Early Medical Retirement for Disabled Federal Workers: Harm of Linguistic Impurities

The integrity of the law is kept intact by the careful scrutiny of compliance, via oversight by guardians whose responsibility it is to maintain, challenge and question the diversionary attempt, however minor and in what seemingly inconsequential modalities, such imperceptible excursions into areas outside of the linguistic purity of the law, regulations and case-law interpretation when attempted.

In Federal Disability Retirement law, it is the Federal Agency itself — the U.S. Office of Personnel Management (OPM) — which often must be kept “in check”.  For, it is precisely those “allowances” of language which provides for licenses not otherwise granted which, if left unchallenged, will continue to repetitively reappear in subsequent decisions rendered for future Federal Disability Retirement applicants.

Thus, in a Federal Disability Retirement denial, it may be that a decision of denial of a Federal Disability Retirement application may state that the medical evidence “does not show that your medical conditions kept you out of the workplace altogether”, or that the diagnostic testing did not establish that the Federal Disability Retirement applicant “had a disabling disease which caused a disablement which incapacitated” the individual — implying, thereby, a standard of medical disability far above and beyond what is necessary for eligibility for Federal Disability Retirement benefits.

Such misstatements must be challenged and refuted; otherwise, the integrity of the law is left soiled and smeared, and future attempts by Federal and Postal Workers may be harmed by the careless allowance of linguistic impurities to surface and fester.

Sincerely,

Robert R. McGill, Esquire

 

FERS Medical Disability Retirement: Conceptual Constraints

Within the world of biology, the distinction between an unicellular eukaryote and a prokaryote is one defined by the absence of a distinct, membrane-bound nucleus.  The latter is thus without a homunculus, constrained by a parameter and protected as the central seat of control.  One would assume that, because of this, the former would be easier to genetically manipulate, while the former would be more difficult.

Similarly, while widespread dissemination of responsibility and delegation of authority may have the positive effect of getting much work done, the corollary negative impact may also become uncontrollably representative of an organization:  loss of qualitative control.

Upon reading a denial letter from the U.S. Office of Personnel Management, whether under FERS or CSRS, from the U.S. Office of Personnel Management, one may begin to suspect that you are dealing with a prokaryote-type of entity:  for anything may be said, and what may be stated may not even remotely be the law of the case.

Being unconstrained by a membrane may have its advantages for survival; being unconcerned by the constraints of language will have its definite impact upon a Federal or Postal employee attempting to obtain Federal Disability Retirement benefits from the U.S. Office of Personnel Management: confusion for the Federal or Postal Worker, or worse, surrender and retreat.  But there are ways to counter such an untethered approach — but one which must use all of the legal tools available to the Federal or Postal applicant.

The key is to build a membrane and change the prokaryote into an eukaryote.  In order to do this, however, one must know the law, apply the law, and force the law upon the organism — thereby effectuating the genetic modification.  Thus does science, logic and law coalesce into a unified, rational whole.  Go figure.

Sincerely,

Robert R. McGill, Esquire

 

CSRS & FERS Medical Disability Retirement: Complexity & the Law

The complaint heard most prevalent is that the “law” is deliberately complicated for the benefit of lawyers, and to the detriment of the lay person.  That is the one of the points which Dickens makes in his work, Bleak House — a lengthy work which meticulously follows the probate of a contested will, where the lawyers involved appear to be the only beneficiaries of the central litigation. But that only tells one side of a story.  

Complexities in any issue surface because of lack of clarity; and lack of clarity manifests itself as each case brings to the forefront questions and concerns previously unspoken or uncontested.  As an example — the issue in Stephenson v. OPM, where the U.S. Office of Personnel Management refused to recalculate one’s FERS Disability Retirement annuity even though the annuitant was no longer receiving SSDI benefits, because OPM interpreted the word “entitled” in a unique and perverse manner — could have been left alone without litigation, and therefore allowed to remain a simple matter.  

This had been going on for decades.  But somebody — Mr. Stephenson in particular — decided that OPM’s actions were unfair, and that it needed to be litigated.  Did it complicate matters?  Complexity is an inherent part of the law, and as issues become contested, the evolution of a body of law can expand into a compendium of complexity.  

It is no different with Federal Disability Retirement.  Yes, Federal Disability Retirement law is a complex body of administrative issues; it requires expertise; but if it was left alone, you can be assured that OPM would step over, on, and around many more Federal and Postal Workers who are otherwise eligible and entitled to Federal Disability Retirement benefits. That is why complexity can go both ways — for the agency, but also for the Federal or Postal employee.

Sincerely,

Robert R. McGill, Esquire

Federal Worker Disability Retirement: He Who Dictates the Law…

He who dictates the law, controls the conditions and criteria which govern a process.  Whether such dictation is an accurate reflection of the actual substance of the law, of course, is another matter.

Thus, when the Office of Personnel Management applies their 7-part criteria, they purportedly and in declarative form assert that it is based upon the substantive law which is extrapolated from the statutory authority which underlies Federal Disability Retirement laws, statutes, regulations, and expansive case-law as handed down from the U.S. Merit Systems Protection Board decisions and opinions rendered by the Federal Circuit Court of Appeals cases.

Merely asserting that a given set of legal criteria has been applied, does not constitute a verification of the proper interpretation of what the law means.  Proper interpretation requires legal analysis, an understanding of the context of how the law was applied, in what fact-scenarios the law was cited, and an argument as to whether it applies in one’s own set of factual circumstances.

Indeed, often the U.S. Office of Personnel Management will describe a linear state of a Federal or Postal employee’s set of medical reports, conditions, etc., then merely declare that the legal criteria was applied, then (without any explanatory nexus between the facts and the conclusion) make a decision stating that the medical conditions “did not satisfy the legal requirements” — without any bridging explanation as to why such a statement should be accepted as true.

Having the authority to dictate the law is one thing; such authority does not mean that one is right, or that such authority grants the agency any great insight into proper legal reasoning.  Fortunately, there are appellate procedures, such as the next step in the process — the Second Stage of the process (Reconsideration Stage), and beyond, to the U.S. Merit Systems Protection Board.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Government Employees: OPM and the 7-Part Criteria

In any denial of a Federal Disability Retirement application under FERS or CSRS, the Office of Personnel Management incessantly refers to their 7-part criteria of eligibility, in making their determination as to the legal viability of a case.

The criteria, as stated, can be both helpful, as well as result in a negative determination, for multiple reasons.  To the extent that it extrapolates and extracts from the relevant Code of Federal Regulations, it minimally states the fundamental legal requirements for eligibility of a Federal employee or Postal employee who is filing for Federal Disability Retirement benefits.

However, because such a basis only extracts from the originating statutory foundation for eligibility, what it completely ignores is the continually evolving cases which clarify, interpret and define the very terms which constitute the criteria.  To that extent, OPM’s adherence to the strict and narrow application of the original “law” can often result in a negative determination, precisely because such an application ignores the subsequent clarifications which have evolved and progressed from various cases which have been litigated, both in the Federal Circuit Courts as well as at the Merit Systems Protection Board level.

Beware of the 7-part criteria; if followed, it can backfire; if not followed, it can backfire.  The 7-part criteria is a Catch-22 in sheep’s clothing.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement from the Office of Personnel Management: Legal Criteria

There is “The Law” — the originating, statutory authority which is passed by Congress — then, the compendium of the entirety of the legal arena, which includes decisions handed down by Administrative and Federal Judges, which comprise the expanding and evolving interpretation, clarification and extension of “The Law”.  

Unfortunately, in making its decision on an Application for Federal Disability Retirement benefits under FERS or CSRS, the Office of Personnel Management constrains itself (and its knowledge of the law) to a template based upon a “7-part criteria” which is extrapolated from the Code of Federal Regulations.  

This 7-part criteria is a simplistic and misleading application of the law.  It is not so much that it is an “error” on the part of the Office of Personnel Management to apply such a criteria; rather, it is that, in evaluating and determining the sufficiency, viability, and meeting of the standard of proof of “preponderance of the evidence” of a Federal Disability Retirement application under FERS or CSRS, it simply does not go far enough.  Because the 7-part criteria fails to include the interpretive evolution of the entirety of the laws governing Federal Disability Retirement, it fails by excluding many Federal Disability Retirement applications which are based upon legal criteria which fall outside of the delimited circumference and parameters of what OPM has set forth. 

In short, they are “behind the times” in many instances, and so when a denial is based upon a misapplied criteria, it is important to point out to OPM that X law applies in particular case Y — where “X” is outside of the scope or knowledge of the Office of Personnel Management.

Sincerely,

Robert R. McGill, Esquire

Federal Worker Disability Retirement: Extrapolating Carefully from “The Law”

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, it is important to recognize the major legal cases (those “landmark cases”) from which many other cases derive their foundational basis.  Such cases form the fundamental and overriding criteria of a legal arena, and this is no different in arguing for Federal Disability Retirement benefits under FERS or CSRS, either for Federal or Postal employees.  Furthermore, in citing a case to argue for one’s position of eligibility and entitlement, it is equally important to have read the cases carefully, and to argue the merits of an issue persuasively and accurately.  

