OPM Disability Retirement: The "Process" at the Reconsideration Stage

It is important to understand that the “process” of filing for Federal Disability Retirement, when it comes to the Second, or “Reconsideration” Stage, encompasses two factual prisms:  (1)  The application has now been denied (obviously, and for whatever reason — most likely because of “insufficient medical evidence”) and (2) it is the stage in the process prior to an appeal to the Merit Systems Protection Board. 

This dual prism of the stage, while self-evident, is important to keep in mind, because it requires a duality of duties:  A.  It requires (for the Disability Retirement Applicant) a duty to show something beyond what has already been shown, while B.  It requires the Office of Personnel Management to be careful in this “process” of review, because if OPM makes a mistake at this stage, then the likelihood is great that they will be required to expend their limited resources to defend a disability retirement case before an Administrative Judge, and if it becomes obvious that the case should have been decided favorably at the Second Stage, it reflects negatively upon the Agency.  OPM is an agency made up of people (obviously); as such, just as “people” don’t like to look foolish, OPM as an Agency made up of people, does not like to look “badly” or “foolish”.  This duality of factual prisms is important to understand when entering into the Second, Reconsideration Stage of the “process”.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Creativity Is Important In the Applicant’s Statement

It is important to creatively inter-weave facts, feelings, medical impact, symptoms and conditions into a persuasive Applicant’s Statement of Disability.  It should not be overly emotional; it should not be voluminously long; it should not be preachy; it should not be written as a doctor would write it.  It is the Applicant’s Statement of Disability, and it should be from the Applicant’s perspective; but as with every writing, the “audience” to whom anything is written, must always be kept in mind.  Remember that the audience is a reviewing Office of Personnel Management representative — one who is evaluating, analyzing, and making a decision upon the application for disability retirement. 

Of course the independent attachment of medical documentation will be persuasive; of course a review of the position description will have an impact; and of course the analysis of comparing the medical condition with the type of job one has will be scrutinized and will be relevant.  It is the applicant’s statement of disability, however, which will most often be the determining factor.  That is why such a statement must creatively weave all of the various aspects of a disability retirement application — facts, emotions, job impact, medical impact, doctor’s statement, personal statement, impact statement — all in a bundle, all inter-weaving, all in a persuasive, creative description.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Denials

Denials received from the Office of Personnel Management are particularly difficult news to digest. It is not so much that the denial itself obviously represents “bad news” (that is difficult enough), but for the disability retirement applicant, it casts a long and foreboding shadow upon one’s financial and economic future. For, obviously, the income from the disability annuity is being relied upon; the applicant filed for Federal disability retirement benefits under FERS or CSRS based upon the assumption that it would be approved, and the future calculation of economic and financial stability was based upon the obvious assumption of an approval. Long-term plans are made based upon the assumption of approval. Further, it doesn’t help that the basis for the denial, as propounded by the Office of Personnel Management, is often confusing, self-contradictory, and without a rational basis. It is often as if the OPM representative just threw in a few names, referred to some doctor’s reports, and essentially denied it with a selective, almost pre-determined view towards denying the claim. This is unfortunate, because the Office of Personnel Management is under a mandate to make its decision based upon a careful and thorough review of the applicant’s supporting documention. However, when the denial is received, one must fight against the initial feelings of defeat and dismay; work is yet to be done, and a view towards the future must always be kept at the forefront. A time to give up is not now; it is time to fight onward, and to move forward.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Perspective from the Office of Personnel Management

In effective argumentation, persuasion, written memoranda, oral presentation, and the entire spectrum of attempting to convince the “other side” of the validity, force, appropriateness, and viability of any administrative or legal filing of any nature, it is often a useful tool to attempt to view an issue from that “other” perspective.

Remember that, in filing a Federal disability retirement application under FERS or CSRS, it is good to consider the fact that the OPM representative who will be reviewing your particular application, merely sees your application as one among hundreds of files assigned to him or her. With that in mind, the essential question becomes: How can my particular application, as one among many, be reviewed in such a way that it “stands apart” so that it will be quickly approved? If you ask that question, or any variation of such a question, then you may be taking a wrong approach.

