OPM Disability Retirement: The Qualifying Medical Condition

The question is often asked, “Does my medical condition qualify for Federal Disability Retirement?”, or some variation of that question.  

Such a question, of course, in order to “make sense” in the context of a Federal Disability Retirement application under FERS or CSRS, must be reformulated, precisely because the manner in which it is posed produces multiple sub-questions.  For, ultimately, the laws and regulations governing Federal Disability Retirement do not provide for a calculus of a mathematical correspondence, where medical condition X is considered a “qualifying” one, whereas medical condition Y fails to meet such a qualification criteria.  

The sub-questions which are immediately necessitated by the originating question, involve multiple factors:  Does the medical condition you suffer from impact your ability to perform one or more of the essential elements of your job?  In what way?  Can you describe how the medical condition impacts your ability to perform your job?  Are you being medically treated for your medical condition?  Will the doctor support you in your quest and application for Federal Disability Retirement benefits?

Take, for instance, the following “extreme” hypothetical, used for purposes of expanding upon the previous conceptual paradigm:  Question:  Does my aching right thumb qualify for Federal Disability Retirement benefits?  Answer:  Normally not.  Sub-question:  If my job requires the constant and repetitive use of my right thumb, and such use is an essential element of my job, can my aching right thumb qualify me for Federal Disability Retirement benefits under FERS or CSRS?  Answer:  In all likelihood, yes.  

Often, it is the right question asked, and not the answer to the original question, which is the important starting point of the process in preparing, formulating and filing for Federal Disability Retirement benefits, whether under FERS or CSRS, from the Office of Personnel Management.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: OPM’s Detailed Denial

Neither length nor detail constitutes legitimacy.  The spectrum of the types and styles of denial letters issued by the Office of Personnel Management in Federal Disability Retirement cases under FERS & CSRS range from a short paragraph under the “Discussion Section”, to 3 – 4 pages of apparent references to doctor’s notes, reports, etc. — with a lengthy lecture about the need for “objective” medical evidence, and about how a particular medical condition “may be” treated by X, Y or Z treatment modalities. 

Don’t be fooled.  One may think that, because OPM provides a seemingly “detailed” explanation of why a particular disability retirement application was denied, that such lengthy detail means that it is somehow “substantive”.  In fact, I often find the opposite to be true:  the shorter the denial, the greater the substance.  The lengthy denial letters contain “substance”, all right — but substance of the wrong kind.  They contain:  Mis-statements of the law; mis-statements of the criteria to be applied; inappropriate assertions of medical opinions (contrary to what one might think, the OPM representative does not normally have a medical degree, let alone a law degree), and a host of other “mis-statements”.  Sometimes, the weightier the denial, the more confusing as far as how to respond.  And, perhaps, that is one methodology as to how OPM wants to approach the case:  If it seems long and complicated, maybe the applicant will sigh, give up, and go away.  Don’t.

Sincerely,

Robert R. McGill, Esquire