Tag Archives: opm federal disability specialist and the evaluation of your disability claim

OPM Disability Retirement: The Human Element & Application of the Law

It may well be that technological advances will one day allow for imputed algorithms to precisely calibrate and decide everything in life; but for the time being, we must all deal with the human element in the process of decision-making.  

Comparative stories abound about how X obtained disability retirement benefits with minimal documentary proof, and even less of an actual medical condition.  It is always an anomaly as to how one can possibly answer the query which involves the following:  “X told a friend of Y, who knows of Z who filed and got his Disability Retirement benefits approved within T-amount of time”.

The particulars of each case must always determine the outcome of the case; some stories become inflated with the telling of the narrative when passed through third parties multiple times; but, on the other hand, there is the possibility that the final narration of the story is entirely true.  The reason is because the human element is still the determinative factor in any Federal Disability Retirement application.  

There is no computerized algorithm which is applied in making a determination at the U.S. Office of Personnel Management.  And, so long as human beings continue to remain a part of the administrative, bureaucratic process in scrutinizing a Federal Disability Retirement application, by analyzing the content and substance and applying the relevant laws, there will never be a perfect continuity or consistency of application.  

In some ways, this is a good thing; for, as each human being is unique, so the story of each medical condition and the impact upon one’s inability to perform all of the essential elements of one’s positional duties, in preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, is also particularized and unparalleled.  May it be so in the future, lest we ourselves become mere drones in this world of conventionalized perspectives.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Initial Denial & Reconsideration

In the Animal Kingdom, there are artificial classifications superimposed by a class of individuals commonly and generically referred to as “scientists”, in which more generalized identifiers are further categorized, until you reach the “genus” classification, and within that genus, the “species” classification.  In the objective world of animals, such classifications are irrelevant and taken no notice of.  Instead, the necessity to be able to identify various species is essentially based upon the ability to recognize one’s natural predators, as well as one’s food source.  

Such anthropomorphic imposition on ordering the world for purposes of our understanding of the world was recognized by Kant in his Critique of Pure Reason, and the ability of Man to impose his a priori categories upon the objective noumenal world.  But in the world of Man, especially for the Federal or Postal employee who has prepared, formulated and filed a Federal Disability Retirement application under FERS or CSRS, it is important to understand the categorized arena within which he or she finds one’s self in.  

Thus, when an initial denial is received by the Federal or Postal worker, it is important to understand that filing a “Request for Reconsideration” does not take the Federal Disability Retirement case out of the hands of the agency which made the initial denial — instead, it is within the same agency (the Office of Personnel Management), but assigned to a next “level” in order for both the Federal or Postal employee to get a “second bite at the apple“, as well as for the deciding body (OPM) to review the case afresh, along with any new or additional evidence which the Federal or Postal employee can supply to OPM.  

This methodology of a second “review” makes sense, in that it allows for the deciding Federal Agency (OPM) to have a chance at correcting itself in the event that its initial decision was made in error, before it is allowed to be appealed to an independent, separate entity, called the Merit Systems Protection Board.  Thus, that same categorization and ordering of the world, superimposed upon the Animal Kingdom, is also utilized in the world of Man.  The same agency, but different sections; if the second review fails, then it is kicked up to a different genus — before an Administrative Judge at the Merit Systems Protection Board.

Sincerely,

Robert R. McGill, Esquire

FERS Medical Disability Retirement: A Fair Hearing

It is a common complaint against the Office of Personnel Management that the particular Claims Representative who reviewed the file and issued a denial in a Federal Disability Retirement application failed to look at, or review, the medical evidence; that the denial letter was merely a restatement or regurgitation of a template referring to a 7-part criteria, and makes statements which could easily have been “cut and paste” from a thousand other such disability denials.

Indeed, there have been times when references to a denial were clearly (and mistakenly) extracted from another file, where the names of doctors and medical documents are referred to which have no relation to the particular individual, and are clearly mixed in from another case.

To be fair, a counter-argument to such criticism is that there is no bureaucracy, with so many cases to review and properly evaluate, and with so few personnel and staff to undertake the massive workload, that could or should “reinvent the wheel” each time a case is set to be reviewed.

Obviously, certain language that is applicable in all (or most) cases will be re-stated, and templates used where such have been standard language used in the past.  Applicable language and statements which merely reiterate the legal and statutory criteria; introductory remarks; conclusory statements — they are all part of a paradigm and template which any administrative bureaucracy may apply.

But the criticism goes much deeper than that:  It is often the case that, clearly, the OPM Disability Claims Representative who wrote the denial did not even read his or her own denial.  Proofreading is an essential part of reviewing, writing, and issuing a decision.  OPM must ultimately realize that each decision is an important, crucial, and often critical point of importance in the life of the applicant.

It is a Federal or Postal worker who has previously dedicated many years of his or her life to a career with the Federal Sector, and the applicant for FERS Disability Retirement benefits deserves a fair hearing.  A fair hearing is defined by a careful evaluation of the particular case.  That is not too much to ask for.

Sincerely,

Robert R. McGill, Esquire