Medical Retirement Benefits for US Government Employees: Denials

Denials issued by the U.S. Office of Personnel Management in a Federal Disability Retirement application are informative in multiple ways; while based upon templates for the most part, they often make arguments which are neither based upon the legal precedents which currently prevail, nor on standards of proof which are applicable.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, the Federal or Postal employee is expected to submit a Federal Disability Retirement application based upon the standard of proof and legal requirements which are current, applicable, and relevant.

Yet, if a denial is issued by OPM — one that is based upon language which is clearly contravening the statutory standards of legal precedents — that requires things which are not truly required, then what does one do?

It is tantamount to proving a negative:  how does one prove that a murder did not occur?  Or that a man did not say something asserted to have been stated?  Or that one’s Federal Disability Retirement application does not contain “compelling” medical evidence, or here’s a better one:  “According to AMA Guidelines, you do not have more than a 5% permanent disability rating…”  What?  For OWCP purposes, that may hold some meaning or relevance, but for a Federal Disability Retirement application, it means absolutely nothing.

The answer to the question, What does one do?  What one must — go to the next level, with the proper legal tools in hand, to answer such nonsense.  Or, better yet, start at the first level with some preemptive legal arguments.

Sincerely,

Robert R. McGill, Esquire

Postal and Federal Disability Retirement: The Use of Percentage Designations

The Department of Veterans Affairs does it; in obtaining a scheduled award from the Officer of Workers’ Compensation Programs, administered under the Federal Employees’ Compensation Act (FECA), the amount determined is based upon it; and so it is understandable that confusions may arise as to its relevance, import and various applicable uses.

Disability ratings represent an attempt to quantify the extent of one’s medical condition, injury, or loss of limb or body mobility, flexion, ability to use, etc.  Such attempt at quantification, no matter what mathematical calculus or methodology employed, must by necessity involve a level of subjectivity; for any such attempt is pre-determined by the criteria which is applied, and any such criteria which purports to apply universally will be unable to accommodate the uniqueness of an individualized case.

In a FERS or CSRS Disability Retirement case, the benefit provided is a flat rate, and is set by statute.  It does not increase or decrease based upon a percentage assignation of a medical disability.  Similarly, in Social Security Disability, the amount of the annuity received does not change because of an increase in percentage.

Whether one can or should use the assigned percentage rating from the VA or from OWCP, in proving or attempting to prove eligibility in FERS or CSRS Disability Retirement cases, is a matter of discretion.  The amount of the disability rating; whether the gross number is a combination of fairly insignificant fractured percentages; the substantive discussion justifying each number, etc. — all of those factors must be taken into consideration before using it in a Federal Disability Retirement application.

Numbers alone rarely mean anything; 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 not the numbers, but the words which support them, which will make the difference.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for US Government Employees: Numbers

Numbers, statistics and percentages rarely tell a complete story, especially in relation to a person’s medical condition.  In Federal Disability Retirement applications under FERS or CSRS, numbers must be utilized carefully and, more importantly, effectively.  Moreover, numbers can be used to diminish or otherwise minimize the seriousness of a medical condition.

For example, if the loss of a forefinger of a right-hand dominant individual would constitute a 5% disability of the “whole person”, does that tell the full story of the impact of such a medical condition upon one’s ability to perform a job which requires daily manual dexterity & use of the right hand?  Or if the loss of vision in one eye were deemed to be a 10% disability, how would one quantify such a medical condition for a computer graphics engineer?

Scheduled awards for Worker’s Comp requires such quantification; and the Veterans Administration ascribes service-connected disability ratings, but unless one descriptively defines the relevance of such numbers to the impact upon one’s ability/inability to perform the essential elements of one’s job, such numbers lose their importance and relevance.

In filing for Federal Disability Retirement benefits under FERS or CSRS, it is important to recognize that the language used, and not the numbers ascribed, determines the relevance and ultimate success.  Numbers must be descriptively quantified; numbers in and of themselves never tell a story, except perhaps to the mathematician, which the workers at the Office of Personnel Management are not.

Sincerely,

Robert R. McGill, Esquire