Federal Employee Medical Retirement: Statutory Violations

As with most bureaucracies, the Office of Personnel Management is first and foremost established and guided by statutory mandate.  However, there is a distinction to be made between the establishment of a particular agency, and the mission and substantive enforcement of the mission as mandated by statute.  

Often, in its very decision-making process of reviewing, evaluating and deciding upon a Federal Disability Retirement application (whether under FERS or CSRS), it is important to recognize that if a decision is made erroneously, it does not imply or infer a statutory violation.  The statute is open to various interpretations, and such openness lends itself to a wide array of discretionary decision-making.  Complaining or fuming about whether or not OPM violated its statutory mandate is an act of futility; the process itself provides for a paradigm of “checks and balances”  — of having the Merit Systems Protection Board and an Administrative Judge look at a case and hold a Hearing on a case “de novo” — meaning, “anew” or “starting fresh”.  

Further, if one believes that the MSPB Hearing and Administrative Judge rendered a wrong decision, there is the further step in the process of a Petition for Full Review, or an appeal to the Federal Circuit Court for review of any error of law made in the decision-making process.  However, the best course of action if one is still before the Office of Personnel Management, or about to present one’s case at the Hearing Stage of the MSPB, is to focus upon the substance of one’s case, and not upon whether or not OPM or anyone else violated its statutory mandate.  

Save your energy and choose your battles; moreover, it is important to keep a singular focus upon the proper goal — of obtaining one’s Federal Disability Retirement annuity.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: The MSPB

The Merit Systems Protection Board (better known by its acronym, the “MSPB”) is the third stage of the administrative process in attempting to obtain Federal Disability Retirement benefits under FERS or CSRS.  By this Stage, while the Office of Personnel Management has been both the “judge and jury” for determining one’s eligibility for Federal Disability Retirement benefits, the case is then handed over to an Administrative Judge to be the arbiter of such determination.

While it is advisable for a Federal or Postal Worker to obtain a FERS/CSRS Disability Attorney from the start of the administrative process, it is of even greater importance to consider obtaining proper legal representation before proceeding down the path of the MSPB.  This statement of advising any Federal or Postal employee to obtain proper representation at the MSPB is made for several reasons, not the least of which includes the following:  The MSPB is the last “stage” of the process in which a Federal or Postal employee who is seeking to obtain Federal Disability Retirement benefits may submit evidence in order to prove one’s case (with some special exceptions); any basis for an appeal, upon the chance that the Administrative Judge rules against you, must be established during the Hearing of the case at this stage; and since this stage is the arena of “the law”, it is important to be familiar with the most recent case-laws which govern Federal Disability Retirement.  The MSPB is not a place to feel one’s way through; it is the playground where the “grown-ups” play.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Workers: When to file for an MSPB Hearing

Filing for Federal Disability Retirement benefits under FERS or CSRS is what is generically known as falling under “Administrative Law“.  That is, Federal and Postal employees must undergo the administrative process of filing with a Federal Agency, the Office of Personnel Management, in an attempt to prove by a preponderance of the evidence that one is eligible for, and therefore entitled to under the law, Federal Disability Retirement benefits under either the Federal Employee’s Retirement System (FERS), the Civil Service Retirement System (the “older” system, or CSRS), or its hybrid, the CSRS-Offset.

If the Agency which makes the decision on eligibility, and it denies a Federal or Postal Service employee’s application twice (both at the Initial application Stage of the process, then again at what is termed the “Reconsideration Stage” of the process), then the disability retirement case can be appealed to an Administrative legal forum specifically set up to hear such cases (as well as many other types of cases involving Federal and Postal employees).

In order to file with the Merit Systems Protection Board (the “MSPB”), one must have received a “final denial” letter from the Office of Personnel Management — and, by “final”, is merely meant the “second denial” letter.  Thus, in order for the Merit System Protection Board (MSPB) to consider an appeal for one’s Federal Disability Retirement benefits, the Federal or Postal employee must have been denied by the Office of Personnel Management on the first two tries — first, with the Initial Application, then for an appeal or the ”Reconsideration” of that application.  Only then may a Federal or Postal employee who is filing for Federal Disability Retirement benefits under FERS, CSRS or CSRS-Offset file an appeal with the MSPB.

