CSRS & FERS Medical Disability Retirement: A Hypothetical

The case-law opinions from the U.S. Merit Systems Protection Board, as well as from the U.S. Court of Appeals for the Federal Circuit, upholds the statement added onto Question 4 of Standard Form 3112A, the form which specifically requests the Applicant’s statement of disability, which asserts:  “We consider only the disease and/or injuries you discuss in this application”.

Failure to identify a particular medical condition can have an adverse impact upon one’s application for Federal Disability Retirement benefits.

Take the following hypothetical: a Federal or Postal employee is terminated from Federal Service; he or she files for Federal Disability Retirement benefits within one (1) year of being separated from service.  While the Statute of Limitations has already been met because the filing has occurred within the 1-year timeframe, during the process of awaiting a decision from the U.S. Office of Personnel Management, the treating doctor has diagnosed with greater specificity the primary and underlying cause of the medical condition.

In his or her haste to file, the (now former) Federal employee quickly noted the diagnosed medical conditions in response to question 4, but nowhere is there an indication of the newly-diagnosed medical condition.  During the wait, it is now more than 1 year from the time of separation.  The quandary:  The Federal Disability Retirement application cannot be withdrawn, because the 1-year Statute of Limitations has already passed, and so he or she is no longer able to re-file.  No additional medical conditions can be added onto the SF 3112A.

Is there a problem? The answer:  Under this hypothetical, potentially yes.

Even if OPM approves the case, there may be future difficulties if OPM approves the Disability Retirement application based upon a medical condition listed, but resolved.  Care in identifying and properly annotating the medical conditions must be taken in preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

Postal and Federal Disability Retirement: Encounters, Problems, Worries…

The entire process of preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS should necessarily anticipate encounters with potential pitfalls, problems, and issues as they appear and erupt, which concern and impact the Federal or Postal employee at every stage of the long procedural process.  

This is a natural part of the application process, precisely because the Federal or Postal employee is suddenly making contact with a multiplicity of personnel and issues:  notification to the agency that one is no longer able to perform one or more of the essential elements of one’s job; filing for a benefit which requires the admission and revelation of the most personal of information — one’s medical condition; encounters with the Human Resources department of one’s agency, one’s treating doctor, one’s supervisor, etc.; the filling out and completing of multiple forms which may determine the outcome of the success or failure of an endeavor which will impact upon one’s financial future and plans; as well as encountering a multitude of other issues, people, and problems in the course of attempting to prove that one is eligible by a preponderance of the evidence for a benefit called, “Federal Disability Retirement”.

Throughout the process, it is important to have the guidance of knowledgeable personnel.  However, there is an important distinction to be made between knowledge and information; there is an infinite plenitude of the latter; the former is what one needs to seek.  

As the process of preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS is a long and challenging process, it is best to anticipate unexpected and unanticipated encounters, worries and problems throughout the process, and to prepare to meet, overcome, and answer each one as they appear.

Sincerely,

Robert R. McGill, Esquire

Federal Worker Disability Retirement: Issues

The issues upon which the Office of Personnel Management denies a Federal Disability Retirement application under FERS or CSRS are normally rather limited.  There are recurrent themes, and some of the more prevalent ones are:  insufficient medical documentation; issues concerning accommodations and attempted accommodations by the Agency; situational disability and issues which focus upon work issues which never should have been included in the Applicant’s Statement of Disability (SF 3112A).  

These are generic designations of the types of issues which an OPM Claims Representative may argue as the primary basis of his or her denial of a Federal Disability Retirement application, and there may be multiple corollary issues which are described — but, ultimately, when all is said and done, there are limited reasons as to why an Initial Stage application for Federal Disability Retirement is denied.  

That fact, however — of the limited basis and reasons — does not mean that the issues are simple; rather, that in responding to a denial from OPM, no matter how lengthy the denial letter may appear (or how short, for that matter), the issues can be neatly “broken down” and placed into manageable categories in order to respond.  Responding to a denial properly (in addition to filing the Request for Reconsideration in a timely manner) is important; how to respond, is all the more important.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for Federal & Postal Employees: Listing the Medical Conditions (Continued…)

If an individual who has filed for Federal Disability Retirement benefits under FERS or CSRS later finds, during the process of waiting for a decision or, between the time of an initial denial and during the Reconsideration Stage or an appeal to the Merit Systems Protection Board — that a previously unlisted medical condition has worsened, can he “add” that medical condition to his Federal Disability Retirement Application?  Can he file an “amended” SF 3112A, Applicant’s Statement of Disability?  The general answer is, “No”. 

However, one can certainly submit a medical report concerning such “previously-unlisted” medical condition if one can reasonably argue that the previously-unlisted medical condition was in fact listed, right there for everyone (i.e., the Office of Personnel Management) to see.  This issue comes up often enough to be of concern, especially because of the valuable time lost in being forced to “withdraw” an application for OPM Disability Retirement and to start all over again in order to add a “new” medical condition.  To safeguard against such a potential event, it is wise to read through the multiple medical conditions when putting together an OPM Disability Retirement packet, and decide which primary diagnoses to include, and at the same time, to “weave” into the narrative of the description of medical conditions, symptoms and areas of pain which can be reasonably interpreted to encapsulate potentially underlying medical diagnoses which may later become prominent and require greater focal emphasis.

Sincerely,

Robert R. McGill, Esquire