Medical Retirement Benefits for US Government Employees: The Balance of Information

In every submission of documentary evidence for a Federal Disability Retirement application, whether under FERS or CSRS, there is the need for discretionary decision-making.

Not every piece of information is relevant or necessary; volume of attachments does not make for sufficiency of substantive content; allowing for certain information to “speak for itself” is often more effective than a long-winded explanatory addendum; and the extent of irrelevant or unimportant information attached or included may well have a decidedly negative impact upon a decision, both in terms of questions raised as to the reason for inclusion of such material, and the detracting nature of such information from the centrality and essence of the submission.

Balance of information is always a consideration.  As time is always of importance, so is maintaining the acuity of attention upon the case worker assigned to review, evaluate and decide upon a case.  Streamlining; making certain that the focus is always upon the nexus between one’s medical condition and the ability/inability to perform one or more of the essential elements of one’s job; and the editorial process of discretionary inclusion of relevant material — these should be the final steps in the formulation and compilation of a Federal Disability Retirement application just prior to submission to the U.S. Office of Personnel Management, whether under FERS or CSRS.

Balance the information — always in favor of relevance, importance, and substantive content.  Fluff is best left to descriptive articulation in a fictional genre.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement for Federal Workers: How to Use Percentage Designations

Carefully.  With discretion.  With an intelligent approach.  Not indiscriminately (a double-negative which, in common parlance, means “discriminately”).  Quantification of pain, of a medical condition, of a loss of use of one’s body functions, ability to have the manual dexterity of the use of one’s fingers, hands, arms; of the flexion and range of motion of shoulders, etc., includes a level of subjectivity at best, and at worst, possibly misrepresents the extent and severity of a disability.

Further, when quantification of the disability of a particular body part is further interpreted to represent a part of a greater whole — as in OWCP/FECA’s attempt to assign a percentage disability of the “whole person”, or when the Department of Veteran’s Affairs calculates a combined percentage rating which is not merely the addition of all lesser individual ratings — it needs some explaining.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, one should obviously utilize all of the available tools, evidence, compilation of documentary evidence, etc., all of which, in their combined entirety, could help to provide persuasive evidence in obtaining an approval from OPM in a Federal Disability Retirement application.  But use of those tools, how it is used, what is used, how it is explained, and whether the explanation is adequate, are all important keys to keep in mind.

OPM is an independent agency.  When you attempt to dictate an outcome based upon a decision of another agency, such an attempt will often appear to be a threat to the very independence of an agency; something which needs to be kept in mind.  What should be submitted is rarely an issue; how it is stated is always a concern.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: Quantifying Quality & Qualitative Quantity

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, it is important to make discretionary decisions concerning multiple aspects of a Federal Disability Retirement application — including the volume, extent, nature, and quality of the medical documentation to be submitted.

Because it is the Applicant (the Federal or Postal employee who is submitting the application) who has the “burden of proof” — that burden which states that by a preponderance of the evidence, one’s Federal Disability Retirement application is more likely to be so than not so — it is therefore up to the Applicant to make determinations as to the quality and quantity of the medical documentation and any other relevant attachments.

Qualitative sufficiency is often a difficult measure to determine; quantitative significance is equally difficult — as in, how much is enough? On the one hand, to submit a thousand pages of medical notes, reports, etc., would probably be “too much”.  But a case which only includes 5 pages of medical reports and notes, while seemingly “too little”, can be more than sufficient if the quality of the records and reports is indisputable and irrefutable in determining that a Federal or Postal employee is no longer able to perform one or more of the essential elements of one’s job.

Ultimately, the discretionary decision will come down to a matter of experience — for it is based upon prior experience that one can make better decisions for the future.  To that extent, to be inrepresented in attempting to obtain Federal Disability Retirement benefits is obviously a disadvantage, because an unexperienced Applicant is merely entering into the arena of Federal Disability Retirement law based upon a “hit or miss” history of inexperience.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Workers: Criteria and Proof, II

In preparing, formulating and filing a Federal Disability Retirement application under either FERS or CSRS, it is important to pause in the beginning stages of the process, prior to “going down the road” of the long and difficult administrative process of preparing a Federal Disability Retirement application, to consider the conceptual distinction between a legal criteria and the proof which is needed in order to satisfy the eligibility requirements of the legal criteria.  

