Federal Disability Retirement: Symptoms Versus Diagnosis

If disability retirement were merely a matter of determining the proper diagnosis of a medical condition, and having a doctor ascribe a percentage rating of disability, then the process of disability retirement would substantively be altered, and perhaps there would be far fewer cases to adjudicate at the Merit Systems Protection Board level. For, if the criteria were that ‘cut and dry’, there would be little for OPM and the applicant & the applicant’s lawyer to argue over. However, it rarely is that ‘cut and dry’ — because the major battle is rarely over the diagnosis; it is rarely over an issue concerning a percentage ascription of disability; rather, it is over the symptoms manifested, the significance of such symptoms upon the type of work one does, and in the impact such symptoms have upon the essential elements of one’s job.

That is why descriptive terms are important in disability retirement law. It is not so important ‘what it is’, as opposed to ‘how it is characterized’. From this perspective, it is important for a disability retirement attorney to be more of a poet than to be cold and analytical — although, the best approach would be to have a little bit of both. Remember to always know the context — the applicant will not be standing in front of an OPM representative showing how terrible the applicant’s medical condition is; there will be no visual presentation; everything is based upon a narrative — the applicant’s statement, the medical documentation, the legal memorandum of the attorney, etc. Thus, it is all-important for the attorney who represents a disability retirement applicant to have a good command of the English language.

Sincerely,

Robert R. McGill, Esquire

OPM FERS & CSRS Disability Retirement: Answering OPM’s Concerns at the Reconsideration Stage

Beyond making sure that you have enough time for your treating doctors to provide you with updated medical documentation at the Reconsideration Stage of the process, an applicant must take care in addressing the the underlying concerns expressed by the Office of Personnel Management.

Unfortunately, this is a stage in the process which will probably require an attorney who is knowledgeable in the area of Federal Disability Retirement law. Why? Because the Specialist who denies an application for disability retirement will often provide a “laundry-list” of purported evidence which the Specialist claims would be “helpful” in proving your case. The laundry list provided is often a mis-statement of the law. It is up the the attorney to point out to the Office of Personnel Management what the correct statement of the law is; at the same time, however, it is important to “read between the lines” of a denial letter, and address some of the underlying “missing links” which provided the basis for the denial.

This is where the assistance of an attorney can be crucial. For it is the job of a disability retirement attorney at the Reconsideration Stage to do three things: (1) point out the correct law, (2) provide updated medical documentation to address the concerns of OPM in the denial letter, and (3) correct any errors that the applicant made in the initial stage prior to having contacted a disability retirement attorney.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS disability retirement: The Applicant’s Methodology

OPM’s methodology is important to understand in preparing a Federal Disability Retirement application. Such understanding of the methodology, however, must be for a singular purpose: to refine the methodology of the applicant in preparing a disability retirement application. Thus, lessons learned must be lessons applied. An applicant must not be overly general in listing and describing the medical conditions.

The list of medical conditions should be in the order of their severity. The list should not be a “laundry list”, but each medical condition should clearly be significant, to the point where a “nexus” can be described between the particular medical condition and one of the essential elements of one’s job.

Finally, an applicant should not overstate the severity of the medical condition described; rather, the supporting medical documentation should support the claims of the applicant in every detail, in every essential respect, and in every significant aspect. The applicant’s statement must have integrity, and must accurately reflect the truth of the applicant’s medical condition. If this is done properly, one’s application for disability retirement should be approved at the first stage of the process.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: OPM’s Methodology II

When the Office of Personnel Management approves an OPM disability retirement application, as I stated in the previous article (OPM’s Methodology), they will normally choose to approve it based upon only one of the listed disabilities. This is because, from OPM’s viewpoint, if the applicant lists multiple medical disabilities, once OPM reaches any one of the listed disabilities and finds that one of them is a basis for an approval, there is no further need for OPM to review the remaining medical conditions.

This methodology requires that future applicants consider the consequences of such a method: it is essential that the applicant base a disability retirement application upon only essential, significant medical conditions, normally best to list them in the order of significance, and further, to document a case in the order of severity.

While I have not heard of a disability retirement application being approved based upon a non-essential, minor medical condition, it is wise not to rely upon the off-chance that OPM might base an approval upon a medical condition that is somewhat “thrown in” as an afterthought, into the applicant’s statement of disability. In other words, it is not a good idea to “throw in the kitchen sink” at the last moment, thinking that by multiplying the quantity of medical conditions listed, that OPM will see how “serious” one’s medical condition is. Remember, it is not the totality of many medical conditions that is important; rather, it is the list, however small, of those medical conditions that prevent one from performing one or more of the essential elements of one’s job.

Sincerely,
Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: OPM's Methodology

When the Office of Personnel Management (OPM) approves a federal disability retirement application, a separate page from the approval letter will often be attached, which states the medical basis upon which the disability retirement application was approved. The separate page will often state something to the effect of: “You submitted an application for disability retirement based upon medical conditions, A, B, C & D; however, your application was approved for medical condition B only.”

The concern here, of course, is that if you are later selected to answer an OPM Medical Questionnaire asking you to re-establish your medical disability for continuation of your disability annuity some years later, that you make certain that you answer such a Medical Questionnaire based upon that very medical condition upon which you were approved. This is obviously important. Some have questioned whether or not you can appeal the approval letter based upon the fact that you believe OPM should have approved you based upon a different medical condition. In my view, this is not an appealable issue, and if you question OPM as to whether they should have considered you disabled based upon another medical condition, you may be in greater danger by OPM reversing themselves based upon a re-review of your case. It is best to leave “well enough alone”. Accept the approval letter based upon the identified medical condition, and inform your treating doctor that you may need his input in the future — to address that very medical condition for which you were approved.

Sincerely,

Robert R. McGill, Esquire