.

While such contextual information may be relevant for OWCP/FECA cases because of the issue of causality and its importance in such cases, the overriding and determining factor in a Federal Disability Retirement application is whether a Federal or Postal employee has a medical condition; how that medical condition prevents one from performing one or more of the essential elements of one’s job; and whether the medical condition will last a minimum of 12 months.

Outside of that contextual information (actually, such information is more accurately identified as content-information), OPM in pragmatic terms has no patience for the historical background of such information.  Obviously, however, some contextual narrative should be included in any Applicant’s Statement of Disability, in order to make the statement meaningful.

One last point:  While historical context may not be relevant for the Initial Stage and the Reconsideration Stage, it may be very important if one finds oneself before an Administrative Judge at the U.S. Merit Systems Protection Board.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: OWCP Acceptance & Federal Disability Retirement

Case acceptance by the Department of Labor, Office of Workers’ Compensation Programs (DOL/OWCP) makes it easier for the Agency to make a determination on issues of accommodation, which is one of the elements which must be established in preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS.  

On the one hand, when a Federal employee has been deemed to be “permanent and stationary”, the issue as to whether or not the Agency can reassign the Federal employee, or accommodate him such that the employee can continue to perform all of the essential elements of his or her job, can be easily established, in conjunction with and through the cooperation of a case manager from OWCP.  But even a modified job does not preclude an employee from filing for, and being eligible for, Federal Disability Retirement benefits under FERS or CSRS, precisely because such a modified or “light duty” job is not a permanent position, but rather an ad hoc set of duties as described in the prevailing case of Bracey v. OPM.

On the other hand, when a Federal or Postal employee has been accepted by OWCP and placed on “temporary total disability” — even if the “temporary” nature of such compensation continues on and on for many years — then it makes it easy for the Agency to simply forget about the employee and not even search to see if accommodating the individual is even possible.  

Thus, being placed on OWCP often makes it a simple administrative matter for the Agency.  No accommodations need to be searched for, and the Agency can move on, leaving the Federal or Postal employee in perpetual limbo.  

Concomitantly, however, for the Federal or Postal employee, the fact that one’s medical condition has been accepted by OWCP/DOL can be used as one element to file for Federal Disability Retirement benefits, to show that being on OWCP has some evidentiary weight that (A) the Agency is unable to accommodate the Federal or Postal worker, and (B) that there is persuasive evidence that another Federal Agency has determined that the Federal or Postal employee is disabled, and (C) that receiving temporary total disability is an indicator that one is unable to perform one or more of the essential elements of one’s job.  

Nevertheless, beyond the proof of acceptance by OWCP, the Federal or Postal employee must still affirmatively prove by a preponderance of the evidence that the medical evidence proves that one is unable to perform one or more of the essential elements of one’s job. Being on OWCP may have some minimal persuasive impact; it is still up to the Federal or Postal employee who is preparing, formulating and filing a Federal Disability Retirement application that he or she is eligible for the benefit.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: The Problem with OWCP

Agencies which have employees who cannot perform one or more of the essential elements of one’s job will often encourage him or her to file for Department of Labor, Office of Workers’ Compensation Program benefits (DOL/OWCP), if the injury or medical condition occurred as a result of an on-the-job incident, or can be shown to have an occupational cause.

That is fine, so far as it goes.  For, OWCP is set up with the intent of addressing those medical conditions and issues which are work-related.  However, when agencies begin to use OWCP as the dumping ground for workers they don’t believe are fully productive, it becomes a problem because OWCP is not intended for long-term compensation, but merely a venue in order to compensate a Federal or Postal employee for a temporary time in order for the worker to recuperate from his or her medical condition or injury, then to return to full duty.  It is not meant to be a retirement system.

Further, it only compensates for those injuries which are causally related to the workplace.  As a dumping ground, it makes it easier for the Federal agency or Postal Service to deny the ability to accommodate the Federal or Postal Worker, or to reassign the individual, and instead to provide the proper forms to file for Workers’ Compensation benefits.  This doesn’t mean, however, that OWCP will accept the claim, either as an original claim or as a recurrence.  OWCP is not a retirement system.  