Remember that filing for disability retirement under FERS or CSRS is not like applying for a job; you are not filing a resume that needs to stand out; rather, it is often best if your particular application is nothing more than a “run of the mill” application — with strong, unequivocal and irrefutable medical evidence, along with strong legal arguments to support your case. Yes, of course your Applicant’s Statement of Disability should explicitly describe the human condition of medical disablement; yes, the “nexus” between your medical condition and your job should be carefully constructed; but no, your application should not necessarily “stand out” as uniquely different — for such an application will often be viewed as “suspicious” and “over-stated”, and may well lead to not just a first viewing, but a re-viewing, and a possible denial

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: The Process & the Office of Personnel Management

The “British Rule” is that “good manners will always get you through any and every form of trouble.”  The process at the Office of Personnel Management is a long and arduous one.  When the disability retirement packet finally arrives at Boyers, PA, it will often sit for approximately thirty (30) days, before it is finally assigned a CSA number (for CSRS employees, it will begin with the number “4”; for FERS employees, it will begin with the number “8”).  The Applicant will receive a form letter from OPM in Boyers, PA, informing you that you have been assigned a CSA number, and that it has been forwarded to the OPM office in Washington, D.C.  This is when patience and good manners must come to the fore.  Of course, there is nothing wrong with calling OPM and inquring about the status of your case.  However, always remember to be courteous; inquire as to the time-frame that the adjudicating disability specialist is expecting; and ask if it would be okay to call periodically, and to let him/her know that if any further documentation is needed, to give you a call — or, if you are represented, to call your attorney.  Whatever you do, do not get angry, and keep it professional — and courteous.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: Medical Documentation

As I often tell my clients in preparing a Federal Disability Retirement application:  The “lynchpin of the application is the medical report”.  Thus, it is important to speak to the doctor about the legal requirements of a medical narrative report.  Doctors, by their very nature, hate to write reports; they are doctors, and doctors perform medical duties; writing a report is an “administrative” duty, and further, writing a medical report for a disability retirement application is a “legal administrative” duty — the farthest thing from what a doctor would like to do.  Additionally, many potential applicants don’t understand that for certain medical conditions — Fibromyalgia, Chronic Fatigue Syndrome, and Multiple Chemical/Environmental Sensitivity cases, and “contact Dermatitis” cases, as well as other related conditions — there are many “do’s and don’t’s” with respect to the substance and content of the medical reports.  The Office of Personnel Management looks for certain key phrases which doctors will often write about in describing certain medical conditions, and it is important to caution the doctors about certain key elements.  It is not that the doctors should not describe the symptoms in a certain manner; rather, once the doctor understands what the legal requirements are, a treating doctor will more fully understand what needs to be said in order to meet that legal requirement.  In other words, doctors will often use “standard medical-ese” in describing symptoms; a fuller explanation is more often needed in order to meet the legal requirements of being eligible for disability retirement.  That is where an attorney’s assistance is often crucial.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Federal Disability Retirement: When the Office of Personnel Management Fails to Apply the Law

Federal disability retirement law is often a frustrating process. On the one hand, for an attorney, it can be a professionally satisfying area of law to practice because the end result — obtaining a benefit for an individual who has shown long years of loyal service to working for the Federal Government; providing a source of income for a person who has been impacted by a medical condition; reaching a successful conclusion to a process: these factors are always satisfying for a practicing attorney. On the other hand — this is an administrative process; it is an area called, “Administrative Law”, and at least at the initial stages of the process, the Attorney handling such a case is dealing with non-attorneys at the Office of Personnel Management.

In other areas of practice, there is often an “equality of competence” (presumably), where attorneys compete or engage in adversarial battle with other attorneys. With Disability Retirement Law, however, the “Disability Specialist” at the Office of Personnel Management often has absolutely no clue as to the current laws governing disability retirement. They simply apply a template and, if a specific case goes outside of that preconceived “template”, then the OPM Representative will often deny the case.

