FERS & CSRS Disability Retirement: The Complexity of the Simple

Federal disability retirement law, the statutes and regulations which govern eligibility; the multiple case-law opinions from Administrative Judges and Federal Circuit Judges interpreting the governing statutes and regulations; the lawyers who argue different aspects and attempt to “fine-tune” existing law (including this lawyer) — the entirety results in “making complex” that which was essentially simple.

There is an old adage that the King who declared the first law of his Kingdom was really attempting to reduce the unemployment figures by creating the need for lawyers. Indeed, “the law” is often made more complex by lawyers. However, while the multiple issues governing Federal disability retirement law under FERS & CSRS may appear, at first glance, “simple”, it is such simplicity which engenders the complex, precisely because laws which reflect a simple conceptual paradigm require extensive interpretation in order to explain the simpleness of the simplicity. That is why law itself is complex. Don’t let the complex confluse you. As you prepare a disability retirement application, recognize that it is a complex process; at the same time, make sure to explain your medical condition and how it impacts your ability to perform the essential elements of your Federal or Postal position in an easy-going, simple and straightforward manner. Don’t make it complex; keep it simple; but recognize the complexities.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: The First Denial

Your Federal disability retirement application was well-prepared:  perhaps it was prepared with the help of an attorney; the medical documentation seemed solidly unequivocal; the doctor made the necessary connections between one’s medical conditions and the type of essential elements of one’s job; the packet, by all accounts, should have been approved, and by all expectations, the approval should have been reasonably expected. 

Instead, you receive a letter stating that your disability retirement application was disapproved, and a “Discussion” section follows, explaining why the Office of Personnel Management denied your application.  Why did this happen?  There are multiple reasons why such a denial can occur:  the OPM specialist could be a person who lacks a clear understanding of the applicable laws governing disability retirement applications (more often than not, this is the case, and what you actually get in the so-called “Discussion” Section of the denial letter is merely a regurgitation of the statutory criteria for eligibility for disability retirement, without a recognition of the interpretation of such criteria by Federal Judges for the Federal Court of Appeals or by Administrative Judges from the Merit Systems Protection Board); it could be as simple as the OPM representative selectively choosing to read the medical reports and records, and disregarding or ignoring supportive portions of the medical records and reports; or it could be that additional medical reports and records need to be obtained in order to “shore up” the application. 

In any event, whatever the reason for the denial, one should not panic.  It is merely one step in a long, administrative process.  The mere fact that OPM denies your disability retirement application does not mean that they are “right” in doing so; indeed, in my opinion, they are rarely right.  That is why one has the right to have it “reconsidered”, and the opportunity to make further legal arguments, and obtain further medical documentation in support of your claim.  And, beyond that, you have the right to file an appeal to the Merit Systems Protection Board — and beyond.  Never give up; always take it to the next step.  In most cases, it will prove that OPM was in error, and in fighting the denial, you will have secured some semblence of financial security for your future.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Long View

What I find when individuals have attempted to file on their own, and get it rejected, is the lack of preparing for the “long view.” Many people hear stories about how “such and such” obtained a disability retirement approval for “far less than the medical conditions I have.” Fair enough. Those stories may be true (I never engage in a discussion about the validity or truth of such stories; they are what they are — stories); nevertheless, there are multiple factors which are considered at each stage of the process of filing for disability retirement: Who the OPM Specialist is that will be reviewing an application; the subjective application of which criteria are applied in a given case; the personal and professional differences that arise between different bureaucrats at the Office of Personnel Management (no, don’t believe in the story that there is an “objective” methodology of applying the law when reviewing each disability retirement application); and multiple other factors, including whether or not your particular disability retirement packet was reviewed by someone at the Office of Personnel Management when he or she had a “bad day”.