On the other hand, OPM Disability Retirement under FERS or CSRS is meant to compensate Federal or Postal employees who have a long-term medical condition.  If the agency cannot accommodate the disabled Federal or Postal Worker, that is an option to be considered.  If you are “unwanted” — and the agency shows every inclination of that — it may be time to consider the option of Federal Disability Retirement.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Intersection with Other Benefits

Federal Disability Retirement benefits under FERS or CSRS from the Office of Personnel Management is an independent benefit from an independent agency.  However, there may be some intersecting features which are important to understand, prior to beginning the process.  

A disability annuity, whether under FERS or CSRS, has an “off-set” feature with certain other federal annuities, by statutory mandate and direction, but not with certain others.  For instance, there is a coordinating offset with Social Security Disability (under FERS), and an election must be made between OWCP Temporary Total Disability payments and Federal Disability Retirement benefits (except for scheduled awards).  On the other hand, there is no offset between a Federal Disability Retirement annuity and VA disability payments.  

In making a decision as to whether to file for Federal Disability Retirement benefits, each Federal and Postal employee should be fully informed as to the offsets with other Federal benefits and payments, as well as whether there are limits and restrictions as to the amount of other “earned income” a person may be allowed to make.  

The importance of finding out which benefits are fully or partially offset is important in making a final decision as to whether it is financially feasible to proceed in preparing, formulating and filing a Federal Disability Retirement application.  Of course, in the end, it is usually a medical decision which is paramount — out of necessity, and not out of choice– as opposed to a financial one.  However, it is nevertheless important to know what is on the other side of the cave, before one enters it to begin with.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Three Pockets

In discussing Federal Disability Retirement benefits under FERS or CSRS, it is important to keep in mind the conceptual distinction between the three “pockets” of compensatory programs or resources (and, not to confuse the issue further, but these three pockets are separate and apart from the 3-legs of the retirement stool envisioned under FERS — the FERS Retirement annuity, Social Security, and TSP).

The three primary pockets of compensatory programs include:  CSRS & FERS Disability Retirement (and its companion hybrid, the CSRS-Offset)  — all of which get recalculated at age 62 to regular retirement; SSDI (Social Security Disability which, under FERS, one must file for automatically as part of the process of submitting for FERS Disability Retirement benefits, but under CSRS, one does not need to); and finally, Department of Labor, Office of Worker’s Compensation Program.

The former two have direct interaction, inasmuch as one who falls under FERS Disability Retirement must also file for SSDI, and if both are accepted, there is an offset of benefits between the two (100% offset the first year of benefits, 60% offset every year thereafter until age 62).  The last of the three pockets, OWCP benefits, as I have stated on many occasions, is not a retirement system, but one may file for such benefits concurrently with filing for FERS or CSRS Disability Retirement benefits (but one must elect between OWCP benefits on the one hand, and FERS or CSRS retirement benefits on the other hand), have both approved, but cannot collect both concurrently.  There is an exception — and that has to do with a “scheduled award”.

While keeping these various benefits conceptually distinct can be rather confusing, it is important to understand the distinctions when contemplating filing for Federal Disability Retirement benefits under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

Federal & Postal Service Disability Retirement: Differing Legal Criteria

Similar benefits, at the State, Local, Private levels, and at the Federal level, each contain differing legal criteria for eligibility. Thus, for instance, Social Security Disability benefits require one set of standards of eligibility; private disability insurance policies require a different set of standards; and state disability benefits often differ from state to state.  This is of course true of Federal Disability Retirement benefits under FERS and CSRS — where the legal standard of eligibility is different from Social Security, Worker’s Comp, and State or private disability criteria.

