CSRS & FERS Medical Disability Retirement: Cornering OPM’s Malleable Stance

At the initial stage of the process identified as “Federal Disability Retirement” from the Office of Personnel Management, whether under FERS or CSRS, it is often difficult for the Federal or Postal worker to grasp the various components which must be gathered, formulated, prepared and consolidated, in order to meet the legal criteria for eligibility.

Once submitted, if an approval is received from the Office of Personnel Management, then one need not be further concerned with whether or not the legal criteria was “met” (although one should still be vigilant in doing those tasks and preparatory work in order to retain and maintain one’s right to Federal disability retirement benefits).

If a denial is received from the Office of Personnel Management, then it is necessary to file a Request for Reconsideration within the thirty (30) day time period, and begin to determine which of the multiple issues OPM has delineated as being the basis of a deficient Federal Disability Retirement application.

Some attempt to do this via a “shotgun” approach — of spraying every answer available and hoping that some of the arguments, supplemental documents, statements, etc., hit the mark in some way.  A different approach is to selectively choose those issues which appear to be central to the case, and answer the essential ones, allowing for such answers to concurrently address the peripheral points brought out by OPM.  A third approach is to identify and consolidate OPM’s alleged basis for the disapproval, consolidate the issues into 2 or 3 main points, then “corner” the arguments by addressing them, concluding that the Federal or Postal employee has addressed the concerns of OPM and therefore OPM should not be able to change them at the Merit Systems Protection Board.

While an MSPB appeal is conducted “de novo” (“anew” or “afresh”, without regard to any previous determinations), it is nevertheless an effective methodology to point out the malleability of OPM’s varying stances, and thereby effectively streamline that which needs to be proven at the MSPB level.  A leopard which changes its spots too often loses its credibility, and making sure that OPM stays in one place is a useful tool in winning a Federal Disability Retirement application, whether under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: The Human Factor

In preparing, formulating and filing a Federal disability Retirement application under FERS or CSRS, the self-contradiction involved in the entire process is that the Federal Disability Retirement packet is being submitted as a “paper presentation” to people at the Office of Personnel Management, yet, concurrently, the preparation of the submission is done with the intent of eliminating the “human factor”, and instead to meet all of the critical elements and the legal burden of proof.  

The human factor necessarily involves human elements, and therefore the potential for errors.  There is no mathematical formula in preparing a Federal Disability Retirement application.  It is not an exact science, and one cannot predict the guarantee of a Federal Disability Retirement application as to its approval.  

Because of the human element involved, one can only attempt to formulate the packet by inoculating against the potential of human errors, and that means that one must understand and interpret all of the legal criteria which are necessary for a successful approach to the process.  The human factor is countered by more human factors — that is why there is a process of appeals — before administrative judges, and Judges at the U.S. Court of Appeals for the Federal Circuit.  The appellate process is a further attempt to review the possibility of human errors, and an attempt to correct such human errors.  

If there was a mathematical construct which could precisely determine the eligibility of each Federal Disability Retirement submission, and there was unanimous agreement that the computer model was fair and without error, perhaps such a computer program will one day make the determination of an approval or denial of a Federal Disability Retirement application.  That is doubtful, however, because we are dealing with human beings, human medical conditions, and human suffering.  As such, the human factor can never be entirely eliminated, and nor should it.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for US Government Employees: Building Blocks

The analogy or metaphor in preparing, filing, and waiting (for a decision) in a Federal Disability Retirement application for FERS or CSRS employees, submitted for review before the Office of Personnel Management, is of a child with square building blocks. If at the first try, the outcome is a nod of approval, nothing further needs to be accomplished.  If, however, a third party (the Office of Personnel Management) comes along and knocks down the building blocks (analogy:  a denial from OPM), then the child must rearrange the building blocks anew, and perhaps add one or two more for reinforcement.  

Thus, depending upon the basis of OPM’s denial (which is often either irrelevant or self-contradictory, or both), one may want to reinforce that which was already gathered and organized, for a re-presentation of both the original evidence, and additional medical or other supporting evidence.  Again, if a third party (OPM) knocks down the second set of building blocks (a second denial at the Reconsideration Stage of the process), then it will be time for further reorganization, and for gathering of additional supporting building blocks.  When it gets to the Third Level of the process, the Merit Systems Protection Board, remember that all of the original building blocks of the process will still be there for the Administrative Judge to review.  That is the point of having the perspective of the entire process as one of “building blocks” — that the entire foundation is still there to be added to and reviewed, in the end, by an Administrative Judge.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: The Wait Seems Longer

For those waiting for their Federal Disability Retirement application under FERS or CSRS, pending before the Office of Personnel Management, the wait seems to be getting longer and longer.  Whether at the initial stage of the application process, or at the Reconsideration Stage, OPM is taking longer to make a decision on a pending application.  Everyone, of course, wants his or her application to be the next in line; and, indeed, it is all the more frustrating when an applicant is told that a decision will be made “within the next 2 weeks”, and after the 2-week period comes and passes, still no decision. 

What makes it worse is that, even after an approval, there seems to be longer delays in processing the approved application before payment is received.  Further, even after the “interim” payments begin, there appears to be a longer wait before a case is “finalized” for payment processing.  Each period of delay results in a ripple-effect throughout the system as a whole, and indeed, in these economic times of hardship, it  places an even greater burden upon those who need the financial benefit most — those who are disabled, and who rely upon the benefit of disability retirement payments for their very livelihood.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Thank the Medical Professionals

If not for the doctors, disability retirement would obviously not be a possibility.  Of course, one may make the self-evident statement that being supportive of a Federal Disability Retirement application is simply part of a doctor’s job; and, to some extent, that would be true.  Doctors should indeed be willing to write up supportive medical narrative reports for their patients. 

Nevertheless, it is because of the doctor, the effort expended, the willingness to testify at a Merit Systems Protection Board Hearing, that the Office of Personnel Management even listens, or reverses a prior denial, and grants a disability retirement application.  Especially when a case gets denied twice by the Office of Personnel Management, it becomes crucial to have the cooperation of the treating doctor to testify in an MSPB Hearing.  This is normally done by telephone, thereby making it a minimal imposition upon the doctor’s time.  Indeed, I often only take a total of 30 minutes of the doctor’s time, including preparation and actual testimony, for an MSPB Hearing.  But the very fact that the doctor is willing to testify — to speak to the Administrative Judge directly to give his or her medical opinion — is often enough to convince OPM to change course, and grant the disability retirement benefits. 

Sincerely,

Robert R. McGill

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