Medical Retirement for Federal Workers: Understanding a Differing Perspective

Sometimes, all that one can do is scratch one’s head.  That common statement — to “scratch one’s head” — is meant to convey puzzlement or disbelief over an action, statement, or occurrence which belies rational explanation.  As rationality has been the foundation of thoughtfulness and considered formulations of explainable actions, so logic and reason have been the joists which provide the bridging support for acceptable discourse.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, one assumes that there will be a fair and reasoned review of each Federal Disability Retirement application.

If a Federal Disability Retirement application is approved, then of course the level of rational discourse need not be extensive — for, implicit in the approval itself is an acknowledgement that the legal nexus between the medical conditions described and the statutory criteria required to be met, have been adequately constructed.  But in a denial, one would expect a well-reasoned discourse of “why”, as opposed to a standard template of identifying various documents submitted, and multiple declarative statements (with barely a rational explanation) of, “You do not meet criteria No. X”.

Often, it is a waste of time to try and understand the perspective of OPM.  The Office of Personnel Management is an agency which is busy and overwhelmed with a volume of cases.  Time constraints often betray the proper application of the law.  It is well that the old saying did not refer to scratching one’s back; for, there are many places where one simply cannot reach in order to scratch, and that is the sense one is left with in reading some of OPM’s denials.

Sincerely,

Robert R. McGill, Esquire

Federal Worker Disability Retirement: Creating a Meaningful Bridge

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, it is obviously important to construct an effective bridge, or nexus, between one’s identified medical conditions and the type of positional duties which one performs at the Federal Agency or the U.S. Postal Service.  

In doing so, one should keep in mind certain essential points, each from the perspective of the Office of Personnel Management (which is the agency which will determine whether the Federal or Postal employee/applicant’s Federal Disability Retirement application will be approved or denied).  

For instance, the Office of Personnel Management (OPM) will only consider those medical conditions which are identified in the Applicant’s Statement of Disability (SF 3112A).  Once a CSA Number (an administrative identifier which is assigned by OPM — an eight-digit number beginning with “4” for CSRS employees and ending with a “0”; and for FERS employees, beginning with an “8” and ending with a “0”) is assigned to an application, the Federal or Postal employee is no longer able to add any further medical conditions without withdrawing the application completely, and re-submitting it anew.

Further, while the Office of Personnel Management will consider specific duties and descriptions of duties which are delineated and expanded upon in the narrative portion of SF 3112A, it is the “official” position description which will ultimately be controlling. Thus, a logical variance from the official position description as to what a Federal or Postal employee does, will not make any difference.  However, if what the Federal or Postal employee states that he or she is doing, is completely at odds with what the positional description states that he or she should be doing, then the controlling default will be the official position description.  

It is wise to keep these two perspectives in mind, in creating an effective bridge for a Federal Disability Retirement application.  For, ultimately, it is the perspective from the “other side” which matters, and as such, OPM’s perspective of how a Federal Disability Retirement application is reviewed and considered, is an important aspect in preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Symptoms & Diagnoses

In filing for Federal Disability Retirement benefits under FERS or CSRS, it is not that a formal diagnosis is unimportant; rather, it is that the diagnosis itself is merely a starting point and does not reveal the story which must be told in order to be eligible for Federal Disability Retirement benefits under FERS or CSRS.  

From a medical viewpoint, for treatment purposes and from the perspective of the treating doctor, identifying the source of the pain, entertaining the various treatment options, considering which treatment modalities will be most effective, etc., all play into identifying the proper source of the symptoms.  Thus, from a treatment perspective, identifying the medical condition by ascribing the proper diagnosis is of paramount importance.  A doctor often cannot begin the proper course of treatment unless and until formal identification is established. To that extent, it is also the beginning point for the treating doctor, in that once a source of pain or origin of symptoms is diagnosed, then various treatment modalities can be considered.  

For purposes of becoming eligible for Federal Disability Retirement benefits under FERS or CSRS, it is also merely a starting point.  As the Office of Personnel Management often likes to point out, “The mere existence of a medical condition does not mean that a person is disabled from performing one or more of the essential elements of one’s job.”  While quoting OPM as the source of legal authority is normally unwise, nevertheless one must grant that this particular statement is true within its limited context, and must be kept in mind when preparing a Federal Disability Retirement application under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: Content & Substance

Form, Content & Substance.  Form is the appearance and the general approach & methodology of a Federal Disability Retirement packet; Content is the essence of that which makes up the materials in the packet; and Substance (hopefully) is the “meat” of the packet itself.  Make sure that what is stated is substantive.  

OPM Representatives have multiple cases.  From the perspective of the Federal Disability Retirement applicant, it is a singular case, because it is one’s own case, and the personal nature of such a case makes it of paramount importance.  From the perspective of the OPM Representative, however, it is one of multiple cases, and it is part of his or her job.  If one has to wade through a generous amount of fluff before getting to the content of the Federal Disability Retirement application, the energy expended may be a distraction from a serious review of the substantive content.  A descriptive narrative bridging the medical condition with the type of job one performs is a necessary component; but as between a concise short story and a novella, the former is to be preferred in preparing and filing a Federal Disability Retirement application under FERS & CSRS.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: The Chasm between Denials

From the perspective of an individual Applicant for Federal Disability Retirement benefits under FERS & CSRS, the individual applicant does not normally observe some other person’s Federal Disability Retirement application, and therefore never has the opportunity to see the “greater process” at work, or patterns of behavior on the part of the Office of Personnel Management.  Yet, there are indeed patterns, and that is why an experienced attorney who has seen literally thousands of Federal Disability Retirement cases over numerous years, has an advantage in responding to OPM’s denials.  Experience lends itself to greater observation.  Experience over time reveals certain patterns.  And patterns of behavior can reveal important principles. 

Certain OPM Representatives provide detailed and (often) irrelevant factual references which can be ignored; others like to “cite the law” and believe that such citations appear irrefutable and authoritative; and still others give scant discussion to laws or to facts.  Thus, there often appears to be a great chasm between the types of denials.  Whether or not there are such differences, an applicant who has received a denial for his or her Federal Disability Retirement case needs to respond to any such denial with a three-pronged attack:  Medical refutation; Factual correction; Legal assertion.  Such an attack will cover any chasm which might exist between the different individuals who send out a denial letter.  More importantly, it will cover the necessary elements for winning a Federal Disability Retirement case.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Those “Second-Class” Medical Conditions

We all know what the “Second-Class” medical conditions are:  Fibromyalgia, Chronic Fatigue Syndrome, Diffuse Pain, Chemical Sensitivity issues, etc.  To some extent, such medical conditions have always been a paradigm of a society — at one time, one could argue that all psychiatric conditions were treated in a similar manner:  accepted at some level as a medical condition, but stigmatized as somehow being less than legitimate.

In a Federal Disability Retirement application under FERS or CSRS, it is patently obvious that the Office of Personnel Management treats certain medical conditions as “second-class” conditions.  They often deny such cases at the initial stage of the process, and unless you point out a compendium of established case-law authorities, OPM will often get away with their groundless assertions.

Words matter, and which words and arguments are chosen to rebut the Office of Personnel Management matters much in a Federal Disability Retirement case.  Such medical conditions are not second-class medical conditions, and OPM should not be allowed to treat them as such.

Sincerely,

Robert R. McGill, Esquire