Often, a question is asked whether a medical narrative report which is prepared for submission to the Office of Personnel Management can be used for submission for other “similar” benefits.  The short answer is, “It all depends”, but the long answer is that, in most cases, one must be very cautious.  When I represent a Federal or Postal employee under FERS or CSRS, one of the first steps in preparing a viable case is to request of the treating doctors a detailed medical narrative report.  One must understand that the treating doctor has, generally speaking, next to no idea as to the legal criteria that must be met under FERS or CSRS.  Furthermore, the treating doctor has no legal knowledge as to the differences between private disability insurance policies, State, Social Security, OWCP or FERS & CSRS.  It is the job of the Attorney to make sure and guide the treating doctors as to the criteria which must be met as to the particular and specialized field for which the medical narrative is being prepared.  This must be done with care, and with detailed guidance.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: Standard Forms Do Not Mean “Standard Responses”

The problem with “Standard Forms” is that they often appear to solicit “standard responses”, and in a Federal Disability Retirement case under the Federal Employees Retirement Systems (FERS) or the Civil Service Retirement System (CSRS), nothing could be further from the truth.  Indeed, it is often because a Federal or Postal employee/applicant who confronts and begins to fill out SF 3112A, Applicant’s Statement of Disability, the very “blocked” appearance of the form, and the constricting questions themselves, makes it appear as if a “standard response” is required.  Don’t be fooled.

By way of example, take a “special animal” — that of a Federal Aviation Administration Air Traffic Controller who must take a disqualifying medication, loses his or her medical certification from the Flight Surgeon, and thinks that filing for Federal Disability Retirement benefits is a “slam dunk”.  Nothing could be further from the truth.  Or, a Customs & Border Patrol Agent who goes out on stress leave, or suffers from chronic back pain.  Are there “standard responses” in filling out an Applicant’s Statement of Disability?  There are certain standard “elements” which should be considered in responding to the questions, but don’t be constricted by an appearance of “standard responses” to a “standard form”.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: The OWCP Paradigm

One may choose OWCP benefits because, financially, it pays more (75% non-taxed for an individual with dependents; 66 2/3% for a single individual) than a Federal Disability Retirement annuity.  It is a pragmatic paradigm to rely upon for the immediate time-frame; however, it is not a practical paradigm for the future.  Obviously, one should obtain an approval from the Office of Personnel Management for one’s disability retirement, concurrently with receiving OWCP temporary total disability payments.  However, upon an approval from OPM, you need to elect between the two — because you cannot be paid by both concurrently.  Many people (rightly) choose to remain on OWCP and keep the OPM Disability Retirement annuity in “limbo or annuity purgatory” — again, because OWCP pays more.

However, as a paradigm for the future, it should not be relied upon forever.  This, because OWCP is not a retirement system.  Instead, it is a system of allowing for payment during a time of occupational disease or injury, for a person to be able to recover from such an injury.  While on OWCP benefits, however, you cannot work at another job (unlike under FERS & CSRS disability retirement); in fact, if you engage in too many physical activities similar to those which you might do at work, you may find that you will be criminally charged for “fraud”.  This has happened to many people, and it should frighten anyone who is on OWCP.  In such cases, you will often find that you have been videotaped over hundreds of hours — but the “edited” version upon which OWCP investigators charge you with, will be a video clip of about 5 minutes.  Next:  Why OWCP is not a good paradigm for one’s future.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: Creativity & Objectivity

The Applicant’s Statement of Disability is a very personal statement; that is precisely why when I take on cases at the Second (Reconsideration) Stage, or at the Third (Merit Systems Protection Board) Stage, I have an opportunity to read heart-felt, personal, and very “emotional” statements written by the individual applicant.  This is not to be negatively critical of such statements — such personal, emotionally-charged statements can be very effective.  On the other hand, it is precisely because the Applicant who writes such a statement — about his or her own personal engagement and experience of the disability — that he or she is unable to provide an objective perspective.  It is very difficult to “stand outside” of one’s self and write about one’s self.  Again, this is not a negative criticism — it is simply what it is.  As an aside, I have had many of my clients who read my interpretive statement of disability, which I craft based upon multiple sources (i.e., by speaking to the client; by having my client fill out a short questionnaire; by reading the medical reports and records, etc.), who tell me later that, yes, the statement of disability accurately reflected their state of medical disability, and further, that it made him or her realize for the first time how “bad off” they were.  It takes a perspective of objectivity to creatively — and accurately — depict one’s own medical disability and the impact of such disability upon one’s life.  For this, a third party — often an attorney — is needed.

Sincerely,

Robert R. McGill, Esquire