Federal Employee Medical Retirement: Back to Fundamentals

In any endeavor, concern or current focus of attention, one can become embroiled in the morass of complexities which comprise the peripheral penumbras of the issue, and disregard the fundamental essence of the matter.  In proverbial terms, it is to overlook the individual trees while viewing the generality of the forest.  So, back to basics.

In a Federal Disability Retirement application, a person who is under FERS (Federal Employees Retirement System — normally those who entered into the Federal Workforce sometime after 1985, and who have a Thrift Savings Plan and contribute to Social Security) or under CSRS (Civil Service Retirement System — pre-1985, with no TSP) may become eligible for Federal Disability Retirement benefits, but must have the following minimum eligibility criteria met: under FERS, you must have at least 18 months of creditable service; under CSRS, you must have at least 5 years of creditable service.

There is a hybrid status applicable for some, called CSRS-Offset, also.  Once that eligibility criteria is met, then the Federal or Postal Worker can take the next step in determining whether one may want to proceed, by asking the following questions: Do I have a medical condition? Does that medical condition prevent me from performing one, if not more, of the essential elements of my position? What are some of the essential elements of my position which I cannot perform? Do I have a treating doctor who will be supportive of my case (remember, this is a medical disability retirement; as such, one must be able to establish through proof of medical documentation, that the medical condition impacts one or more of the essential elements of one’s job)?

These are some of the preliminary, basic questions which should be asked and answered, in order to begin the process of determining whether Federal Disability Retirement is the best pathway for the Federal or Postal employee suffering from a medical condition, in order to manage and maneuver one’s way through the thick forest of a bureaucracy known as the U.S. Office of Personnel Management, which is the agency which ultimately receives and reviews all Federal Disability Retirement applications, whether you are under FERS, CSRS, or CSRS-Offset.

Sincerely,

Robert R. McGill, Esquire

Postal and Federal Disability Retirement: The Independence of Each Program

The disparate nature of each Federal program, with little to no intersecting coordination amongst them (with the exception of SSDI and FERS Disability Retirement benefits in the coordination of payments upon approval of each) betrays the unplanned, thoughtless creation of each program, as well as a sense that each agency wants to maintain its feudal control and assertion of independent power.

That perhaps explains, in part, why each program ignores the extent of persuasive authority the approval of another program should logically have, upon an approval and acceptance by the “other” program.  Does it make sense that being granted “unemployability” status under the Department of Veterans Affairs ascription of percentage disability ratings would only have a nominal impact upon a FERS Disability Retirement application?  Or that an SSDI approval would have, at best, a persuasive effect upon a FERS Disability Retirement?

It is somewhat more understandable that a case accepted by OWCP/Department of Labor would have minimal impact upon a FERS or CSRS Disability Retirement application, precisely because the former is set up as a program of rehabilitation in an effort to return the Federal or Postal employee back to his or her job.

The only true “coordination” of benefits occurs between SSDI and FERS — and that, only if both are approved, and payments are received concurrently; but even then, there are often overpayment problems, lack of the left hand knowing what the right hand is doing, etc.

Thus Coordination and intersection between departments, agencies and various programs rarely occurs.  Agencies tend to want to remain independent.

Such lack of coordination, however, does not mean that the FERS or CSRS Federal or Postal employee should not force a legal argument upon OPM when a significant finding is made by another agency or program.  For, in the end, it may not be the U.S. Office of Personnel Management which listens, but an administrative judge at the MSPB, or a 3-judge panel on the Federal Circuit Court of Appeals; in which case, a precedent will have been set, for all to (hopefully) follow.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Misunderstanding Leading to Irreversible Detriment

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, the Federal or Postal employee must first engage in a general foraging for information.

The act of gathering information is of importance; for, just like the animal in the wild who must “learn” to forage for food before the first winter comes, so the Federal or Postal employee who is contemplating filing for Federal medical/disability retirement benefits must develop the keen sense of how to gather the necessary, pertinent and relevant information concerning the entire bureaucratic process, and once gathered, to sift through the vast array of information to determine truth, falsity, relevance, effectiveness, and that which is erroneous or misleading — to one’s detriment.

