Federal Disability Reconsiderations & Additional Medical Information

The denial comes in the mail; it is a further delay, a negation of prior efforts; for many, it undermines and constitutes a condemnation of sorts, and a refusal of an affirmation sought in places and from people where none is offered.  It is, after all, another piece of correspondence which negates the negative:  the medical condition itself and the loss of one’s ability to perform one or more of the essential elements of one’s job, represented the first foundation of negation; now, a denial from the U.S. Office of Personnel Management merely confirms, via a second negation, the loss of positive forces inherent in failure and Federal bureaucracies.

But all things in life must be kept in their proper perspective, and a reaction of disproportionate magnitude must be kept in check; life is often a series of mishaps; yes, it just seems that such unfortunate events happen to certain individuals, and as the old adage goes, when it rains, it pours.  Once the initial shock of the denial is withstood, then the trepidation and cautious perusal, followed by an obsessively careful scrutiny, of the reasons for the denial issued by the U.S. Office of Personnel Management, is engaged; but the futility of such efforts will become apparent.

The monotony and disinterested voice behind the volume of verbiage and almost bellicose verbosity becomes more than apparent: either the administrative specialist at the U.S. Office of Personnel Management did not read the medical file or, more likely, selectively chose to extrapolate statements and findings out of context in order to justify the denial of one’s Federal Disability Retirement application.

At this Second Stage of the process of trying to obtain Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether the Federal employee is under FERS or CSRS, it matters not what the words say with respect to the denial issued by OPM; the file is immediately transferred to a general, unassigned file, awaiting further instructions from the person to whom the denial has been issued:  if left unanswered, the file will disappear within the cauldrons of bureaucratic warehouses; if a Request for Reconsideration is timely filed, then it will ultimately be assigned to someone in the Reconsideration Division at OPM; but, in either case, it is no longer the responsibility of the OPM representative who issued the denial, and no amount of phone calls, venting or sending of additional information to that person will make a whit of difference, until (a) the Request for Reconsideration is timely filed, and (b) the Federal or Postal employee addresses some of the concerns brought up in the denial itself.

The Reconsideration process itself is fraught with dangers and potential pitfalls; it confirms that perhaps the Federal or Postal employee should have sought the advice, counsel and guidance of an attorney who specializes in Federal Disability Retirement law, but moreover, as most mistakes are correctable, it may be a wise avenue of choice to seek legal assistance, finally.

In any event, time factors must be considered, and the time lost today by extension of a denial, further confirms the oldest adage of all, that being penny wise is to be pound foolish,  a saying that is often attributed to Benjamin Franklin, but can be traced to those earlier.

Sincerely,

Robert R. McGill, Esquire

 

Disability Retirement for Federal Workers: Responding to OPM Templates

One can readily discern a template-based letter; it attempts to appear as if the denial is tailored to the particular set of circumstances and unique medical submissions of the Federal or Postal employee to whom the letter is addressed, but upon closer inspection, most of the language could to interchangeably utilized for anyone or everyone.

There may be a paragraph or two which quickly identifies or otherwise lists certain specific medical reports, with names of doctors and the dates of their reports; aside from such references, however, the rest is merely a template of language which is cut and pasted for purposes of justifying a denial.

Such is the administrative, bureaucratic approach of the U.S. Office of Personnel Management.  And, indeed, templates in and of themselves are not necessarily indicative of anything negative; for, as reinvention of the wheel should not be performed for each task engaged, so every Federal Disability Retirement application must meet a certain set of legal criteria, and to that extent they are “all the same”.  The problem in responding to a template-based denial from the U.S. Office of Personnel Management, however, is the disadvantage one is placed in for responding to such a Letter of Denial.  For, the template can contain multiple points which seemingly require a response, and which may appear overwhelming.

Don’t be fooled.  To address each and every point of contention is often to get mired into a level of minutiae which need not be engaged.  Take a wider view of things, and get some guidance and advice.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: The Syndrome of, “I Can’t Understand It”

In all aspects of life, both professional and personal, it is easy to get stuck in a rut where one cannot walk away from a particular irritant.  

In preparing, formulating and filing for Federal Disability Retirement benefits under FERS or CSRS, one cannot afford to engage in the luxury of pausing for too long in attempting to understand the reasoning, rationale, or alleged justification for a denial of a Federal Disability Retirement application under FERS or CSRS, as issued by the Office of Personnel Management.  

It is easy to get caught up in attempting to “figure out” the foundational basis of an OPM denial.  One can get stuck in a self-pity mode of asserting to one’s self that everything had been carefully gathered; the medical documentation was impeccable and irrefutable; even the Agency supported the Federal Disability Retirement application by acknowledging and conceding the fact that (A) the Federal or Postal employee’s medical documentation was of a severity such that (B) it prevented him or her from performing one or more of the essential elements of one’s job.  