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

Federal Employee Medical Retirement: The Connection between the Prehearing Statement and the Hearing

When a Federal Disability Retirement application under FERS or CSRS has been denied twice by the Office of Personnel Management, and one appeals the Federal Disability Retirement case to the Merit Systems Protection Board, there comes a point when the scheduling order requires that each side (the “Appellant” or the one who filed the appeal, and the Office of the Personnel Management) file a “Prehearing Statement”.  

Do not underestimate the importance of preparing a Prehearing Statement.  It is not simply a listing of the witnesses to be testifying at the MSPB Hearing; more than that, it is an opportunity to set the issues, to form in the mind of the Administrative Judge the parameters of what will be proven; an opportunity to proffer and plant the seeds of the evidence which will be presented; to undermine and preempt many of the arguments which are used customarily by the Office of Personnel Management; to argue for the Bruner Presumption (even if it does not strictly apply); and to show how, at this preliminary stage of the process, that the upcoming Hearing is really an unnecessary event.  Thus, the Prehearing Statement, as well as the Prehearing Conference, is an important preliminary step in setting the stage for success in a Federal Disability Retirement case.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for Federal & Postal Employees: Beyond the MSPB

Because filing for Federal Disability Retirement benefits under FERS & CSRS is a process which may potentially take the full stages — from the initial application stage, to the Reconsideration Stage, to the Merit Systems Protection Board; then, if denied at the MSPB, to the Petition for Full Review, and if denied there, to the Federal Circuit Court of Appeals; as a result, it is a good idea to be represented by a Federal Disability Attorney.  Remember that the last two stages of the process only allow for arguing an error of law.  To that extent, if one pauses for a moment and reflects — everything ultimately comes down to an error of law.  Very rarely is there a misinterpretation of the facts. 

In a Federal Disability Retirement case, the medical evidence is fairly straightforward.  Yes, there can be some arguments concerning the interpretation of the extent and severity of the medical conditions, but the substantive focus of disagreement between the applicant and the Office of Personnel Management normally comes down to the appropriate application of the standard of law, and whether the application has met the burden of proof and satisfied the legal criteria for eligibility.  As such, the essence of a Federal Disability Retirement application comes down to whether OPM — and subsequently the Administrative Judge — has mis-applied the law.  Thus, at each stage of the process, it is important to lay the foundation by pointing out where the error of applying the law happened — at each and every stage of the process.

Sincerely, Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: The MSPB

The entire process of preparing and filing a Federal Disability Retirement application under FERS or CSRS should be accomplished with the view that it will end up at the Merit Systems Protection Board, being heard by an Administrative Judge.  This is why much thought and preparation should foreshadow each application.  There should be a running theme throughout the narrative which reveals the individuality of a person’s medical condition and how that medical condition impacts his or her ability/inability to perform one or more of the essential elements of one’s job. 

Truth should always be the guide; however, truth is always influenced by perspective.  It is the “perspective” of the Office of Personnel Management, in all Federal Disability Retirement cases under FERS & CSRS, to carefully scrutinize the narrative of the medical condition, impact upon the job, and the ability and inability to have the necessary connection between the two.  It is the perspective of the supervisor who will render his or her opinion based upon a limited knowledge and observation.  Perspectives must be questioned.  Thus, there is the opportunity for cross-examination at the MSPB level, which must be engaged in artfully and with care.  Each individual believes that his or her Federal Disability Retirement application is a “sure thing” at the First Stage of the process — until the reality sets in.  The reality, of course, is that every application must be prepared as if it is going to the MSPB, because it well might, and often does.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for Federal & Postal Employees: Listing the Medical Conditions (Continued…)

If an individual who has filed for Federal Disability Retirement benefits under FERS or CSRS later finds, during the process of waiting for a decision or, between the time of an initial denial and during the Reconsideration Stage or an appeal to the Merit Systems Protection Board — that a previously unlisted medical condition has worsened, can he “add” that medical condition to his Federal Disability Retirement Application?  Can he file an “amended” SF 3112A, Applicant’s Statement of Disability?  The general answer is, “No”. 