To counter all of the multiple factors over which we don’t have any control, one must always take the “long view” — the view that it may take two denials, and end up before a Judge at the Merit Systems Protection Board. At that point, it is important for the Judge to see how well-documented the case has been prepared; that legal arguments have already shown that OPM was unreasonable in its initial decision and its Reconsideration Denial; and how, despite additional attempts at fulfilling OPM’s requests for additional medical documentation, that OPM continued to be unreasonable. By preparing for the “long view”, a disability retirement packet not only has the best chance of getting it approved in the “short run”, but also at the Merit Systems Protection Board.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: The Process & the Office of Personnel Management

The “British Rule” is that “good manners will always get you through any and every form of trouble.”  The process at the Office of Personnel Management is a long and arduous one.  When the disability retirement packet finally arrives at Boyers, PA, it will often sit for approximately thirty (30) days, before it is finally assigned a CSA number (for CSRS employees, it will begin with the number “4”; for FERS employees, it will begin with the number “8”).  The Applicant will receive a form letter from OPM in Boyers, PA, informing you that you have been assigned a CSA number, and that it has been forwarded to the OPM office in Washington, D.C.  This is when patience and good manners must come to the fore.  Of course, there is nothing wrong with calling OPM and inquring about the status of your case.  However, always remember to be courteous; inquire as to the time-frame that the adjudicating disability specialist is expecting; and ask if it would be okay to call periodically, and to let him/her know that if any further documentation is needed, to give you a call — or, if you are represented, to call your attorney.  Whatever you do, do not get angry, and keep it professional — and courteous.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Merit Systems Protection Board

An appeal to the Merit Systems Protection Board in a Federal Disability Retirement case means that the disability retirement application has been denied twice by the Office of Personnel Management:  at the initial application stage, then at the Reconsideration Stage.  This is often considered to be the third and last try — of convincing an administrative judge (an “AJ”) that you are entitled and eligible for disability retirement.  There are, of course, two additional stages — an appeal to the Full Board and to the Federal Circuit Court — but such avenues present only the right to reverse a decision of the Merit Systems Protection Board, and no new evidence can be presented.

Thus, one might consider the Merit Systems Protection Board as the “last stop” in the administrative process.  Do not think, however, that the process must necessarily be won before the Administrative Judge in a hearing — much work and persuasive argumentation should be made to the OPM representative who is handling the case at this MSPB Stage.  The OPM representative at the Third Stage of the process is usually an attorney; they are competent; they are versed in the case-law — and thus open to be persuaded by legal argumentation.  While the administrative stages (the Initial Stage and the Reconsideration Stage) involved OPM representatives who are non-attorneys, the MSPB Stage involves seasoned attorneys who present an opportunity for persuasion and argumentation, and thus a golden opportunity to convince OPM to reverse their own decision before coming to a Hearing.  Such an opportunity should never be missed, and every effort should be made by the applicant’s attorney to have multiple contacts with the OPM representative prior to the date of the Hearing.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Which Disabilities To List

When I look at a potential disability retirement case, I find it helpful to look at the case not only prospectively, but retrospectively. While not a “rule” cast in stone, when the Office of Personnel Management approves a disability retirement case, it will normally attach a page which identifies which disability — normally one, often two, sometimes three — was/were the basis for the approval.  Thus, it is important when preparing a disability retirement packet and application, to identify which medical disabilities will be listed and depended upon; and further, once is it approved, it is helpful to look to the future, for there is a random chance that every 2 years or so, you will be selected to answer a Medical Questionnaire to determine if you are still disabled.

Thus, if you list a minor medical condition, and you get approved for that minor medical condition, if you recover from that condition, you can potentially lose your disability retirement benefits in the future. (Note:  for those of you who are my clients, please do not worry; no client of mine who has received a Medical Questionnaire has ever lost his/her disability annuity)   Thus, it is important to identify those medical conditions which are the “most serious”, and base your medical disability retirement packet upon the most serious, long-term disability first –before listing secondary or additional medical disabilities.  This is not to say that you should not list more than one medical disability; indeed, in preparing my packets for my clients, I will often list more than one, but I do it in sequential fashion, and when I put together my legal memorandum in arguing my case on behalf of my client, I constantly refer back to the central medical disability.