Yet, while listing each of the medical evidence and recognizing the extent of the symptomatologies, the prior surgeries, the medication regimens, etc. — despite all of that, the concluding sentence by the Office of Personnel Management states:  “We cannot determine by the evidence presented that you are disabled under the law,” or, “The medical evidence submitted is insufficient to meet the criteria for Federal Disability Retirement purposes.”  

What?  However, it is best to simply “move on”.  

It does little to no good to remain entrapped in the syndrome of, “I can’t understand it,” because that same syndrome inevitably leads to, “I am going to waste my time trying.”  Extract what can rationally be understood; present updated medical information; prepare the best and most compelling legal arguments, and prepare for the long haul of the legal administrative process.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Workers: Patience & the Hinge

The hinge on a door is the mechanical contraption which allows for the swinging motion to occur.  Without it, the door will remain in place or, if one attempts to pull at the door, it will merely move towards you and continue to block the pathway.  Metaphors have been created from the invented device — a person can become “unhinged” meaning, similar to a door collapsing, a man or woman can lose the hope that a door represents as an entrance or an exit, to enter or leave.  

Preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS for the Federal or Postal employee can represent that “hinge” on a door.  It allows for hope viewed from a perspective of “now”, representing one side of the doorway, involving the debilitating medical conditions, the impact both upon one’s professional abilities, as well as upon the personal life with its correlative issues touching upon wives, children, parents, financial instability, etc.; and on the other side, the potential to receive a basic annuity so that one may exit in order to attend to the serious medical conditions without fear of becoming homeless.  

Yet, during the process of attempting to obtain Federal Disability Retirement benefits, because of the long delays, the months upon months of uncertainty awaiting for the decision from the Office of Personnel Management, the hinges can begin to rust and crumble.  This is especially true if a denial is received at the First Stage of the process, because it appears as if the door has slammed shut, and the hope for exiting and entering a different phase of one’s life has been lost.  But one must never lose the proper balance and perspective that is necessary to survive the fulfillment of the entire administrative process.  

Filing for, and obtaining, Federal Disability Retirement benefits under FERS or CSRS is a process — the First Step is merely that:  part of the entirety of the process.  A denial at the Initial Stage of the process does not constitute an unhinging of the doorway to the future; rather, it merely represents a moment of time when the door got stuck because of the change in weather, where the wood expanded for a season, making it difficult to open it.  It just needs a little more effort, and patience, to take it to the next step of the process.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: The Initial, Reactive Response

When a denial is received at the first stage of a Federal Disability Retirement application process, the initial, reactive response is often one of two avenues, both of which are the wrong paths to venture down:  either a Federal or Postal employee immediately writes an angry, emotional response or he/she gives up and decides that the statements made, the reasons given, etc., in the denial letter from the Office of Personnel Management are too powerful and overwhelming to overcome.  

Both responsive avenues constitute the wrong approach; neither responsive approach reflects the true state of the case.  

While there may be cases where the applicant has failed to make even a minimal attempt at meeting the burden of proof in a Federal Disability Retirement application, such a case is one in which the undersigned attorney has never encountered.  For, there is a presumption (a truthful one, I believe) that filing for Federal Disability Retirement benefits is never out of choice, but always out of necessity.  

Federal and Postal workers don’t file for Federal Disability Retirement benefits without good cause.  In a denial letter from the Office of Personnel Management, the statements made and the claims of rational discourse as to the reasons for the denial, do not mean that they are true.  Just because OPM says so, doesn’t make it true. Careful thought, reflection, and thoughtfulness of strategy in responding to an OPM denial is what is needed.  Do not react — at least, not initially.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement for Federal Workers: Reconsiderations

When a Federal Disability Retirement application under FERS or CSRS is denied at the first stage of the process, a Federal or Postal worker who filed for the benefit has the administrative right to request that it be “reconsidered” by the Office of Personnel Management.  Once requested, the case file is turned over to the “Disability Reconsideration Branch” of the office, and will be reviewed and evaluated by a Disability Specialist — not the same person who reviewed it at the Initial Stage of the process. 

