OPM Medical Retirement Attorney: Formulating the Effective Case

Is it inherently presupposed that a case to be formulated is one which should be “effective”?  By the insertion of that term, of course, it immediately implies a retrospective vantage point — an “ends” to “means” view of an outcome-based approach.

If a Federal or Postal employee who files for Federal Disability Retirement benefits, whether under FERS, CSRS or CSRS Offset, receives a denial from the U.S. Office of Personnel Management, one assumes that the case was not “effectively” formulated.  On the other hand, if an approval is received from OPM, one need not consider any such issue, but merely moves on to the “when” phase — as in, “When am I going to get paid“?

Outcome-based formulation of a case is never an unwise approach; but the mere fact that a denial is issued by OPM after reviewing a given Federal Disability Retirement application, does not mean that the case itself was not originally “effective” in the formulation and submission.

There are OPM “administrative specialists” who systematically deny cases; certain others who require a higher standard of proof beyond what the law mandates; and even those who extrapolate clear evidence in a denial which establishes eligibility for Federal Disability Retirement, but nevertheless concludes with a disapproval.  Such arbitrary outcomes may seem unfair and unwarranted, but it is a reality which must be faced.

In light of this, the positive outlook to embrace is the fact that Federal OPM Disability Retirement is an administrative process with multiple stages for appeals and additional bites at the proverbial apple.  From the outset, it is always a good idea to carefully prepare, formulate and file an “effective” case; but the mere fact that the first attempt fails to achieve the outcome desired, does not diminish or extinguish the positive assessment reached at the outset when first the Federal Disability Retirement packet was submitted; rather, it just means that additional proof and evidentiary addendum must be forthcoming to satisfy the bureaucratic process of further effectuating the efficacy of an already-effective case.

Sincerely,

Robert R. McGill, Esquire

 

Federal and Postal Disability Retirement: On the Other Hand

On the other hand, there is no such thing as a “lost cause” case.  To assert such a conclusion would be to presumptively admit defeat.  In Federal Disability Retirement cases, there is always a good chance of prevailing, whether or not a mistake was made; whether or not a doctor annotated, on a particular day in a moment of hope, that the patient showed “hopeful improvement”.  Yes, it is the job of the Office of Personnel Management to cling onto such peripheral statements, and to magnify such statements such that they appear to encompass the essence of the medical condition.

It is always with some amusement that I hear an agency Human Resources person state something to the effect of:  “Well, you know, Mr. McGill, this is not an adversarial process.  We and the Office of Personnel Management are merely here to determine the eligibility of the Federal worker, and to make sure that he or she fits the criteria.”

Not an adversarial process?  Is the Office of Personnel Management “there” to help you?  Is that why, in their template denial letters, they latch onto the most peripheral of issues and emphasize those points which allegedly present a problem, and ignore the rest of the medical evidence?  Any Federal or Postal employee who is contemplating filing for Federal Disability Retirement benefits under FERS or CSRS would be wise to see the entire Federal Disability Retirement process as one of an “adversarial process”.  If you don’t, you proceed at your own peril.  On the other hand…

Sincerely,

Robert R. McGill, Esquire