Federal Employee Medical Retirement: Sometimes, It’s “The Law”

An assumption is often made that the “Disability Specialist” at the Office of Personnel Management who reviews the Federal or Postal Disability Retirement application understands, comprehends, and applies the laws governing Federal Disability Retirement applications.

Now, such an assumption may be logical and reasonable, to the extent that one thinks (A) that those who aspire to working in a specific specialty have some knowledge or understanding of the specialty, and (B) if a decision is made which involves discussing “the law”, one presumes that the mere discussion of it proves some knowledge of it.

The problem with such reasoning, however (apart from the popular tripartite acronym which originates from the word “********-u-me”), is that it betrays the facts:  often, from reviewing the denial letters generated from the Office of Personnel Management, it is painfully clear that the administrative specialist, the legal specialist, or whatever other “specialist” designation has been embraced by the worker at the Office of Personnel Management, simply fails to apply all of the applicable laws which govern Federal Disability Retirement applications.

This is understandable, to this extent:  OPM representatives (other than those representing OPM at the MSPB level) are not lawyers, and as such, do not keep up with the latest evolution of the laws governing Federal Disability Retirement issues.  Whether that is a good thing or a bad thing, is another matter altogether.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Continuing Patience

It is difficult to be patient.  The Office of Personnel Management, in reviewing and evaluating each case, takes its time.  One can attempt to “read into” each day, as to whether the longer wait is more beneficial than a decision which is to be made in short order.  Calling to check on the “status” of the case can have a negative effect upon a decision, although it is not “supposed to” do so. 

Often, the response by OPM’s representative is that a decision will be made “this week” or “next week” or “by the end of the month”.  Time passes, and there is no decision.  These past couple of weeks, OPM has sent out many decisions that were long-in-waiting.  When the decision is a favorable one, then of course the burden of the wait is suddenly lifted.  When the decision is a denial, then the response is often one of anger, disbelief or discouragement.  Once the emotions are set aside, then one must accept the reality of further waiting.  Yes, patience is a virtue, and Federal and Postal employees must be the virtuous of all people.  But those are empty, vacuous and meaningless words when one must wait to see what the future holds. 

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: Miscellaneous

Some cases take months to win; others, merely a week or so.  In some Disability Retirement applications under FERS or CSRS, a half-page report of substantive medical evidence is enough; in other cases, it is the compilation of voluminous material which must be argued and persuasively emphasized, in order to convince the representative at the Office of Personnel Management that the Federal or Postal employee is entitled to Federal Disability Retirement benefits. 

Professionally, it gives me no greater satisfaction when a case takes a week, or if it is approved based upon a half-page medical report, than if it takes months or volumes of medical evidence:  an approval by any means results in the satisfaction of a client.  There a some cases in which a client “grumbles” when I am hired, paid, and am able to reverse an OPM decision within a week; but I try and explain to all clients that when you hire an attorney, you hire the attorney not only for his professional competence, knowledge and experience, but also for the reputation that an attorney brings to the forum.  I have attempted to build a reputation of integrity with the Office of Personnel Management, and there are many times when OPM will reverse their previous decision upon my entering my appearance into a case.  I share this fact with great humility, and an appreciation that one’s reputation still means something in this world.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: How Many Should Be Listed?

I am often asked the question:  How many health conditions or disabilities should I list in my Applicant’s Statement of Disability (SF 3112A)?  This question is often preceded by another question and answer:  What are your medical disabilities (me to the caller)?  Answer:  I have about ten of them (caller to me).  Let me start out by giving some free advice:  Don’t list ten medical conditions.  Don’t list nine.  Don’t list eight.

When the Office of Personnel Management reviews a Federal Disability Retirement submission under FERS or CSRS, the OPM Representative will review your disability retirement packet until it is approved — and no further.  Approval comes about upon a finding that one of your listed medical conditions disables you from performing one or more of the essential elements of your job.  Now, sometimes OPM will find that a combination of 2 or 3 medical conditions disables you together:  meaning that OPM perhaps found that while a single one did not disable you under their criteria, a combination of two or three did.