A person who has filed for Federal Disability Retirement benefits has thirty (30) days to Request Reconsideration.  While the 30-day period may arguably have some flexibility based upon when the applicant actually received the denial letter, it is nevertheless a good policy to adhere to the 30-day time-frame by counting the date of the denial letter as the “beginning” date.  Obviously, it is better NOT to be placed in a position of having to argue whether or not the applicant met the 30-day deadline.  Further, it is best to send it in via a means where confirmation of receipt can be shown.  OPM is a large bureaucracy, and things get lost in the morass of the volume of submissions.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Unequivocal Doesn’t Mean That One Is “Right”

In a denial letter from the Office of Personnel Management, the Claims Specialist/Representative will often make statements in confident, unequivocal terms.  “You have not…”   “The medical evidence fails to show…”    “Your doctor never…”   “The law requires that you…”  Such a voice of unequivocal confidence often leaves the impression that there is no room for argument; that the case is lost; that there really is no point in even attempting to argue with the Office of Personnel Management.  Nothing could be further from the truth. 

Merely because an individual makes statements in an unequivocal manner, is not a basis for determining the truth or falsity of his or her argument.  In a Federal Disability Retirement application under FERS or CSRS, there is almost always room for disagreement.  We are speaking about interpretation of medical documents, the significance of what is said, etc.  We are talking about the different and proper application of the OPM Disability law, and the multitude of case-law which would be applicable.  Don’t let the voice of a statement fool you as to the validity of the statement.  In a Federal Disability Retirement case, the Office of Personnel Management is rarely right; they just like to sound like they are.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: The Strategy of Disheartening the Opposition

When Federal and Postal employees who have filed for FERS Medical Retirement benefits and have been denied at the initial stage of the process, many are sincerely disheartened.

In my initial contact with the denied applicant, there are multiple levels of reactions, including:  the denial letter points to legal criteria which they were unaware of; it refers to doctors notations which are taken completely out of context; they have completely ignored major portions of what the doctor has stated; OPM points to legal criteria which has been met, but which OPM simply denies that it has been met.

What can be done?  This is the strategy of disheartening the opposition.

In other denials, it is simply a matter of referring to a doctor’s report here, and to a medical notation there; then to simply declare:  You have not submitted sufficient medical documentation and fail to meet the legal criteria to be eligible for Federal Disability Retirement benefits.

What can be done?  No explanation; just scant references, then a unilateral declaration.  Again, this is the strategy of disheartening the opposition.  What to do?  Don’t get disheartened.  Respond.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: OPM’s Rationale

Too much time is often spent on the “rationale” or “reasons” for a denial from the Office of Personnel Management, under the “Discussion” Section of a denial letter.  By “time spent”, however, is not meant that one should not selectively rebut, refute and address some of the reasons delineated in an OPM denial letter; rather, what too many people do is to complicate matters by “reading into” the reasons given for the denial. 

One of the jobs of an attorney who specializes in Federal Disability Retirement law under FERS & CSRS is to prepare an application for Federal Disability Retirement benefits, rebut a denial, or file an appeal to the Merit Systems Protection Board, based upon one’s experience, wisdom and sense of that which OPM is looking for.  This is accomplished by having learned from a myriad of sources:  from seeing the types of prepared disability retirement packets which have been successful in the past; from learning from past legal arguments and rebuttal arguments as to which have been most persuasive for OPM; and from having conducted multiple Hearings before the Merit Systems Protection Board and learning exactly what the Administrative Law Judge has been most persuaded and convinced by.  Further, having read countless denial letters by people who have attempted to file for Federal Disability Retirement benefits at the first stage without an attorney, it is important to focus upon the relevant issues which OPM is seeking, and to disregard those issues which are peripheral or irrelevant.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Each Step is a New Review

There are only one of several ways in which a Federal disability retirement application under FERS or CSRS can be lost: Either a Judge at the Federal Circuit Court of Appeals renders a final opinion denying a Federal or Postal Employee his or her disability retirement, or the Federal or Postal employee simply gives up.  As to the former:  Even then, if the Federal or Postal employee has not been separated from service for more than one (1) year, he or she may file a new application for disability retirement. 

Thus, we are left with the latter:  a disability retirement applicant simply gives up.  By “giving up” is meant:  the next step is not taken; the time-frame within which to file a Request for Reconsideration or an appeal is allowed to “lapse”; or, if an appeal is taken, it is done with resignation and surrender.  Nothing good can come out of such an approach.  Each step of the process in a Federal disability retirement case must be attacked aggressively.  Each step must be looked at as a potential place for a new review. Think about it in reverse:  If you don’t take the next step, then nothing good will certainly happen, so what is there to lose?  Indeed, there are times when a client hires me to file a Request for Reconsideration or an appeal to the Merit Systems Protection Board, and the mere filing of my appearance into the case persuades and convinces the OPM representative to reverse course and grant the disability retirement application.  The point of making such a statement is not to “brag”, but to make the larger point:  good things can happen only if you affirmatively act.  Otherwise, you are left with what King Lear said to his daughter Cordelia, that “nothing can come from nothing”. 

Sincerely,

Robert R. McGill, Esquire