Medical Retirement Benefits for US Government Employees: The Game of Go

The game of Go involves planning, strategy, finesse, a sense of when to aggressively pursue, and a lesson of when to withdraw.  It is a game originating from China, thousands of years old, yet identical in play and rules today.  It is a game of daily living; and, indeed, even the tactile component of feeling the soft smoothness of each stone as you place them on the surface of the playing board, along with the geometric beauty of the patterns which your opponent complements as you lay your handiwork — all with the attribute of two basic colors:  black and white.

One can always make too much of an analogy between sports and life; fiction and reality; a mere game, and a process.  Games ultimately are what they are:  a play which, in the end, has no significance beyond the entertainment of the moment.  But some games help to sharpen one’s sense of daily living.

The metaphor and analogy to be applied between the game of Go and practicing law, including preparing, formulating and filing on behalf of Federal and Postal employees to obtain Federal Disability Retirement benefits from the U.S. Office of Personnel Management, is the need to understand the process; to present the evidence in a bold and unabashed manner; and to understand the “opponent” and what the opposition represents and will likely do.

Preempting what the U.S. Office of Personnel Management is likely to do in response to one’s handiwork, is an essential part of both the game of Go and of any practice of law.  That is why a legal strategy is important and relevant in the preparation of a Federal Disability Retirement application — for, like the game of Go, unless you make the proper connections between the medical evidence, the law, one’s positional duties, and one’s statement of disability, you will be surrounded by your opponent’s tactile placement of experienced handiwork, and find that all of your efforts have come to naught.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: Flexibility in a Plan

“What is the game plan?”  That is the question which, when posed, is evidence that one recognizes that engagement in an activity or process should have a logistical and strategic paradigm from which to proceed.

Such an overarching plan need not be a formally drawn, meticulously detailed one; it can be fairly general in its guideposts, with some specificity in milestones.  But to formulate a plan which is discernibly comprehensible is an important first step before initiating any process, whether legal, recreational or otherwise.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, the plan of action is important to the overall administrative facet, if only to respond to outside pressures which will almost certainly prevail upon the Federal or Postal employee — from one’s agency; from the financial pressures which will continue to remain a factor; from the ongoing medical condition itself.

Yet, within any “game plan” or “master plan”, one must also figure in a necessary component of flexibility.  Just as the future is never a certainty or a predictable development, so changes in a process where one is attempting to file for a benefit will often incur and involves unforeseen changes and malleable circumstances.

An unseen event or trigger, however, does not necessarily mean that one cannot proceed; it merely require the ability to circumvent the obstacle, if indeed it is an obstacle at all.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Preempting Anticipated Problems

The obvious and self-evident problems of many can be characterized as failing to know what the questions are; for, if the question is unknown, how can one provide an answer?

Thus, in entering into the surreal universe of Federal Disability Retirement benefits, which can be both a procedural, administrative nightmare, as well as a substantive morass of conflicting and confusing legal framework, the novice who first encounters the Standard Forms (SF 3107, with Schedules A, B & C for the FERS employee; SF 2801 with Schedules A, B & C for the CSRS employee; and SF 3112 series for both the FERS and CSRS employee) may well have a perspective that, inasmuch as the questions asked are fairly easy to comprehend, the answers themselves would naturally, likewise, be easy to append.

But as much of law and the success of legal reasoning involves the preempting of anticipated problems (e.g., that is precisely what Estates & Trusts attempts to do — to anticipate any objections of those who are heirs or potential beneficiaries of an estate), so the lack of knowledge of the wide body and historical evolution of how X came to be through the legal evolution and expansion of Y, results in the grave disadvantage of the Federal or Postal Worker who stumbles upon the compendium of the Federal Disability Retirement process.  And, of course, the U.S. Office of Personnel Management loves nothing more than to look upon the unknowing Federal or Postal applicant, with hungry eyes, ready to pounce upon such lack of knowledge.

Preempting a problem requires the anticipation of the question; and knowing the question is the first step to coming up with an answer.

Sincerely,

Robert R. McGill, Esquire

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

OPM Disability Retirement: Burden of Proof

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, a considerable amount of effort goes into anticipating any objections which may be encountered by the Office of Personnel Management, and to “preempt” such anticipatory objections by addressing them at the outset.  

A proper balance must be maintained in engaging in such preemptive accounting, because one does not want to address the issues which would unnecessarily create a “red flag”, yet at the same time, discussing and explaining reasonable areas of potential concern should be a part of any Federal Disability Retirement application.  

The problems always arise because it is the Federal or Postal employee who is filing for Federal Disability Retirement benefits who has the affirmative burden of proving one’s eligibility for Federal Disability Retirement benefits.  The Federal or Postal employee must, by a preponderance of the evidence, prove his or her “burden of proof” affirmatively.  

Conversely, the Office of Personnel Management has the authority to review, criticize, analyze, and ultimately approve or deny a Federal Disability Retirement application under FERS or CSRS.  They can merely sit back and take pot shots at an application, point out that this particular legal criteria was not “sufficiently met”, or simply make a generic statement that the medical evidence did not present a “compelling enough” case (what in the world could such a generalized non-statement possible mean?).  

Yet, one must play the language game, and play it well, and the best way to play it is to attempt to preempt and anticipate OPM’s potential objections, and to meet one’s burden of proof by jumping ahead, and predicting how an OPM Representative might view the Federal Disability Retirement application that is being prepared.  Predicting the future is always a tenuous endeavor; nevertheless, one must engage the potential pitfalls, and anticipate the actions of the Office of Personnel Management, if one is going to be successful.

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