Now, in all fairness, most of the people at OPM have a fair idea of the current law, and more importantly, are open to being informed, educated and persuaded by an attorney that a particular case, with its various wrinkles (and all cases have their unique wrinkles), should be approved because of compliance with a particular statute, a relevant case-law, or a particular regulatory statement. In some particular cases, however, when an OPM representative makes a decision based upon complete ignorance of the prevailing disability retirement laws, one can only throw up one’s hands, and hope that the Reconsideration Specialist will have greater knowledge — or, at the very least, is open to being educated on the proper application of the law.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: The Frustration of Dealing with OPM

The Office of Personnel Management is a large bureaucracy which handles thousands of cases, including disability retirement applications. Lately, more and more frustrating post-approval issues are appearing, including: sudden interim payments without any prior notice of approval of a claim (not a bad thing to happen, certainly, in comparison to a denial); non-receipt of a letter from OPM, whether approving it or denying it; no communication from OPM after an approval, for months on end; and other problems ad infinitum, ad nauseum. Unfortunately, once a disability retirement application has been approved, there is very little that an attorney can do, anymore than the client can do. Persistence is the key; courtesy is the keyhole; finding the right, competent person at the Office of Personnel Management, and being courteous and persistent, often opens the door. Remember that there is a wide chasm of qualitative difference between “rudeness” and “persistence”; the former will never get you anywhere; the latter can be accomplished with courtesy, and get you very far. When contacting someone at the Office of Personnel Management, keep three (3) things in mind: (1) Be courteous (2) get the name and telephone number of the individual you are speaking with, and (3) try to obtain a specific date on which you will call that person back, and be clear as to what action it is that you want taken, and why. Persistence, courtesy, and further persistence.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirements: The Office of Personnel Management

I once heard a pastor make a rather unremarkable statement, but profound nevertheless in its simplicity and truth: “Where there are people, there are problems.” To assume that an Agency will make a proper, objective and legally sufficient decision all the time, most of the time, or even more often than not, is probably asking too much. The Office of Personnel Management, as with any Agency, is an entity — a large bureaucracy — made up of “people”. Yes, there are laws governing disability retirement; yes, there are rules, regulations and “criteria” which form the foundational basis for the “decision-making” part of evaluating each disability retirement case; but more profoundly, there are “people” who review, interpret, and apply those rules, regulations, and legal criteria in determining the final outcome: approval or disapproval of a claim.

That is why it is important in “how” a case is presented, as much as “what” it is that is being presented. With people, there are personalities; with personalities, there are variances in how any given OPM person reviews a case and makes a decision, from one to another. Where an attorney can be most helpful, is to “elevate” a case out of being merely one case among many, to making a presentation of a case on three fundamental levels: (1) the seriousness of the medical condition, (2) the legal sufficiency of the disability retirement application, and (3) persuasion by argumentation that it would be a mistake — a misapplication of the legal criteria — to disapprove a disability retirement application. All in all, this comes down to one profound issue: Where there are people, there are problems; and where there are problems, it is often a good idea to make the best presentation possible, at the outset of a disability retirement case.

Sincerely,

Robert R. McGill, Esquire

Patience During the FERS & CSRS Disability Retirement Process

It is now post-Labor Day Weekend. Summer is essentially over. The Office of Personnel Management will be back in “full force”. The inclination will be to call up OPM and impatiently — imprudently — demand that one’s disability retirement application be reviewed, because it has been sitting on Mr or Ms. X’s desk for the last 90 days. Be cautious of what you request, or demand — because you may get your wish, but with an outcome you do not desire — a denial. I often remark to my clients that if patience is a virtue, then Federal and Postal Workers must be the most virtuous people in the world, because you are the ones who must be most patient — during the years of service you have given, during the process of dealing with a demanding public, and finally, during the process when you need the Federal Government to act quickly — the disability retirement process. Be patient; thereby, be virtuous. Unfortunately, OPM does not have a statutory mandate during the administrative process. If you must call OPM, be courteous in your inquiry, and inquire only if necessary.

Sincerely,

Robert R. McGill, Esquire