Federal and Postal Disability Retirement: Periodic Clarifications

Periodically, despite multiple prior blogs addressing certain issues, it becomes clear that confusions continue to abound, and a clarification is in order.

In many ways, such necessity for periodic clarifications only emphasizes the inherent complexities in Federal Disability Retirement law, despite the foundational simplicity of what needs to be proven.

Indeed, while the substantive law requires the primary basis of proving, by a preponderance of the evidence, the nexus between one’s official positional duties, and the medical conditions which prevent one from performing one or more of the essential elements of one’s job; nevertheless, there are numerous procedural issues and hurdles which must concurrently be met in order to qualify for Federal Disability Retirement benefits.

Thus, for instance:  the Federal or Postal employee must file an application for Federal Disability Retirement benefits within one (1) year of being separated from Federal Service — not 1 year from the date of being placed on LWOP, or from the “date of injury”, etc.

Further, SSDI must be filed by FERS employees, but of course Social Security will not even consider a filing for purposes of evaluating eligibility until a person has stopped working — nevertheless, for FERS Disability Retirement purposes, all that is necessary is a receipt showing that one has filed for Social Security Disability benefits.

And one more:  never wait for one’s agency to act in a Disability Retirement case; such waiting merely constitutes an act of futility, and one which almost always results with an adverse effect upon the Federal or Postal employee.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Standards

The existence of a standard constitutes an irrelevancy if the application of it is based upon an unknowable, incalculable methodology.  Standards represent a paradigm which, if implemented, provide for stability and consistency, precisely because one can rely upon the same application in all instances, and indeed, that is what is often defined as “fairness”.

Thus, in sports — if the referee makes all calls based upon a known standard, there is very little to argue with respect to the “rules”; one may, of course, challenge the interpretation of the “facts” and charge that the referee is blind and did not see the play as reality reflected; but no one can argue the minutiae of the standard itself.  In society, and in a civilization governed by rules and accepted procedures of administration, if a standard is disagreed upon, then a democratic method of change is normally considered an appropriate methodology of redefining the lines previously demarcated by the “old” standard.

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 assumed that the standard which would constitute “fair play” will be one of “preponderance of the evidence”, but the actual implementation of such a legal standard will necessarily depend upon whether the Case Worker at OPM actually understands what that standard means.

It is, ultimately, a low civil “bar” to meet; and when a denial is rendered, the language contained within the denial will often reveal the extent of comprehension on the part of the OPM Case Worker.  Pointing a misapplication of the standard is sometimes a useful tool in taking the Federal Disability Retirement case to the next level — the Reconsideration Stage of the process — but unduly focusing upon the mistakes of the previous Case Worker is often a waste of time.

Balance is the key; application of the correct standard is vital to the working efficiency of a bureaucracy; pointing out a misapplication is why attorneys exist.  They are, ultimately, technicians of written standards.

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 a Federal 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 Federal Disability Retirement benefits.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Medical Support, Belief, Documentation and the Diagnosis

Ultimately, in preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, one must always remind one’s self that this is a “paper presentation” (regardless of the prevailing and inevitable march towards a paperless society) to the U.S. Office of Personnel Management (OPM).  As such, there are certain inextricable components in the presentation itself, which must be reviewed, evaluated, and decided upon before proceeding.

As a “presentation” which is meant to be persuasive — i.e., proving by a preponderance of the evidence that one is entitled to the Federal Disability Retirement benefit, whether under FERS or CSRS — it must obviously have the essence of the proof itself:  Medical Support.  Without the medical support, one need not consider moving forward at all.

Once the Federal or Postal employee has ascertained that he or she has the medical support to proceed, then the question is one of obtaining the documentation which confirms such support.  For, a pat on the back and a wonderful smile from the doctor will not be persuasive to OPM; the doctor must be willing to document, in detailed format, the support which is expressed.

Next, in sequential order, the medical documentation must reveal, convey, and persuasively reflect, a level of belief which will be tested in the event that the Federal Disability Retirement application is denied at the First Stage of the Process, and further tested if it is denied at the Second, or Reconsideration Stage, of the process.  Thus, in short, the treating or supporting doctor must possess a level of belief in one’s case, and be willing to support that belief throughout the entire administrative process.