Furthermore, it is important to understand that, because the medical conditions and disabilities upon which OPM makes their decision on will be the basis for future continuation of your disability retirement annuity (in the event that you receive a Medical Questionnaire in the future), it is important to limit the listing of one’s medical disabilities on the SF 3112A to those conditions which will likely last for more than 12 months.

Conclusion:  It is important to sequentially prioritize the medical disabilities, in the order of severity, chronicity and duration.  Further, it is important to NOT list the minor medical conditions which, while they may be aggravating, and have impacting symptoms, may not necessarily prevent one from performing the essential elements of your job.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Reconsideration Decisions

Types of reconsideration decisions denying an applicant his or her Federal Disability Retirement benefits under FERS or CSRS can and do span the entire spectrum, depending upon the OPM representative who writes up the decision:  from half a page (barely giving a passing, respectful review to a packet which took multiple hours to put together) to over 3 pages long (in the “Discussion Section”); from merely listing general principles of law and generalized, template-like denials to apparent detailed (but very selective) references to various medical reports submitted by the applicant as part of the disability retirement packet — they all boil down to the same thing:  a denial at the initial application stage.

Often, an initial reaction to the denial encompasses a myriad of responses, ranging from incredulity, to resignation, to anger, to indignation.  Set aside the emotionalism.  Further, there is often the reaction to that “one piece” of medical information which the applicant believes should have turned that “denial” into an “approval” — that “one piece” of medical note, statement, sentence, or paragraph which the OPM representative conveniently disregarded or chose not to reference.  Don’t ruminate over it.  It may well be that it was deliberately disregarded; it may even have been overlooked.  More than likely, the OPM representative was fully aware of it, but decided to selectively choose his or her basis as the more “important” and “substantive” evidence, forming the core rationale of the denial.  Don’t waste time.  More work is needed — both medical as well as legal.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Each Step is a New Review

There are only one of several ways in which a Federal disability retirement application under FERS or CSRS can be lost: Either a Judge at the Federal Circuit Court of Appeals renders a final opinion denying a Federal or Postal Employee his or her disability retirement, or the Federal or Postal employee simply gives up.  As to the former:  Even then, if the Federal or Postal employee has not been separated from service for more than one (1) year, he or she may file a new application for disability retirement. 

Thus, we are left with the latter:  a disability retirement applicant simply gives up.  By “giving up” is meant:  the next step is not taken; the time-frame within which to file a Request for Reconsideration or an appeal is allowed to “lapse”; or, if an appeal is taken, it is done with resignation and surrender.  Nothing good can come out of such an approach.  Each step of the process in a Federal disability retirement case must be attacked aggressively.  Each step must be looked at as a potential place for a new review. Think about it in reverse:  If you don’t take the next step, then nothing good will certainly happen, so what is there to lose?  Indeed, there are times when a client hires me to file a Request for Reconsideration or an appeal to the Merit Systems Protection Board, and the mere filing of my appearance into the case persuades and convinces the OPM representative to reverse course and grant the disability retirement application.  The point of making such a statement is not to “brag”, but to make the larger point:  good things can happen only if you affirmatively act.  Otherwise, you are left with what King Lear said to his daughter Cordelia, that “nothing can come from nothing”. 

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The "Process" at the Reconsideration Stage

It is important to understand that the “process” of filing for Federal Disability Retirement, when it comes to the Second, or “Reconsideration” Stage, encompasses two factual prisms:  (1)  The application has now been denied (obviously, and for whatever reason — most likely because of “insufficient medical evidence”) and (2) it is the stage in the process prior to an appeal to the Merit Systems Protection Board. 

