Federal Employee Medical Retirement: Deprogramming a Preconditioned Approach

The preconditioned attitude of the general public is that, if X has a medical condition, then such medical condition, by the very nature of the condition itself, will either entitle one to benefits, or not.  Such an approach is what one is conditioned to expect — that by the very nature of the medical condition itself, means that it will either lead to, or not lead to, a specified result.  This viewpoint and approach is based upon a definitional standard, where the very essence of what it means to suffer from X already predetermines whether one is eligible and entitled to benefit Y.

Social Security assumes such an approach.  To some extent, so does OWCP, because the Department of Labor is willing to pay a certain amount of compensation based upon a predetermined calculus of a percentage rating, for loss of limb, loss of use, loss of functional capacity, etc.

This is why Federal and Postal employees who first contemplate preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, will attempt to tie the fact of having a medical condition with the question, “Does this qualify me for Federal Disability Retirement benefits?”  But that is the wrong paradigm to use in asking the question.  For, eligibility for Federal Disability Retirement benefits from OPM is not based upon a definitional ascription of a medical condition; rather, it is that “third element” — the connection between X and Y, X representing the medical condition and Y standing for the positional duties which the Federal or Postal employee must engage.

In many respects, Federal Disability Retirement answers the philosophical question which David Hume asked:  Is there a necessary connection between cause and effect?  For Federal Disability Retirement purposes, the answer is a resounding “yes”.

Sincerely,

Robert R. McGill, Esquire

 

Postal and Federal Disability Retirement: The Beast of Burden

The burden is undertaken by those have little choice in the matter, but who willingly submit to the responsibility and obligation.  Traditionally, the “beast of burden” (other than being a Rolling Stone song) refers to a somewhat-domesticated animal, perhaps a donkey or an ox, who must bear the weight of man’s work.

In law, the “burden” is one of proof — of the affirmative obligation to present one’s facts, persuasive argumentation based upon such facts, and the application of the relevant law which supports both the facts and the arguments.  The “other side” in the litigation has no burden at all, and can simply sit and do nothing, if he or she so chooses, and see whether or not the plaintiff, the appellant or the Federal Disability Retirement applicant has submitted sufficient proof such that he or she has met his/her burden of proof.

As the weight placed upon a beast of burden is often heavy and demanding, so in a similar vein the litigant who has the burden of proof should always expect to exceed what is “necessary” in any given case.  For the Federal or Postal employee who is filing for Federal Disability Retirement benefits through the U.S. Office of Personnel Management, whether under FERS or CSRS, it is indeed a heavy burden to bear in order to meet the legal criteria of a Federal bureaucracy who has the unmitigated power and authority to approve or deny.

The burden of proof — it is as heavy as that which we place upon a beast of burden, and the weight of such responsibility can overwhelm us, lest we have the reserve of strength to plod onward.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Foundational Paradigm

Ultimately, Federal Disability Retirement is based upon the persuasive delineation of three primary elements:  A medical condition; impact of the medical condition upon one or more of the essential elements of one’s job; and an inability on the part of the agency to accommodate the resulting impact of the medical condition upon one’s inability to perform all of the essential elements of one’s job.

How one proceeds to “prove” the case; what “kind” of evidence one needs to provide; the qualitative nature of the proof to be submitted; the quantity and volume of the type of evidentiary submissions to be included; these are determined by necessity based upon the nature of the medical condition itself.

Thus, some medical conditions may require merely a few pages; others, extensive supporting documentation, including treatment notes, diagnostic test results, explanatory clinical encounters and narratives which show a history of treatment-resistant modalities of medical applications as well as fulfillment of such extensive attempts which validate that the patient/applicant is not a “malingerer”, but rather exhibits symptoms which defy traditional approaches both for diagnoses and treatment.

It is always upon the first of the three elements identified which forms the foundational basis of a Federal Disability Retirement application; the sequential nexus of the two following almost creates itself, like the phoenix arising from the ashes, only in this case, from the debilitating medical condition from which one suffers.

Sincerely,

Robert R. McGill, Esquire

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

Ultimately, a Federal Disability Retirement application is a paper-presentation to the U.S. Office of Personnel Management.  Yes, yes, we are entering into a “paperless” technological society, and that is fine; but by “paper presentation” is meant in a generic sense, that the proof necessary to obtain eligibility and entitlement to a Federal Disability Retirement benefit, must be presented in a format which is readable, comprehensible, and coherent — whether on a computer screen or in paper format.

The burden of providing such proof is upon the “applicant” — the Federal or Postal employee who is attempting to obtain Federal Disability Retirement benefits.  That “burden” is both a legal one, as well as a regulatory one.  There are different levels or requirements of what constitutes proof, depending upon the requirements of what must be proven.

In a general sense, one can assert that all that is necessary in a Federal Disability Retirement case is to gather together one’s medical records, wrap them in a secure bundle, and forward them to the U.S. Office of Personnel Management.  Will such an approach “prove” one’s Federal Disability Retirement application?  It might — depending upon the seriousness of one’s medical condition, and whether the Disability Retirement Specialist assigned to such a case will take the time to infer and imply.  But to make an inference, or to expect an implication to be discerned, takes an unnecessary chance at misunderstanding, failure, and the unwanted “denial”.

Instead, the better approach is to explicitly explicate.  Always remember that 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 a difference between suffering from a medical condition, and proving that the medical condition prevents one from performing one or more of the essential elements of one’s job.  It is the latter which is necessary to be approved for a Federal Disability Retirement benefit.  As to the former — while an unfortunate circumstance — it is not enough to suffer to prove one’s case.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Government Employees: The Realizing Process

By definition, a process entails multiple procedural steps.  Filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management encapsulates procedural administrative steps, and these include denials and appeals.

Yes, it is true that a certain percentage are approved at the first stage of the process.  Yes, it is also true that not everyone must go to the Second, or Reconsideration Stage of the process, or the Third Stage, the U.S. Merit Systems Protection Board.  But the fact that “not everyone” must be subjected to X, does not undermine, erase, or otherwise nullify the truism that it still remains a “process”, as opposed to an application for an entitlement benefit.

As a process, one’s Federal Disability Retirement application with OPM must be proven.  In order to prove a case, one must submit certain qualifying documentation.  As the U.S. Office of Personnel Management is the initial and secondary reviewer and determining agency for the first two stages of the process, so they have personnel of differing qualitative abilities — from pure incompetence, to indifference, to superior case workers who understand the full and complete application of the law, the regulatory criteria, and the statutory applicability of case-law interpretation.

Since it is the only process around, it is something we have to live with, and ultimately, follow.

Sincerely,

Robert R. McGill, Esquire