Finally, the doctor must be able to make a diagnosis, but more than that, to support the diagnosis, and be willing to make the “nexus” between the diagnosis, the patient’s physical, emotional and cognitive capabilities, and to relate them to one’s positional duties of one’s job.  It is through this process of connecting the dots, where the end-goal is achieved:  of obtaining one’s Federal Disability Retirement benefits.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Workers: Corresponding Responsibilities

The problem with being responsible for something, is that the moment there are any consequences which result from the assertion of it, everyone lifts their finger and points it in another direction.

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 the responsibility of the Applicant to prove by a preponderance of the evidence, that he or she is eligible and entitled to Federal Disability Retirement benefits.  Yet, those who simply go through either the local or district Human Resources (sometimes euphemistically referred to as the “Human Capital” or appended with a conceptually interesting term, “Services”) Office, will be requested to sign SF 3112C, the “Physician’s Statement“, where, at the top of the form, a box for a return address exists.  The address to which the physician’s statement and medical records are sent, is often filled in as the Agency’s H.R. Office.

Thus, the consequence of such a chain of events will often be:  the individual Federal or Postal employee, who has the responsibility to prove by a preponderance of the evidence one’s Federal Disability Retirement application from OPM, will have a doctor, medical facility, psychiatrist, therapist, and any number of medical providers, directed to forward sensitive medical documentation directly to an agency’s Human Resources Office, prior to reviewing such documents for accuracy, effectiveness or requested formulation.  And if the Federal Disability Retirement packet is sent over to OPM, and is then denied based upon information which is either inaccurate or incomplete, to whom will the finger be pointed at?

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for US Government Employees: The Legal Standards

Recent decisions issued by the Full Board of the U.S. Merit Systems Protection Board — specifically, Henderson v. OPM, decided on January 31, 2012, reestablishes the two general standards of applicable evidentiary approaches in proving a Federal Disability Retirement case, whether under FERS or CSRS.  Whether or not the U.S. Office of Personnel Management will “comply” with the applicable standards as set forth by the MSPB is another question.

Often, the “trickle-down” effect of a legal opinion can take years to accomplish — and by that time, further refinements by the courts and by the MSPB may have made such legal opinions moot, irrelevant or otherwise restrictive in its practical application, anyway.  For the time being, however, the two legal approaches can be generally stated thus:  One must prove, by a preponderance of the evidence in all Federal Disability Retirement cases, either (A)  That certain specific medical conditions prevent one from performing certain specific essential elements of one’s job (somewhat like a 1 – 1 correspondence, or more generally, a medical opinion showing that medical condition X prevents job duties Y because of Z) or (B) as stated previously in Bruner and multiple other cases, there is an “inconsistency” between one’s medical condition (or multiplicity of medical conditions) and the type of positional duties one must engage in to perform the essential elements of one’s Federal or Postal job.

The former criteria to satisfy may be deemed “particularized”; the latter may be seen as a more “generalized” approach.  While there is certainly a conceptual distinction between the two, in pragmatic terms, such a distinction may be without too much difference, if only because doctors will often go back and forth between the two approaches, anyway, in writing a medical narrative report.

The conceptual distinction is not as apparent as one between “explicit” and “implicit”, but certainly the former approach encapsulates a greater specificity of detailing a connection between X and Y, whereas the latter requires the reader or reviewer (i.e., OPM or the Administrative Judge) to think through and analyze the entirety of the issue.  But that life would not be so complicated.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: Obtaining, Maintaining and Preserving

Just as preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management is an administrative process — as opposed to an “entitlement” where a simple act of filing or meeting an automatic requirement makes one eligible and entitled — where one must prove by a preponderance of the evidence that the Federal or Postal employee meets all of the legal criteria for eligibility; similarly, once the Federal or Postal employee obtains the Federal Disability Retirement benefits, it is a “process” which one must be prepared to embrace, in order to maintain the continuing viability of one’s Federal Disability Retirement benefits, and further, in order to preserve the right to retain and continue to receive the Federal Disability Retirement benefits.

That is why it is important to understand the entirety of the administrative process — not only in obtaining the benefit itself, but to ensure future compliance with the statutes, regulations and case-law.  While legal and on-line resources are certainly available and abound with information, ultimately those very resources must be applied; and in order to apply them, they must be interpreted by someone who understands the entirety of the administrative process.  “Trial and error” is often not the best approach in preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, if only because the “error” may outweigh the benefit of the trial itself.