However, one can certainly submit a medical report concerning such “previously-unlisted” medical condition if one can reasonably argue that the previously-unlisted medical condition was in fact listed, right there for everyone (i.e., the Office of Personnel Management) to see.  This issue comes up often enough to be of concern, especially because of the valuable time lost in being forced to “withdraw” an application for OPM Disability Retirement and to start all over again in order to add a “new” medical condition.  To safeguard against such a potential event, it is wise to read through the multiple medical conditions when putting together an OPM Disability Retirement packet, and decide which primary diagnoses to include, and at the same time, to “weave” into the narrative of the description of medical conditions, symptoms and areas of pain which can be reasonably interpreted to encapsulate potentially underlying medical diagnoses which may later become prominent and require greater focal emphasis.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: The Problem with Answering an OPM Denial

A denial of a Federal Disability Retirement application under FERS or CSRS from the Office of Personnel Management always leaves the applicant and his or her attorney at a disadvantage.  This is because OPM is never answerable to any resulting consequence of a denial; at least, not directly.  Think about it this way:  In the initial application, if an OPM Disability Retirement application is properly prepared and submitted according to, and within the parameters of the laws governing Federal Disability Retirement, one would assume that it should be approved.  If it is denied, then the case is sent to the “Reconsideration” division of OPM — meaning, to another person. 

Now, taking it out of the hands of one OPM Representative into the hands of another, has both the good and the bad mixed together:  the good is that it will now be reviewed afresh by someone else; the bad is that the person who denied the original application has no further responsibility for the denial.  This is true, incidentally, with respect to the Reconsideration Stage of the process; if a second denial is issued, the person who issues the second denial also has no responsibility to answer for the basis given in the denial. 

The “light at the end of the tunnel“, however, comes when it is finally taken up by an Administrative Judge at the Merit Systems Protection Board.  While the AJ cannot hold anyone at OPM responsible for a denial which never should have been, at the very least, when the AJ reviews the record and finds that the previous denials were unfounded or rationally without legal foundation, an immediate recognition of a baseless denial can help the applicant.  Ultimately, rationality and legal integrity has a chance to prevail; it sometimes takes more than one bite at the apple.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Service Disability Retirement: Each Level of the Process

Disability retirement, as I have often written about, is a process.  Each stage of the process has certain “requirements” which should be met — by “requirements”, I mean that each stage of the process (the Initial Application Stage, the Reconsideration Stage, and the Third Stage of the Process, a Hearing before an Administrative Judge at the Merit Systems Protection Board) has certain aspects of proof, certain methods of approaching the level of satisfying the burden of proof, etc.  There are, of course, the further stages of Appeal — at the Full Review at the MSPB, and the Federal Circuit Court of Appeals — but these appellate stages deal only with whether or not the Administrative Judge applied “the law” properly or not.

Thus, at the first three stages of the process, there is the necessary requirement of “winning” by submitting the proper medical and other evidence, to persuade the Office of Personnel Management and the Administrative Judge that your Federal Disability Retirement application under FERS or CSRS meets the legal criteria for eligibility.  This is the season for Reconsiderations; the Office of Personnel Management will often make many of its decisions just before Christmas, and just before the end of the year.  If an applicant under FERS or CSRS gets denied at the Initial Stage, just make sure that you hire an attorney who knows what he or she is doing, and isn’t just a “general practice” lawyer who is as blind as the next person, and will merely be one blind person leading the blind.  Each Stage of the process requires a level of expertise to meet the “requirements” necessary to satisfy that particular level; just make sure that you will be led by an attorney who not only knows what those requirements are, but further, knows how to meet those requirements.

Sincerely,

Robert R. McGill, Esquire