This dual prism of the stage, while self-evident, is important to keep in mind, because it requires a duality of duties:  A.  It requires (for the Disability Retirement Applicant) a duty to show something beyond what has already been shown, while B.  It requires the Office of Personnel Management to be careful in this “process” of review, because if OPM makes a mistake at this stage, then the likelihood is great that they will be required to expend their limited resources to defend a disability retirement case before an Administrative Judge, and if it becomes obvious that the case should have been decided favorably at the Second Stage, it reflects negatively upon the Agency.  OPM is an agency made up of people (obviously); as such, just as “people” don’t like to look foolish, OPM as an Agency made up of people, does not like to look “badly” or “foolish”.  This duality of factual prisms is important to understand when entering into the Second, Reconsideration Stage of the “process”.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Disability Retirement: The "Process"

In my last writing, I briefly discussed why filing for Federal Disability Retirement benefits is, and must be looked upon as, a “process” as opposed to a mere “filing” with an expectation of an “automatic” approval.  This is because there is a legal standard of proof to be met, based upon a statutory scheme which was passed by Congress, and based upon a voluminous body of “case-law” handed down by the Merit Systems Protection Board and the Federal Circuit Court of Appeals.  With this in mind, it is wise to consider that, because it is a “process” with two administrative “stages” to the process, as well as an Appeal to an Administrative Judge at the Merit Systems Protection Board, then potentially to the Full Board via a Petition for Review, and finally to the Federal Circuit Court of Appeals — as such, each “step” in the process would naturally have a different and “higher” level of the laws governing Federal Disability Retirement. 

Because of this, it is often a frustrating experience for applicants, because a rejection or denial at the First Stage of the process often reveals the utter lack of knowledge by the OPM representative of the larger compendium of case-laws that govern and dictate how disability retirement applications are to be evaluated and decided upon.  Often, the so-called “discussion” of a denial letter is poorly written, meandering in thoughtlessness, and self-contradictory and with unjustifiable selectivity of statements from a medical report or record.  Such poor writing reflects a first-level decision-making process, and can be a frustrating experience upon reading the denial letter.  It is good to keep in mind, however, that the entire application procedure is a “process”, and each level is designed to have a greater level of competency and knowledge in the law.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Creativity Is Important In the Applicant’s Statement

It is important to creatively inter-weave facts, feelings, medical impact, symptoms and conditions into a persuasive Applicant’s Statement of Disability.  It should not be overly emotional; it should not be voluminously long; it should not be preachy; it should not be written as a doctor would write it.  It is the Applicant’s Statement of Disability, and it should be from the Applicant’s perspective; but as with every writing, the “audience” to whom anything is written, must always be kept in mind.  Remember that the audience is a reviewing Office of Personnel Management representative — one who is evaluating, analyzing, and making a decision upon the application for disability retirement. 

Of course the independent attachment of medical documentation will be persuasive; of course a review of the position description will have an impact; and of course the analysis of comparing the medical condition with the type of job one has will be scrutinized and will be relevant.  It is the applicant’s statement of disability, however, which will most often be the determining factor.  That is why such a statement must creatively weave all of the various aspects of a disability retirement application — facts, emotions, job impact, medical impact, doctor’s statement, personal statement, impact statement — all in a bundle, all inter-weaving, all in a persuasive, creative description.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: Viewing the Office of Personnel Management

Agencies are “like” people; they are “organic” organizations (a redundancy?), and as a corporate-like entity, they respond and react as people do:  cerebrally, emotionally, reactively, angrily, etc.  If one views an agency in this way — treating the entity as one would a person — then you will often get the same or similar results as when dealing with your brother, a spouse, or a neighbor.  And, indeed, as a logical approach, this only makes sense, because agencies and organizations are made up of people. 

Thus, when filing an application for Federal Disability Retirement benefits, it is often important to think of “incentives” in approaching the Office of Personnel Management, to make every effort to have a carrot/stick approach in filing a disability retirement application.  The “stick” part of it, of course, is the law — the threat of making sure that OPM knows that you will be willing to go the full course — to the Merit Systems Protection Board, to the Full Board Appeal, to the Federal Circuit Court of Appeals.  If OPM denies your case and they get it reversed at the appellate level, it makes them “look bad”.  That is the stick to hold over them — the force of the law.  The carrot part of it is to streamline it and make it as easy as possible by obtaining a clear and concise medical report.

Sincerely,

Robert R. McGill, Esquire