As such, it is advisable to consult with an OPM Disability Retirement attorney  who can guide one through the administrative process — not only at its inception, but in its continuing maintenance and retention of this benefit called, Federal Disability Retirement.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Workers: The Corresponding Bridge

In preparing, formulating and filing for Federal Disability Retirement benefits from the Office of Personnel Management, whether under FERS or CSRS, the Federal or Postal employee must always keep in mind the overriding connection throughout the entire administrative process — the correspondence between the medical condition and one’s positional duties.

Thus, redundancy and reiteration of the impact and connection between the two elements should be seen at every turn — in the medical reports; in the applicant’s statement of disability; in the Supervisor’s Statement (if possible); in the SF 3112D, Agency Efforts for Reassignment and Accommodation, etc.  

As Social Security bases its decision in determining the disability of an applicant upon factors which involve the medical condition itself and its impact upon daily living abilities, so Federal Disability Retirement under FERS or CSRS takes a different focus and approach:  it emphasizes and evaluates the necessary connection between the medical condition one suffers from, and the impact upon one’s positional duties in the official slot held by the Federal or Postal employee.  

As the law focuses upon that “necessary connection,” so the evidence which is presented to the Office of Personnel Management, in meeting the legal criteria by a preponderance of the evidence, must emphasize and repetitively, where possible, delineate such a connection.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Government Employees: A Bridge Too Far

The step-by-step process which the Federal or Postal employee must engage in for purposes of formulating an effective Federal Disability Retirement application under FERS or CSRS, is defined by the bridge, or “nexus”, which one must formulate, connecting the two separate entities:  on the one side are the medical issues; on the other, one’s positional duties which one has been engaging in and successfully performing all these many years for one’s agency or the U.S. Postal Service.  

The job of the potential Federal Disability Retirement applicant is to bring the two separate and distinct entities together, by preparing and formulating a connecting “bridge” or “nexus” between the two.  This is because one of the most important evidentiary showings that one must prove, by meeting the legal standard of “preponderance of the evidence“, is that the Federal or Postal employee is no longer able to perform one or more of the essential elements of one’s official positional duties.  

The problem with any such bridge which must be constructed and carefully formulated, however, is that many Federal Disability Retirement applicants put forth too much information, to the extent that some information may in fact defeat or otherwise damage the connection, by providing information which may be irrelevant (less damaging, but creates peripheral problems and confusion), of ancillary legal issues (may be more damaging, depending upon whether the Federal Disability Retirement applicant has brought in work-related issues which may point to a description of “situational disability”); or, provide information on certain medical conditions which contradict other information provided (again, often more damaging to a case).  

It is always important to provide enough information to the Office of Personnel Management to meet the burden of proof, of a preponderance of the evidence, in preparing, formulating and filing a Federal Disability Retirement application; too much information will sometimes be damaging; too much of the wrong kind of information may be very damaging.  As the title of the well-known book implies, one must be careful not to construct a “bridge too far”.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: OPM’s Standard of Proof

In reviewing a Federal Disability Retirement application under FERS or CSRS, the mandate of burden is determined both by statute and regulation, and the Merit Systems Protection Board reiterates the burden of proof in each of its decisions — that of proving one’s case by a “Preponderance of the Evidence“.  

This is a relatively low standard of proof — of showing that one is eligible and entitled to Federal Disability Retirement benefits under FERS or CSRS based upon a showing that, with all of the evidence considered, it is more likely than not that the Federal or Postal employee has shown that he or she cannot perform, because of one or more medical conditions, one or more of the essential elements of one’s job.  

There is often a question as to whether this same standard of evidentiary showing applies to the Office of Personnel Management, and this question is posed because of the statements made in many of the denial letters (which then prompts a necessary request for Reconsideration, or an administrative appeal to the 2nd Stage of the process; or, if denied at the 2nd Stage — the Reconsideration Stage — then an appeal to the Merit Systems Protection Board) issued by the Office of Personnel Management, to wit:  The evidence you submitted did not show a “compelling” reason why you could not…; The medical evidence did not show that you had to be “excluded from the workplace completely”; and other statements which seems to require a higher showing than that of “preponderance of the evidence“. 

OPM is supposed to follow the same standard of proof — that of preponderance of the evidence.  Sometimes, they need to be reminded of it.  

However, inasmuch as the safety mechanism for review of an improper standard is an appeal to the Merit Systems Protection Board, such a reminder often must take the form of an appeal.  Without the appeal basis, the Office of Personnel Management can ignore the relevant statutory burden of proof.  But then, that would not be the first time that an agency acted in a non-compliant manner.

Sincerely,

Robert R. McGill, Esquire