Tag Archives: opm medical retirement qualification ruled by legal criteria of eligibility

Federal Disability Retirement Lawyer blog: Meeting the Legal Criteria

Lawyers often speak about “the law” as if it has the character of a science — of established principles which are objective, without the arbitrary influences of subjective interpretive devices or nuances. But even science itself fails any pure test of universal unalterability; one need only read Kuhn’s description of shifting paradigms in the history of science (The Structure of Scientific Revolutions) to understand that objectivity is merely another word for pragmatism. For, that which “works” or is “effective” in the eyes of the greatest number of people, is what matters to most people. That is why success is an irreplaceable harbinger of general opinion.

In the Federal government, one would like to expect application of rules, regulations, etc., somewhat in an algorithmic form, where favoritism is lacking, and where everyone has a “clean shot” at everything.

Especially when it comes to a benefit such as Federal Disability Retirement, which impacts those who are most unfortunate — one beset with a medical condition such that one can no longer perform all of the critical elements of one’s job — an expectation that an objective criteria which can be met by pure factual presentation, legal magnification of relevant statutes and laws, and perhaps some modicum of argumentation for persuasion, is what it should really occur in a perfect world.  But as the proverbial perfect world fails to materialize, we must do with what we are given; subjective interpretation, and selective analysis are merely human frailties and imperfections.

That is why legal argumentation and countering of subjectivism must be the proper, employed approach.

Federal and Postal Disability Retirement, whether for CSRS or FERS employees of the Federal government, must be fought for, and “won”; there is no mathematical algorithm of objective application; there is no parallel universe of perfection; there is only the human condition, which requires interpretation, knowledge, analysis, and argumentation which persuades and cajoles.

Sincerely,

Robert R. McGill, Esquire
Federal Disability Retirement Lawyer

Federal Employee Medical Retirement: The Other 12-month Confusion

The other issue which may involve a 12-month period — aside from the Statute of Limitations, which allows a Federal or Postal employee to file for Federal Disability Retirement benefits within 1 year of being separated from Federal Service — is the duration of one’s medical condition.

Federal and Postal employees will often confuse the issue, and believe in error that they must suffer through a minimum period of 12 months before they can even begin the process of filing for Federal Disability Retirement benefits. This is an error either in the proper interpretation of the law, or through receipt of misguided information from third parties.  The law simply requires that a Federal or Postal employee filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, have a medical condition which will impact him or her for a period of at least 12 months.

Practically speaking this would make sense.  For, since the bureaucratic process of preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management takes a minimum of 8 – 10 months for the entire process anyway, it would make no sense to have a medical condition which will be “cured” within that time frame, for a Federal or Postal employee to file in the first place.

The minimum requirement of the 12-month period can be easily addressed in the “prognosis” portion of a doctor’s statement.  Most doctors can prognosticate within a couple of months of beginning treatment, concerning the long-term duration of a medical condition; whether it is chronic, lasting, or likely permanent.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, knowledge equals the ability to overcome obstacles, and knowing the law will allow the Federal and Postal employee contemplating filing for Federal Disability Retirement benefits to possess the necessary tools to effectively manage his or her life and future.

Sincerely,

Robert R. McGill, Esquire

Federal Worker Disability Retirement: Application of a Neutral Legal Criteria

The application of law upon determination of a Federal Disability Retirement application is based upon a set of criteria which focuses upon the impact of a medical condition on the Federal or Postal employee’s ability or inability to perform all of the essential elements of his or her job.  Thus, it is different from other government programs or compensation benefits, in that it ignores such issues as causality or prima facie accepted medical diagnoses.

Indeed, one can have a serious medical condition and still be denied one’s Federal Disability Retirement application if one fails to show the nexus, or the impacting connection, between the serious medical condition and one’s ability/inability to perform all of the essential elements of one’s Federal or Postal job.  In that sense, the applicable legal criteria is neutral in its very essence:  first, the Office of Personnel Management should (obviously) apply the law in a “neutral” manner, without regard to the person who applies, or be influenced in any way by the agency; but, moreover, and more importantly, the law itself is neutral to the extent that it makes no judgment upon the medical condition itself — only upon the medical condition in conjunction with the impact to one’s ability/inability to perform the essential elements of one’s job.

As such, in preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, the primary focus in attempting to prove this point — both from a medical perspective as well as from the applicant’s approach — should be to emphasize the connection between the diagnosed medical condition and the essential elements of one’s job, and not merely upon the seriousness of the former.  Only in this way can the neutrality of the legal criteria properly assess the viability and force of one’s Federal Disability Retirement application.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for US Government Employees: Qualifying

The concept of “qualifying” is both peculiar as well as interesting; for, one questions whether one can “qualify” for a sports event (often, this encompasses issues of age, physical ability, whether gender may disqualify you, etc.); and then there are “qualifying events”, where you must pass certain levels of “test” activities in order to get to the next round, as in golfing events.  In racing events, there is always talk about getting through the “qualifying” stages; and, similarly, in attempting to secure a job, the applicant is often questioned as to whether he or she has the “qualifications” for the position.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, there is also the initial question of whether a Federal or Postal worker “qualifies” for the benefit identified as “Federal Disability Retirement”. Here again, to “qualify” means that a Federal or Postal worker meets certain requirements. Thus, there are automatic dis-qualifiers, such as: If you are not a Federal or Postal worker, but work for the county or state, then you do not qualify for benefits under FERS or CSRS from the Federal system. Similarly, if a FERS individual does not have at least 18 months of Federal Service, or a CSRS Federal employee does not have at least 5 years of Federal Service (which is obviously unlikely), then you cannot “qualify” to even apply for Federal Disability Retirement benefits from the Office of Personnel Management.

