Federal and Postal Disability Retirement: Targeted Use of Collateral Evidence

Case-law from the U.S. Merit Systems Protection Board, as well as judicial opinions rendered by the U.S. Court of Appeals for the Federal Circuit, maintain the standard of acceptable proof for a Federal Disability Retirement case submitted to the U.S. Office of Personnel Management, for Federal and Postal employees under either FERS or CSRS.

The primary basis for a Federal Disability Retirement application is clear:  A medical condition which exists, which prevents the Federal or Postal employee from performing at least one, if not more, of the essential elements of one’s job; that a legally viable accommodation is not possible; that reassignment to another position at the same pay or grade is not reasonably feasible; that the medical condition will last a minimum of 12 months; and that the Federal or Postal employee must file for such benefits during the tenure of one’s employment as a Federal or Postal Employee, or within 1 year of being separated from Federal employment.

The core of one’s proof is generally based upon the treatment and opinion of one’s treating doctor.

Every now and again, however, there are “collateral” sources of proof which should be considered, and for various reasons, which must be relied upon for establishment of one’s eligibility for Federal Disability Retirement benefits.  Such proof may include: opinions rendered by Second-opinion or “referee” doctors in an OWCP case; percentage ratings provided by the Department of Veterans Affairs; SSDI approval determinations; separation from the Agency based upon one’s medical inability to perform the essential elements of one’s job; medical notes for FMLA; and even (sometimes, but rarely) a decision granting disability benefits by a private insurer; and other such collateral sources of proof.

Such proof, of course, should never replace the centrality of one’s own treating doctor, and further, should always be targeted and submitted with discretionary judgment.  Sometimes, it can be the “other evidence” which makes the difference in a case; other times, if used indiscriminately, can be an indicator of the weakness of one’s case.

Be careful; be targeted; use discretion.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Workers: Undue Focus upon Minutiae

It is like the story of the man who rushes in breathlessly and declaratively warns others of the impending tornado, and with only minutes to spare, he is stopped and asked, “But will we still be able to watch our evening shows?”  The focus upon relevant details; of the “larger picture“; of logical and sequential sets of facts, as opposed to getting irrelevant information correctly stated, is often a problem in writing effectively.

The ability to use discretionary choices in separating factually important descriptions from those which are tertiary at best — will result in having the reader focus upon the essential aspects of one’s presentation, in any context or forum.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, it is vitally important to separate and bifurcate that which is primary in importance, that which is secondarily of relevance, and those factual minutiae which, even if left out, will make little or no difference to the substantive content of a Federal Disability Retirement application.

Often, Federal and Postal employees who suffer from severe psychiatric conditions will unduly focus upon minutiae which, in the context of their medical conditions, are exponentially quantified in magnified importance beyond reason or rationale.  One must understand that such is the very nature of the psychiatric condition itself; but recognizing it as such, and trusting in the wise counsel and advice of one’s attorney, is the best first step in making sure that one’s Federal Disability Retirement application will have a fighting chance for an approval.

Sincerely,

Robert R. McGill, Esquire

Federal Worker Disability Retirement: Discretionary Extraction

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, there is often the question of whether X should be included, or Y should be left out.  Whether certain elements, issues, substantive descriptions, etc., should be included, excluded, extracted or otherwise inserted, largely falls into discretionary decision-making; sometimes, however, personal or professional discretion should not be the guiding criteria; rather, the compelling necessity directed by the legal requirements should dictate the decision itself.

Making such decisions often fall into three basic categories:  Substantive; ancillary; an admixture of the first and second.  Obviously, “which” medical conditions should be included will normally fall into the substantive category; the “history” of the medical condition, the circumstances under which the medical condition came about, and certain medical conditions which one might suffer from, but which have little or no impact upon one’s ability/inability to perform the essential elements of one’s job, might be considered ancillary; and lastly, the admixture of the two — of agency-induced issues which may have resulted in an EEO action; stress-related conditions from a hostile work environment:  these must be considered carefully, and should rarely be included in a Federal Disability Retirement application.

Ultimately, the guiding principle should be:  Don’t muddy the waters.  But the true guide should always be “the law”, and what purports to uphold that which proves by a preponderance of the evidence a Federal Disability Retirement application.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Workers: Discretion, “What Ifs”, Etc.

The anxiety and angst which accompanies the preparation, formulation and filing of a Federal Disability Retirement application under FERS or CSRS, from the U.S. Office of Personnel Management, is on the one hand understandable, and yet, because it is an administrative process which may potentially involve multiple stages, and require investment of an extraordinary amount of time, and because it is requires a rationally-based approach in meeting the legal criteria for approval, it must be viewed and approached with a quietude of professionalism.

There are obviously times when the Statute of Limitations is about to impose some restrictive encroachment of formulation, and thus one must respond appropriately.  And, much of the decision-making process involved in whether to attach X-document, or to include Y-statement, is a discretionary matter — one which should often be left to an OPM Disability Attorney who has had some prior experience in the matter.

