Federal Disability Retirement: OPM’s Detailed Denial

Neither length nor detail constitutes legitimacy.  The spectrum of the types and styles of denial letters issued by the Office of Personnel Management in Federal Disability Retirement cases under FERS & CSRS range from a short paragraph under the “Discussion Section”, to 3 – 4 pages of apparent references to doctor’s notes, reports, etc. — with a lengthy lecture about the need for “objective” medical evidence, and about how a particular medical condition “may be” treated by X, Y or Z treatment modalities. 

Don’t be fooled.  One may think that, because OPM provides a seemingly “detailed” explanation of why a particular disability retirement application was denied, that such lengthy detail means that it is somehow “substantive”.  In fact, I often find the opposite to be true:  the shorter the denial, the greater the substance.  The lengthy denial letters contain “substance”, all right — but substance of the wrong kind.  They contain:  Mis-statements of the law; mis-statements of the criteria to be applied; inappropriate assertions of medical opinions (contrary to what one might think, the OPM representative does not normally have a medical degree, let alone a law degree), and a host of other “mis-statements”.  Sometimes, the weightier the denial, the more confusing as far as how to respond.  And, perhaps, that is one methodology as to how OPM wants to approach the case:  If it seems long and complicated, maybe the applicant will sigh, give up, and go away.  Don’t.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: Creativity & Objectivity

The Applicant’s Statement of Disability is a very personal statement; that is precisely why when I take on cases at the Second (Reconsideration) Stage, or at the Third (Merit Systems Protection Board) Stage, I have an opportunity to read heart-felt, personal, and very “emotional” statements written by the individual applicant.  This is not to be negatively critical of such statements — such personal, emotionally-charged statements can be very effective.  On the other hand, it is precisely because the Applicant who writes such a statement — about his or her own personal engagement and experience of the disability — that he or she is unable to provide an objective perspective.  It is very difficult to “stand outside” of one’s self and write about one’s self.  Again, this is not a negative criticism — it is simply what it is.  As an aside, I have had many of my clients who read my interpretive statement of disability, which I craft based upon multiple sources (i.e., by speaking to the client; by having my client fill out a short questionnaire; by reading the medical reports and records, etc.), who tell me later that, yes, the statement of disability accurately reflected their state of medical disability, and further, that it made him or her realize for the first time how “bad off” they were.  It takes a perspective of objectivity to creatively — and accurately — depict one’s own medical disability and the impact of such disability upon one’s life.  For this, a third party — often an attorney — is needed.

Sincerely,

Robert R. McGill, Esquire

Federal/OPM Disability Retirement: Filing for SSA

I keep getting the same feedback that tells me that people are still receiving erroneous information: SSA disability benefits do NOT have to be applied for first before you file for OPM Disability retirement benefits. In fact, the Office of Personnel Management only needs the receipt showing that a disability retirement annuitant filed for SSA disability benefits at the time of approval. Further, OPM would actually prefer that the SSA denial was based upon reasons other than the fact that the Applicant is still working, because the coordinating off-set between SSA & FERS disability benefits would come into play; however, if an applicant files for SSA benefits & files for disability retirement benefits while still working (and, for most individuals, it is an economic necessity that one continue to work for as long as possible during the process of obtaining disability retirement benefits), then that individual will summarily be denied by the Social Security Administration based not on the medical disability claimed, but rather, upon the fact that the applicant’s current income exceeds the maximum allowed by the Social Security Administration rules governing income and eligibility for benefits based upon income. Thus, for the 50th time: a FERS disability retirement applicant does NOT need to file for SSA disability benefits before filing for OPM disability retirement benefits. At some point in the process, prior to, or at the time of approval by OPM, the individual should file, obtain a receipt of filing, and fax it to OPM.

I hope this clarifies the issue.

Sincerely,

Robert R. McGill, Esquire