Those are immediate qualifying “events”.  Then, of course, the main event — the tournament of all competitive activities for Federal Disability Retirement purposes — concerns whether or not a Federal or Postal Worker qualifies for Federal Disability Retirement benefits because of his or her medical condition.  This foundational qualification can only be answered by looking at the medical condition, the support of the treating doctor, and whether and to what extent the medical condition impacts one’s physical or psychological ability to perform the essential elements of one’s job.

For that main event, one must rise to the level akin to the professional athlete.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for US Government Employees: Time and Clarity

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, two primary elements must be shown:  A.  That one suffers from a medical condition such that the medical disability prevents one from performing one or more of the essential elements of one’s job, and B.  That the medical condition will last for a minimum of twelve (12) months.  This second part of the requirement — the 12 month period — can bring about some interesting issues.

Despite the simplicity of what it requests in terms of information, the issue is often confused and confusing.  Federal and Postal workers contemplating filing for Federal Disability Retirement benefits will often wonder whether one has to be “out of work” for a period of 12 months before even filing (somewhat similar to SSDI, where one must be out of work for a specified period of time) — but that is not what the statute requires.  What is required is merely that the medical condition must have a duration of at least 12 months, and so a prognosis should suffice — i.e., if the medical condition suffered has lasted for 5 months, say, and the doctor provides a prognosis that it will continue for a minimum of 2 – 3 more years, and perhaps permanently, that should satisfy the legal requirement of a medical condition lasting for a minimum of 12 months.

On the other hand, when the doctor states that it has lasted since X date and will be a “permanent” condition, that should also satisfy the legal requirement.  However, OPM will often fail to comprehend what “permanent” means, and will deny a case based upon the fact that the “12 month period” has not been met.

Further, the issue of “when” a medical condition began is an interesting one, because if one goes too far back, then that may show that despite the medical condition, the Federal or Postal employee has been able to perform the essential elements of one’s job.  The question is thus not one of “when the medical condition began”; rather, the question is one of “when did the medical condition prevent one from performing one or more of the essential elements of one’s job.”

Clarity is the key, always, and when one is dealing with Claims Specialists at the U.S. Office of Personnel Management who are reading multiple files day after day, and confusing and confounding one with the other, making certain that the medical reports, legal arguments and Applicant’s Statement of Disability are clearly and concisely delineated, will help to guide OPM to a proper and successful decision.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: “If Only They Understood”

Preparation of a paper presentation to the Office of Personnel Management must result in a product which is concise, effective and persuasive.  

The last term of the tripartite phrase, “persuasive”, is often the most difficult for the Federal or Postal employee, whether under FERS or CSRS, to objectively assess in a neutral, non-involved manner.  This is because the unrepresented Federal or Postal employee who attempts to prepare, formulate and file a Federal Disability Retirement application under FERS or CSRS is identical to the subject of the prepared application, and thus often has the approach and attitude of, “If only the case worker at the Office of Personnel Management knew what I am going through.”

Persuasion, the art of persuasion, and effective persuasion are comprised of a delicate balance between saying too little and overstating a case.  It is the ability to convey a state of facts which are confirmed by the medical records; involving a narrative which touches upon empathy, sympathy and a sense of pain or condition which the reader and recipient can somehow relate to; constrains ancillary issues which tend to detract from the central point of the narrative; and concludes with the idea that all of the “legal criteria” have been met.  

Obviously, it is through the power of words which such a persuasive Federal Disability Retirement application, submitted to the Office of Personnel Management, must be presented.  When the subject of the words is identical to the author of the words, the emotional turmoil is often mis-directed in the preparation of the Federal Disability Retirement packet.  

In the end, “if only OPM understood” — can become a reality if and only if the applicant understands first the objective legal criteria which must be met; then proceeds to meet those criteria in a systematic, detached manner; yet at the same time understanding the power of persuasion.

Sincerely,

Robert R. McGill, Esquire

FERS OPM Disability Retirement: Facts, Laws & Persuasive Argumentation

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, it is important to distinguish between facts, laws, and persuasive argumentation, as well as the targeted audience to whom such distinguishing elements are being conveyed.

For the first two “stages” of the administrative retirement process, the Federal or Postal employee will be addressing personnel at the U.S. Office of Personnel Management.  This is merely at the “administrative”, or “agency” level of the process.

Thus, the initial review, analysis, and application of the legal criteria will be performed by a non-lawyer, and any application of a legal criteria to determine the eligibility of the Federal Disability Retirement application will be done in a rather mechanical manner.  By “mechanical manner” is merely meant that the criteria to be applied is merely an extrapolated generic form of interpretation, and will be applied by comparing the “list” of legal criteria against the submission of the Federal or Postal employee.

Whether there is sufficient justification in the medical report and records; whether the description of the Federal or Postal employee’s job comports with the official position description; whether the agency has offered an “accommodation“, and if so, in what form; whether a reassignment to another position at the same pay or grade was offered and declined — and other applicable criteria will be applied, analyzed and annotated by the OPM Representative.

If the Federal Disability Retirement application is denied at this initial stage of the process, then it will again be reviewed at the Reconsideration Stage of the process — assuming that the Federal or Postal employee files a timely Request for Reconsideration with the Office of Personnel Management.

It is at the next stage of the administrative process — an appeal to the Merit Systems Protection Board — that any legal argument will ultimately begin to carry significant and relevant weight.  For, at the MSPB, an Administrative Judge will review the entire file, and proceed to conduct a new hearing “de novo”, that is, “fresh” or “anew”, and weigh the evidence, the legal arguments, and determine the persuasive impact of either or both.

Sincerely,

Robert R. McGill, Esquire