In this day and age when the “culture at large” believes that an individual who speaks the loudest, uses words which appear in form articulate, and in cadence of some eloquence, the reverberations to the legal community have been felt both qualitatively and quantitatively.  Lawyers are supposed to be word-crafters; lay individuals who have some inkling of “the law”, may have some competence in the legal arena, but in order to survive the multiple pitfalls which are inherent in any area of law, it is wise to consider “that which” must be proven, as opposed to the proof itself.  

It is thus important, in preparing to formulate a Federal Disability Retirement application under FERS or CSRS, to review the statutes which govern the eligibility criteria for Federal and Postal employees; to read through the regulations; to research the case-laws as interpretive devices which can expand, constrict or regurgitate the statutory authority as written, as handed down by Administrative Judges at the Merit Systems Protection Board; then, upon a thorough and competent understanding of the legal criteria applicable in a Federal Disability Retirement application under FERS or CSRS, to begin to gather the “proof” which is necessary in order to satisfy and meet the legal criteria.  

Only upon an understanding of the distinction between criteria and proof can one then proceed to gather the latter in order to satisfy the former.  Early distinctions made can clarify and avoid later confusions encountered; or, as the age-old dictum goes, being penny wise is preferable to ending up pound foolish (or some variation thereof).

Sincerely,

Robert R. McGill, Esquire

Federal Worker Disability Retirement: Criteria & Proof

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, a two-step process (at a minimum) must be engaged in when compiling the foundational presentation of a Federal Disability Retirement application.  

First, a thorough reading, comprehension and understanding of the “what” in reviewing the criteria applicable for eligibility and entitlement to a Federal Disability Retirement application:  What does it say?  What is required?  What type of evidence meets the requirements?  And sometimes just as importantly:  What has previously failed to meet the requirements?  

Thereafter, once the conceptual framework of grasping and understanding the “what” of the process, and proceeding to gather the information requested in preparing and formulating one’s Federal Disability Retirement application under FERS or CSRS, then the pre-filing conceptual stage of the second-order should be engaged in:  “Whether”.  

Whether what is gathered is sufficient to meet the legal criteria necessary to be eligible and entitled to Federal Disability Retirement benefits under FERS or CSRS; whether it is either (or both) qualitatively and quantitatively sufficient to meet the legal criteria for eligibility.  The “whether” question is a much more universal one, in that it must encompass the full panoply and compendium of the evidence gathered.  Not that it cannot be supplemented at a later date (it can), although there are restrictions and limitations imposed by what is delineated on one’s Applicant’s Statement of Disability (SF 3112A).

Understanding the conceptual distinction between the “what” and the “whether” is an important mental exercise to undertake, if only on a superficial level of making one pause for a moment to consider whether the extensive effort one must endure will be worthwhile.  

It is better to take the necessary and sufficient time at the outset, than to find out after much effort has been expended, that both the “what” and the “whether” have been insufficient to meet the basic legal criteria for eligibility for Federal Disability Retirement benefits under FERS or CSRS from the Office of Personnel Management.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Disability Retirement: Discretionary Decisions

In preparing, formulating and filing for Federal Disability Retirement benefits under FERS or CSRS, there are obviously the “basics” which one must submit, in order to meet the legal standard of proof of preponderance of the evidence.  

Thus, submitting “adequate” medical documentation which formulates a nexus between the medical condition upon which the Federal Disability Retirement application is based, and the essential elements of one’s job; writing the descriptive narrative to complete the Applicant’s Statement of Disability (SF 3112A), and filling out the other standard forms in order to meet the minimum requirements, are deemed “non-discretionary”, in that one does not have the choice of filing such paperwork  — it is a requirement.  

However, certain other documentation can be designated and categorized as “discretionary” —  whether to include certain medical conditions, and therefore medical documentation which bears upon the particular medical condition; whether to include paperwork from one’s OWCP, Department of Labor filing; Veteran’s Administration ratings, findings, medical documentation; Social Security Disability paperwork; additional statements from co-workers; Private Disability Insurance paperwork, etc.  

“Discretion” implies freedom to act or not act, but the problem will often arise, “In what context”?  Discretion is a wonderful, liberating position to be in; acting effectively in a discretionary manner requires research, and knowing the relevant criteria to apply in making a proper decision; and an understanding of the laws governing Federal Disability Retirement in making the “right” discretionary decision.  

Using discretion in making discretionary decisions is the key to obtaining a positive discretionary determination from the Office of Personnel Management.

Sincerely,

Robert R. McGill, Esquire