Disability Retirement for Federal Workers: The Universe of the Possible (Part I of II)

Children are brought into the extensive and unlimited world of the “possible”, precisely because (we believe) it provides for greater expansion of the fertile, creative mind.  But for the adult, the world of the “possible” is conceptually meaningless, and without objective import; for, the statement and belief, “X is possible”, retains no boundaries, and therefore it allows for all manners of fears, frauds and frivolities.

It is interesting to listen to news stories which confuse the concepts between the universe of the “possible”, and that which is “probable”.  When a report is issued beginning with, “Sources say it is possible that X occurred,”, it is of no greater or lesser value than if one declares that it is “possible that aliens from Mars intervened in an event”.  Both are equally possible.  It is only when facts enter an equation that the universe of the “possible” becomes contained to the smaller world of the “probable”.

For Federal and Postal employees who have encountered the “real” world of medical conditions, dealings with unsympathetic agencies, confrontations with supervisors and managers, the world of the “possible” quickly shrinks to the harshness of one’s immediate environment.  Concurrently, however, as fears and thoughts of potential agency actions magnify concerns and ruminating upon the unknown, one often allows for those childish dreams to wander, and to entertain the universe of the possible.

Get the facts; obtain proper counsel and advice; for it is only when facts and advice based upon real-world events are gathered, that one can properly limit the unlimited universe of the possible and deal with the reality of the probable.

For Federal and Postal employees who must make decisions for a real future, where filing for Federal Disability Retirement benefits must be seriously considered, and where an encounter with the bureaucracy and administrative processes circumscribed by the U.S. Office of Personnel Management must be followed, it is important to recognize that the universe of the possible is merely for children and the unbounded imagination of childhood; whereas the world of the probable is what adults must contend with daily.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Proof, Assertion, and the Conceptual Distinction

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 necessary — first and foremost — to understand that the benefit of Federal Disability Retirement is not an “entitlement” under any definition of the word; there is no automatic triggering mechanism by which a Federal or Postal employee becomes a Federal Disability Annuitant, unless one proves, by a preponderance of the evidence, that one has met all of the eligibility requirements necessary to obtain the benefit. 

Further, while the standard of proof established by statute is a relatively low one in comparison to others (i.e., “preponderance of the evidence” merely requires that the truth of X is more likely than not, as opposed to other, more onerous standard of proof, such as “beyond a reasonable doubt” or “clear and convincing”, etc.), nevertheless, the mere assertion of a statement of facts will not qualify the Federal or Postal employee for Federal Disability Retirement benefits.

A standard — or “burden of proof” — means exactly that:   One must prove it, and proof requires more than the mere assertion that X is so.  Specifically, in an OPM Disability Retirement application, one must prove that one is medically unable to perform one or more of the essential elements of one’s Federal or Postal position, and in order to meet that burden, medical documentation of a sufficient and persuasive nature must be submitted along with a Federal Disability Retirement application, which includes many Standard governmental forms.

Knowing and recognizing the conceptual distinction between asserting X and proving X is an important first step in preparing, formulating, and successfully filing for OPM Disability Retirement benefits.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: Denials II

It is, indeed, frustrating when a governmental agency makes life-impacting decisions which seem to be spurious and capricious. A review of a disability retirement application by the Office of Personnel Management is supposed to be thorough, with sound reasoning and a fair application of the law. And, in all fairness, the majority of cases appear to meet that standard. It may well be, of course, that since all approval letters of disability retirement applications are standard templates, with boilerplate language and instructions, and since most of my cases are approved at the first level, the impression left is that OPM does a good job in reviewing the cases.

When a case is disapproved, however, it is often the case that the denial is based upon factors which defy logic, which appear to have little or no rational basis, and which selectively focuses upon a narrow reading of the medical reports and records. Thus, often the OPM Representative will take a statement out of context, and declare that the doctor stated X when a full reading of the medical report shows that the doctor actually stated Y. This is unfortunate, and does not reflect the careful review, analysis, and fair rendering of a decision made by most OPM representatives, but occurs often enough to be of concern. On the bright side, however, is that there is always the ability to take it completely out of the hands of OPM, after a second denial — and allow an administrative judge to review it objectively, at the Merit Systems Protection Board. That is why the MSPB was created and exists — to have a third party, objective body review the decision-making process of the Office of Personnel Management.

Sincerely,

Robert R. McGill, Esquire

FERS/CSRS Disability Retirement Compared To OWCP

OWCP vs. OPM Disability Retirement

The Department of Labor administers Federal Worker’s Compensation Benefits through the Office of Workers’ Compensation Programs (OWCP). Such benefits are non-taxable, and are paid for temporary total disability, for injuries or medical conditions which result from, or are caused by, a workplace injury. There are many tangential factors which may be added to this basic definition, but for purposes of distinguishing OWCP from the Office of Personnel Management (OPM) Disability Retirement, this definition will suffice. Additionally, generally speaking, OWCP/Federal Worker’s Compensation is not a “retirement system.”

OPM Disability retirement, on the other hand, is a retirement system. As a result of a medical condition which impacts one’s ability to perform the essential elements of one’s job, a person is eligible to retire early, based upon a “medical disability.” A person on OPM Disability Retirement is separated from the Federal Agency, and he or she may “move on” in life, and perhaps start another career (with certain limitations as stated below).

When is it Time to File for FERS/CSRS Disability Retirement?

An individual must file for Federal Employees Retirement System/Civil Service Retirement System (FERS/CSRS) disability retirement benefits with the Office of Personnel Management within one (1) year of being separated from Federal Service – otherwise, the right to be eligible for disability retirement benefits is lost. Do not confuse this with being placed on Leave Without Pay (LWOP), or being out on OWCP for being injured. The clock begins ticking when you are actually separated from service. Most people, however, should not wait until they are separated to file for disability retirement benefits, but rather, should file whenever it becomes apparent that he or she can no longer perform one or more of the essential elements of the job.

Taxable vs NonTaxable Benefits

OWCP benefits are non-taxable. OPM Disability Retirement benefits, on the other hand, are taxed. While receiving disability retirement benefits, a person may undertake a job search, accept another position, and earn up to 80% of what his or her former position currently pays. Individuals receiving OWCP temporary total disability may not work at another job – period. Here is a sample scenario using OPM Disability Retirement rules:

A worker’s average salary for 3 consecutive years totals $50,000. The individual goes out on disability retirement, and after the first year (in which he would receive 60%, or $30,000), he is eligible to receive an annual annuity of 40%, or $20,000. The worker then applies for and accepts a job in the private sector. The worker can accept a job that pays up to $40,000 per year (80% of the current salary), and still be eligible to receive the $20,000 per year disability annuity.

The 80% Rule Increases Over Time

The rule is “80% of what a person’s former job pays currently.” If 5 years from now, a person’s former position pays $60,000 per year instead of $50,000, then he can make up to $48,000 per year at the job, because 80% of $60,000 is $48,000.

Filing for Disability Retirement while on Workers’ Compensation

It is often not a bad idea for those who are receiving OWCP benefits to remain on OWCP for as long as they can stand it (i.e., the persistent harassment, the constant oversight by so-called “2nd opinion doctors”, etc.) — but to always have the FERS/CSRS disability retirement annuity approved as a back-up source of income. Individuals may file for disability retirement concurrently while on OWCP — but you simply cannot collect from both at the same time (See 5 C.F.R. Sec. 844.105, “Relationship to workers’ compensation. (a) Except as provided in paragraph (b) of this section, an individual who is eligible for both an annuity under part 842 or 844 of this chapter and compensation for injury or disability under subchapter I of chapter 81 of title 5, United States Code (other than a scheduled award under 5 U.S.C. 8107(c)), covering the same period of time must elect to receive either the annuity or compensation.”).

When OWCP terminates payments (and there is a very good chance that this will happen at some point in the near future), it is a wise option to have your disability retirement benefits approved, but held in an inactive status. Federal workers have every right to elect one benefit over the other. Indeed, if you wanted to, you are allowed to go back and forth between OWCP and FERS/CSRS disability retirement.

As a secondary issue on this matter, a closer look at 5 U.S.C. Section 8106, paragraph (c) (2), (OWCP) on “partial disability” compared with the definition for disability retirement reveals: that “partially disabled employee who refuses or, neglects to work after suitable work is offered to, procured by, or secured for him, is not entitled to compensation.” This means that if OWCP secures a job for you as a retail store greeter for instance, and pays you the difference between your salary and what retail store pays — and you decide to say “no”, OWCP has every right to cut off your payments.

On the other hand, under the laws concerning FERS & CSRS disability retirement, 5 C.F.R.Sec. 844.103 (a)(2) states that, in order to be eligible for disability retirement, the individual “must, while employed in a position subject to FERS, have become disabled because of a medical condition, resulting in a deficiency in performance, conduct, or attendance, or if there is no such deficiency, the disabling medical condition must be incompatible with either useful and efficient service or retention in the position.” The difference here is that, under OWCP, if you are “partially disabled,” if you are offered any job that OWCP believes you can do, you must accept it. On the other hand, under FERS/CSRS disability retirement laws, if you are partially disabled — meaning that you simply cannot do at least one or more of the essential elements of your job — then you are entitled to disability retirement benefits, and your agency or the Postal Service cannot simply offer you any job; they must offer you a job in the same pay or grade, and one in which you are qualified or, if you are in the Postal Service, then it must an accommodation in the same craft.

Controlling Your Future

Under OWCP, you have no control over your future – OWCP determines your future. Under OPM Disability Retirement, you can obtain disability retirement benefits, and then take control of your future and work at another job of your choice, make up to 80% of what your (former) position pays and still continue to receive your disability annuity.