One of the worst things that a lay, non-lawyer applicant can do is to mis-cite a case or a statute, and its meaning and ancillary conclusions.  For, when the Office of Personnel Management reviews a case and refutes a particular issue, and further points out that a legal precedent or statutory authority has been mis-applied, one’s credibility as to the substance of the application is not only undermined, but further, the viability of one’s legal argument has been subverted.  As such, it is normally advisable to leave the law to lawyers — and in Federal Disability Retirement cases under FERS or CSRS, to leave it to lawyers who specialize in the field. For, to do little or no harm to one’s self is certainly better than to saw off the branch which one has grasped onto, no matter how tenuous the position to begin with.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Reconsideration Response — Refrain from Reflexive Response

When a denial is received for an Application for Federal or Postal Disability Retirement benefits under FERS or CSRS, sometimes they are replete with comical “errors” and omissions.  Thus, anywhere from mistaken identities, to wrong job identifications, to the wrong doctors named; from medical conditions which were never claimed, to diagnostic tests and surgeries which were never submitted; these are just some examples of errors and omissions which one might find in the body of the “Discussion” in an OPM denial letter.

The reflexive temptation is to put together a string of harangues and accuse the OPM Representative of incompetence, incoherence, ineptitude, and inability to perform the essential element of his or her job.  Such a reflexive response would be the wrong tact to take, however.  One should refrain from making such “ad hominem” attacks.

Instead, the better way to go about it would be to politely point out the major errors, the omissions of any medical or other substantiating documentation, in an understated way, then to argue the main points that need to be argued to rebut the denial letter.  While the former methodology may make you feel good, in the end, it is an approval which will prove to be of lasting elation.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: The Law II

A more extensive article on the recent case of Reilly v. OPM has already appeared in FedSmith.com, because it is an important step forward in Federal Disability Retirement Law.  Decided July 15, 2009 by the United States Court of Appeals for the Federal Circuit, it topples another idol of a false standard imposed by OPM:  that medical documentation which is written by a doctor after a Federal or Postal employee is separated from Federal Service may be dismissed as being near-irrelevant in evaluating and reviewing a Federal disability retirement application. This has never made sense, since many medical conditions are progressive and degenerative in nature, and that is precisely what the Court in Reilly argues.  “The field of forensic medicine abounds with examples of subsequent medical examinations relevant to a prior condition,” the Court in Reilly argued, citing the classic example that “inferencesabout prior intoxication can be drawn from blood alcohol tests conducted at a later time.”  Further, where “proximity in time, lay testimony, or some other evidence provides the requisite link to the relevant period the subsequent evidence can be very probative of a prior disability.” Of course medical evidence gathered within the 1-year period after separation of service should be given probative value.  The Court in Reilly states that principle clearly.

Sincerely, Robert R. McGill, Esquire

OPM Disability Retirement: The Case of Fibromyalgia

Fibromyalgia is one of those medical conditions that the Office of Personnel Management systematically “targets” as a condition which is prima facie “suspect”. This is despite the fact that there are cases which implicitly “admonish” OPM from engaging in the type of arbitrary reasoning of denying a disability retirement application because they “believe” that “no objective medical evidence” has been submitted, or that the “pain” experienced (diffuse as it might be) is merely “subjective”, or that the chronicity of the pain merely “waxes and wanes”, and a host of multiple other unfounded reasonings. Yet, cases have already placed a clear boundary around such arbitrary and capricious reasonings.

A case in point, of course, is Vanieken-Ryals v. OPM, a U.S. Court of Appeals for the Federal Circuit case, decided on November 26, 2007. In that case, it clearly circumscribes the fact that OPM can no longer make the argument that an Applicant’s disability retirement application contains “insufficient medical evidence” because of its lack of “objective medical evidence”. This is because there is no statute or regulation which “imposes such a requirement” that “objective” medical evidence is required to prove disability. As long as the treating doctor of the disability retirement applicant utilizes “established diagnostic criteria” and applies modalities of treatment which are “consistent with ‘generally accepted professional standards'”, then the application is eligible for consideration. Further, the Court went on to state that it is “legal error for either agency (OPM or the MSPB) to reject submitted medical evidence as entitled to no probative weight at all solely because it lacks so-called ‘objective’ measures such as laboratory tests.” Statues are passed for a reason: to be followed by agencies. Judges render decisions for a reason: for agencies to follow. Often, however, agencies lag behind statutes and judicial decisions. It is up the an applicant — and his or her attorney — to make sure that OPM follows the law.

Sincerely,

Robert R. McGill, Esquire