But the “what ifs”, as in, “What if I say A” as opposed to “having said B” is something which should be avoided.  Obsessing over singular statements — even if it is true that a denial of a Federal Disability Retirement application could potentially focus upon a statement, characterized in a wrong manner, or taken out of context (as OPM often does) — is normally unproductive.

While most “mistakes” in a Federal Disability Retirement application can be corrected, explained or expanded upon into obsolescence, one thing which cannot be accomplished is to put artificial blinders on OPM in the event that something is stated or submitted which otherwise should not have.  Even if one were to refile at a later date, once a CSA Number is assigned to a case, the U.S. Office of Personnel Management maintains the original documentation which was filed with their office.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Disability Retirement: Discretionary Decisions

In preparing, formulating and filing for Federal Disability Retirement benefits under FERS or CSRS, there are obviously the “basics” which one must submit, in order to meet the legal standard of proof of preponderance of the evidence.  

Thus, submitting “adequate” medical documentation which formulates a nexus between the medical condition upon which the Federal Disability Retirement application is based, and the essential elements of one’s job; writing the descriptive narrative to complete the Applicant’s Statement of Disability (SF 3112A), and filling out the other standard forms in order to meet the minimum requirements, are deemed “non-discretionary”, in that one does not have the choice of filing such paperwork  — it is a requirement.  

However, certain other documentation can be designated and categorized as “discretionary” —  whether to include certain medical conditions, and therefore medical documentation which bears upon the particular medical condition; whether to include paperwork from one’s OWCP, Department of Labor filing; Veteran’s Administration ratings, findings, medical documentation; Social Security Disability paperwork; additional statements from co-workers; Private Disability Insurance paperwork, etc.  

“Discretion” implies freedom to act or not act, but the problem will often arise, “In what context”?  Discretion is a wonderful, liberating position to be in; acting effectively in a discretionary manner requires research, and knowing the relevant criteria to apply in making a proper decision; and an understanding of the laws governing Federal Disability Retirement in making the “right” discretionary decision.  

Using discretion in making discretionary decisions is the key to obtaining a positive discretionary determination from the Office of Personnel Management.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: SSDI Approval as a Special Case

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, there are multiple discretionary decisions which must be made in preparing a paper presentation to the Office of Personnel Management.  For instance, should determinations made by Second-Opinion or Referee doctors in a case which concurrently involves OWCP issues be included in the submission?  Should VA ratings be part of the packet?  Should determinations by a private disability insurance company be included? Should a determination by the Social Security Administration — which often will come about when the packet has already been submitted to the Office of Personnel Management while awaiting a decision — be forwarded to OPM?  

In proving one’s eligibility for Federal Disability Retirement benefits under FERS or CSRS, one must affirmatively prove, by a preponderance of the evidence, that one is eligible for the benefit.  That leaves much of the decision-making process regarding what information is relevant, helpful, pertinent and substantive, up to the Federal or Postal employee and/or his attorney to decide.  There are multiple details, and it is often in the minutiae and details which will win or lose a case.  Should all medical conditions be made a part of the packet?  

These are all discretionary issues to be decided, with the possible exception of Social Security.  Inasmuch as SSDI must be filed, and inasmuch as the statutory mandate is that SSDI and a FERS Disability Retirement annuity must be offset if both are approved, an approval by SSDI is a special case which is non-discretionary.  Not only must OPM be informed of its approval; under the case-law, it must be considered in the process of deciding upon a Federal Disability Retirement case.  Nevertheless, it still remains merely persuasive authority, and not determinative.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Discretionary Determinations

Reviewing medical documentation often involves a discretionary determination in preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS.  Relevant documentation should be filed as an attachment in support of a Federal Disability Retirement application; sometimes, medical reports, notes and records which are from specialists or referral doctors, contain information which is helpful, irrelevant, or detrimental to an application, and determinations as to whether to file it or not is a matter of discretion.  

It is the responsibility of the Federal or Postal employee to prove, by a preponderance of the evidence, that one is entitled and eligible for Federal Disability Retirement benefits under FERS or CSRS.  Meeting the criteria of eligibility is a matter of some latitude; determining what evidence to include involves a certain amount of discretion; in either case, one must affirmatively prove one’s case.  

Thus, FMLA paperwork previously completed by the doctor may have addressed a particular issue for a specific timeframe; OWCP forms previously filled out by the doctor may pertain more to a particular time-period or for the issue of causation, etc.  In the totality of the picture of one’s history of medical conditions, one must utilize a discretionary sense of wisdom in determining which medical evidence will be helpful, and which may potentially hinder.  It is never an exact science; but then, science itself is no longer an exacting endeavor.

Sincerely,

Robert R. McGill, Esquire