Foraging is a learned tool, necessary in the wild, and a key component of the natural process of selectivity.  It begins with an inborn part of an animal’s nature, but must be honed in the wild — to be clever, quick, and be able to distinguish between that which is good for one’s diet, as opposed to that which may be poisonous.

By analogy, in the vast array of the universe of information “out there”, one must be able to quickly discern and bifurcate information concerning Federal or Postal Disability Retirement benefits, dividing between relevance and irrelevance, substance versus fluff, for purposes of failure versus defeat.  As information gathering leads to action upon the knowledge gained, so one must be cautious in determining the source of such information.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Government Employees: Use of Collateral Sources

Context is important.  Identifying the relevance of importance, however, is discretionary, and requires some insight into the impact which a differentiated distinction might require.

Allow for some expansive explanation:  In attempting to obtain OWCP/DOL benefits, one may want to argue against the validity of a medical evaluation — i.e., by attacking the claimed “independence” of the medical evaluation (argument:  the doctor is being compensated by the Department of Labor; 25% of his practice is devoted to such evaluations, and out of that, 95% of his evaluations are found to be in favor of the Department of Labor, etc.).  But the fact that one may want to attack the relevance and validity of an  independent medical examination within the context of the Office of Worker’s Compensation, does not mean that when one files for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, that one should necessarily and unequivocally discard the received report from OWCP.

There may well be statements contained in such a report which may be useful in arguing to OPM that one’s Federal Disability Retirement application should be approved.  Can one argue positively that it is an “independent” medical examination?  Absolutely.  In fact, the contrary argument should be made:  that because the doctor was selected by another government agency (Department of Labor), it is all the more so that the medical opinions of the particular doctor are relevant and of significant impact.  One must be careful, of course, in using such collateral sources for support of one’s Federal Disability Retirement application, but so long as the proper context is identified and understood, one should always consider the use of such “other” sources of support — but never to replace the primary importance of one’s treating doctor.  Context, properly understood, can result in substantive argumentation of relevant and significant import.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Medical Support, Belief, Documentation and the Diagnosis

Ultimately, in preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, one must always remind one’s self that this is a “paper presentation” (regardless of the prevailing and inevitable march towards a paperless society) to the U.S. Office of Personnel Management (OPM).  As such, there are certain inextricable components in the presentation itself, which must be reviewed, evaluated, and decided upon before proceeding.

As a “presentation” which is meant to be persuasive — i.e., proving by a preponderance of the evidence that one is entitled to the Federal Disability Retirement benefit, whether under FERS or CSRS — it must obviously have the essence of the proof itself:  Medical Support.  Without the medical support, one need not consider moving forward at all.

Once the Federal or Postal employee has ascertained that he or she has the medical support to proceed, then the question is one of obtaining the documentation which confirms such support.  For, a pat on the back and a wonderful smile from the doctor will not be persuasive to OPM; the doctor must be willing to document, in detailed format, the support which is expressed.

Next, in sequential order, the medical documentation must reveal, convey, and persuasively reflect, a level of belief which will be tested in the event that the Federal Disability Retirement application is denied at the First Stage of the Process, and further tested if it is denied at the Second, or Reconsideration Stage, of the process.  Thus, in short, the treating or supporting doctor must possess a level of belief in one’s case, and be willing to support that belief throughout the entire administrative process.

Finally, the doctor must be able to make a diagnosis, but more than that, to support the diagnosis, and be willing to make the “nexus” between the diagnosis, the patient’s physical, emotional and cognitive capabilities, and to relate them to one’s positional duties of one’s job.  It is through this process of connecting the dots, where the end-goal is achieved:  of obtaining one’s Federal Disability Retirement benefits.

Sincerely,

Robert R. McGill, Esquire