Sincerely,

Robert R. McGill, Esquire

Patience During the FERS & CSRS Disability Retirement Process

It is now post-Labor Day Weekend. Summer is essentially over. The Office of Personnel Management will be back in “full force”. The inclination will be to call up OPM and impatiently — imprudently — demand that one’s disability retirement application be reviewed, because it has been sitting on Mr or Ms. X’s desk for the last 90 days. Be cautious of what you request, or demand — because you may get your wish, but with an outcome you do not desire — a denial. I often remark to my clients that if patience is a virtue, then Federal and Postal Workers must be the most virtuous people in the world, because you are the ones who must be most patient — during the years of service you have given, during the process of dealing with a demanding public, and finally, during the process when you need the Federal Government to act quickly — the disability retirement process. Be patient; thereby, be virtuous. Unfortunately, OPM does not have a statutory mandate during the administrative process. If you must call OPM, be courteous in your inquiry, and inquire only if necessary.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability retirement: End of Summer and Postal VER

Summer is almost at an end. The Postal Service, through the auspices of the Office of Personnel Management, is offering Voluntary Early Retirement (VER). For many, this is a positive thing; the decision to take the VER should be a financial decision. An analysis comparing the monetary return should be made between what an employee would receive under the VER and under disability retirement; if the financial difference is great, then obviously the employee should consider filing for disability retirement after the VER has been approved.

Remember that the employee would have one (1) year to file for disability retirement benefits, after the individual has been separated from service. Steps should be taken now, however, before accepting/filing for the VER, to establish the medical condition and disability prior to separation from service. This can be done by discussing the medical condition with one’s treating doctor, before the VER is applied for. Such early steps will help ensure the success of a future filing for disability retirement benefits — because the employee must establish that the medical condition impacted one’s ability to perform the essential elements of one’s job prior to separation from Federal Service.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: When & How to Act

When people call me to ask if they need legal representation in filing for disability retirement benefits under FERS or CSRS, I try and provide as “objective” an opinion on the matter as possible. I represent hundreds of people in filing for, and obtaining, disability retirement benefits; it is my specialty, and it is how I make a living. At the same time, however, I believe that I can be completely honest in providing guidance as to whether an individual should obtain legal representation, or needs to obtain representation.

For instance, for individuals who have already sent in their disability retirement packets to OPM (via the Agency for those still on the rolls; directly to Boyers, PA for those who have been separated from service for 31 days or more), I normally advise the applicant to wait — wait until a decision has been rendered, and hopefully the individual will not have to expend the funds for attorneys fees, and an approval will be in the mail. On the other hand, every now and then, an applicant who is waiting for a decision from the Office of Personnel Management, will describe the content and substantive materials comprising the disability retirement packet, and certain statements — during a telephone consultation with me — concerning what is stated in the applicant’s Statement of Disability, will give rise to concern, and in those instances, it may be wise to either withdraw the application, or immediately take steps to supplement the disability retirement packet.

Each FERS or CSRS disability retirement packet is unique, because each individual & individual’s medical condition is unique. That’s what makes the practice of law in the field of representing Federal and Postal disability retirement applicants so interesting, and so professionally satisfying.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Purpose of Case Law Citation

Is it necessary for a Federal Disability Retirement Applicant to cite relevant case-laws and statutory authority when filing for disability retirement? Or, should the medical evidence be sufficient? Certainly, there is no statutory requirement that “the law” be referenced when filing for disability retirement. And, further, it is normally not a good idea for a non-lawyer Federal or Postal employee to refer to case-law or relevant statutory authority, if only because non-lawyers often mis-state the law, or misinterpret relevant case-law authority.

The primary purpose why I refer to, and cite relevant statutory authority and case law, even at the initial administrative stage of filing for disability retirement on behalf of a Federal or Postal employee (normally, I will prepare a lengthy legal memorandum for each case), is because I want to preempt any mis-statement of law to the benefits specialist reviewing the application packet. It is important at each stage of the process to point out the relevant law, the applicable case-law, the judicial opinions which have addressed the multiple issues which can deter or potentially derail a disability retirement application. While the benefits specialist at the Initial Stage of the process may not be fully aware of the applicable laws, it is the job of the Attorney to point out the law, and demand that the Office of Personnel Management conform to the relevant, current judicial constraints which should be adhered to.

Sincerely,

Robert R. McGill, Esquire