FERS & CSRS Disability Retirement for Federal and USPS Workers: Responses

Whether fair or not; whether consistent or a lack thereof; the one who holds the power of determination ultimately has the authority of interpretation — until and unless a higher authority supersedes such power.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, the Federal or Postal employee can seemingly comply with all of the requirements of the laws and case-laws governing Federal Disability Retirement eligibility and entitlement, and still be denied.

The standard response on the telephone is often, “I thought I had a slam-dunk case…”  But the problem with approaching a governmental bureaucracy is that one assumes (wrongly) that application of the law will be implemented in an interpretively consistent manner.  But where individuals are involved, a multiplicity of interpretive approaches will surface.

Some OPM personnel will focus upon certain legal aspects over others; others will apply a “higher” bar of passage as to what meets the “preponderance of the evidence” test; and still others will be so obtuse as to refuse, or merely fail to, accept that when a doctor (for example) states that a condition is “permanent”, that such a statement logically entails and encapsulates the satisfaction of the requirement that a medical condition will last a “minimum of 12 months“.

How to respond to such inconsistencies? By reasserting the law; citing applicable case-law; by preemptively guiding OPM into approving one’s Federal Disability Retirement case.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for US Government Employees: Denials

Denials issued by the U.S. Office of Personnel Management in a Federal Disability Retirement application are informative in multiple ways; while based upon templates for the most part, they often make arguments which are neither based upon the legal precedents which currently prevail, nor on standards of proof which are applicable.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, the Federal or Postal employee is expected to submit a Federal Disability Retirement application based upon the standard of proof and legal requirements which are current, applicable, and relevant.

Yet, if a denial is issued by OPM — one that is based upon language which is clearly contravening the statutory standards of legal precedents — that requires things which are not truly required, then what does one do?

It is tantamount to proving a negative:  how does one prove that a murder did not occur?  Or that a man did not say something asserted to have been stated?  Or that one’s Federal Disability Retirement application does not contain “compelling” medical evidence, or here’s a better one:  “According to AMA Guidelines, you do not have more than a 5% permanent disability rating…”  What?  For OWCP purposes, that may hold some meaning or relevance, but for a Federal Disability Retirement application, it means absolutely nothing.

The answer to the question, What does one do?  What one must — go to the next level, with the proper legal tools in hand, to answer such nonsense.  Or, better yet, start at the first level with some preemptive legal arguments.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Resisting Tendencies

In filing an application for Federal Disability Retirement benefits under FERS or CSRS, there is a tendency to assuming that the Federal Agency will be providing a complete, fair, impartial, and thorough review of one’s application, and that one’s disability retirement application will be applied in accordance with the law.  Such a tendency to expect a certain level of competence and impartiality is certainly understandable; but the reality is far from the tendency of such expectation.

There are many factors which interfere with such expectations: the competency of the assigned OPM representative; the knowledge (or lack thereof) of the individual Representative; the caseload; and multiple other factors. Thus, when there is the false expectation that one’s Federal Disability Retirement application has been fully reviewed and the entirety of the law has been taken into consideration, there is a tendency to believe what the Office of Personnel Management has said as gospel truth.  “There is insufficient objective medical evidence to…”   “The MRIs failed to reveal that…”   “Your doctors failed to state that…”

These are all generic statements that may or may not be true, but sound like they provide a basis for a denial.  Resist the tendency to believe what OPM says; ultimately, a Federal Disability Retirement application must comply with the laws which govern the administrative process, and may well have to go to an administrative judge to prove the issue.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: The Cost of Doing Nothing

The Office of Personnel Management has been sending out a number of decisions, and many have been denials.  They seem to come in batches; whether by coincidence, or in systematic fashion, OPM has tended in recent months to send out denials which fail to explain, leaving aside any concept of “discussion“, the basis of their denials.  

The irony of having a section entitled, “Discussion”, then merely delineating a regurgitation of the “applicable criteria to be eligible for Disability Retirement benefits“, then making a conclusory & declarative statement somewhat in the form of:  “You do not meet criteria X and Y” is hardly a “discussion” of the issues.  Moreover, even in the denials which appear to be lengthy is the number of sentences, paragraphs or pages, the content is devoid of any substantive discussion of the issues.  It is more often simply a reference to a doctor, without any rational basis given as to what is lacking, but merely ending with a statement of conclusion, saying, “No objective medical evidence was provided,” or “The medical evidence does not show that…”  One would expect that a logical structure of reasons would be provided, but such an expectation would fall short of what actually occurs.  The real problem is that, in reading such a denial letter, one doesn’t know where to start, what to answer, or what additional information needs to be submitted.  Thus, you must “read between the lines”.  The cost of doing nothing is to get a further denial; that is simply not an option.  The best option is to reinforce what is already there.

Sincerely,

Robert R. McGill, Esquire

FERS Disability Retirement for Federal and USPS Workers: Selective Reality

The problem with an unrepresented Federal or Postal employee who files for Federal Disability Retirement benefits from the Office of Personnel Management, is that because this is the one and only encounter with OPM, any response from them will be a narrow, one-dimensional perspective.

Thus, if the Office of Personnel Management denies the Federal or Postal disability retirement application, such a denial, the manner in which it is written, the content, the apparent delineation of “the law”, and the loosely-stated declarative statement while vaguely referring to the insufficiency of one’s medical documentation, will result in a narrow perspective, in a vacuum of reality created by OPM.

OPM’s denial letters are notorious for its selective reality.  Such selective reality will completely ignore all medical statements which seem to support the OPM disability retirement application, while selectively focusing upon every tidbit of medical notations which favor the denial.

Thus, be careful if on any given day, you arrive at the doctor’s office and the doctor asks you how you are feeling, and you respond with, “I’m feeling pretty good, today.”  Such a conversational statement may nullify the fact that, in its proper context, what the reality of your statement meant to convey was:  “I’m feeling better today in comparison with yesterday and the entire month before, but in no way could I perform my job even today.”  But OPM will selectively pick upon that one statement, and run with it — to a complete and total basis in denying your Federal Disability Retirement application under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire