Federal Disability Retirement: Facts and Explanations

There is often a widespread misconception that “facts” need no elucidation or explanation, and somehow speak for themselves.  There are, indeed, times when self-imposed limitation of apparent eloquence and bombastic, grandiloquent and pretentious verbosity is of use; for, scarcity of adjectives and brevity of prose can leave the plains and tundra of a descriptive narrative’s call for less inhabitants, and not more, to reveal the beauty of the linguistic landscape; but even in such instances, facts still require explanation.

Facts without explanation constitute mere artifacts floating in a vacuum of a historical void.  It is thus the prefatory context provided by explanatory delineation, or the sentence next which elucidates the relevance and significance of an event before. Without the explanation, facts merely remain an artifice with a lack of architectural integrity, lost in the quagmire of historicity without dates, times or epochs of reference.

For Federal employees and U.S. Postal workers who are considering filing for Federal Disability Retirement benefits through the U.S. Office of Personnel Management, whether the Federal or Postal worker is under FERS, CSRS or CSRS Offset, the misunderstanding between the conceptual bifurcation of “facts” and “explanations” is often exponentially magnified to the detriment of the Federal Disability Retirement applicant when one presumes that “medical facts” speak for themselves.

Thus does the Federal or Postal worker who is preparing a Federal Disability Retirement application simply bundle up a voluminous file of medical records and declare, “See!”  But such declarative intonations accompanying files of “facts” do not explain in meeting the legal criteria to qualify for Federal Disability Retirement.  An explanation is in response to the query by a governmental agency and bureaucracy which requires that justification through explanation will meet the preponderance of the evidence test in being eligible for Federal Disability Retirement benefits.

Yes, there are some “facts” which may not require explanation — such as the beauty of a morning dawn pink with a quietude of poetry, where words fail to embrace the peaceful mood within the serenity of nature; but such facts do not reflect the chaos of the paperwork being received by the U.S. Office of Personnel Management, and very few there care about the pink dawn of nature, but want an explanation as to why the Federal or Postal employee is entitled to Federal Disability Retirement benefits.

Sincerely,

Robert R. McGill, Esquire

 

Federal Worker Disability Retirement: Getting Lost in a Morass

At each step in the administrative process of preparing, formulating and filing for Federal Disability Retirement benefits from the Office of Personnel Management, including any responses to denials from OPM in order to qualify for the subsequent stage of the process (i.e., a Request for Reconsideration must be filed within thirty (30) days of the denial; an appeal must be filed with the Merit Systems Protection Board, etc.), there is always the danger of becoming lost in the morass of peripheral issues, often resulting from a sense of panic upon an initial reading of correspondence received.  

Thus, whether it is a letter from the Office of Personnel Management for additional medical documentation; a decision of denial at the Initial Stage of the Process; a second denial from the Office of Personnel Management — it is important to have a sense of how one must extract the essential points which must be addressed, and refuse to respond in a reactionary, ineffective manner.

Compiling an immediate response based upon an initial reading is normally a waste of time.  Verbiage which takes up space on a page of paper does not in and of itself mean that it requires a substantive response.  Much of what the Office of Personnel Management states can be summarized in a couple of sentences, once all of the ancillary issues are set aside.  

Further, it is more often the case than not, that what the Office of Personnel Management states as the requirements of “the law” is simply wrong.  OPM is rarely up-to-date on the current case-law as handed down by the Merit Systems Protection Board or the Federal Circuit Court of Appeals. Compliance with the law is one thing; compliance with the wrong law and an erroneous interpretation of legal requirements is quite another.  

To panic is to remain in a morass; to re-review the legal requirements in the administrative process of applying for, and becoming eligible for, Federal Disability Retirement benefits, whether under FERS or CSRS, is essential to the road to success.

Sincerely,

Robert R. McGill, Esquire

Federal Worker Disability Retirement: A Federal, not a State, Issue

Filing for Federal Disability Retirement benefits under FERS or CSRS constitutes a “Federal” issue, and not a “State” issue.  What this means is that an attorney representing a Federal or Postal employee in obtaining Federal Disability Retirement benefits under FERS or CSRS is not restricted from representing that particular Federal or Postal employee because of the specific state in which a person resides.

Every now and then, it is clear that there is some confusion on this matter.  It is the Office of Personnel Management — a Federal Agency located in Washington, D.C. — which makes a determination on a Federal Disability Retirement application, for the first two (2) stages of the process.  Thus, whether a person lives in California, Hawaii, Texas, Georgia, etc., is irrelevant with respect to legal representation by an attorney who has his or her license to practice law from a state other than the one in which the prospective client resides.

As a Federal issue, and not a State issue, the jurisdictional ability of an attorney who specializes in practicing administrative law in assisting Federal and Postal employees obtain Federal Disability Retirement benefits under FERS or CSRS crosses any and all state boundaries.  What should thus be the focus in determining which attorney is the appropriate one to hire should be based upon experience, competence, reputation and “comfort level” — those criteria which should always be taken into consideration when hiring an OPM Disability Retirement attorney.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for Federal & Postal Employees: Time to File

When should I file?  This is a question which is asked often; it is a telling, revealing question, because it is often a rhetorical question.  It is as if the question begs to be answered with an unequivocal, “You must file now”. 

Aside from the time it takes, which is generally between 6 – 8 months from the time the entire process begins until the time the Office of Personnel Management approves an OPM Disability Retirement application at the First Stage of the process (and certainly this general time-frame needs to be taken into account because of financial circumstances, accrued sick and annual leave which may be used, and multiple other factors for consideration), the Federal or Postal worker who is contemplating when to file an application for Federal Disability Retirement benefits generally knows the answer to the question. 

As a general rule, if one asks the question, then the answer is already known.  If one is expecting a PIP, comes home each day dreading and exhausted, living with the anxiety that the Agency is waiting for an excuse to get rid of the employee; if each night and weekends are spent just recuperating in order to make it into the office for another day, then to ask the question, “When should I file?” becomes merely a tautology.  To arrive at that point is to make it into an emergency; it is better to project into the future; as a football coach once said, “The future is now.”

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

Federal Disability Retirement: OPM’s Detailed Denial

Neither length nor detail constitutes legitimacy.  The spectrum of the types and styles of denial letters issued by the Office of Personnel Management in Federal Disability Retirement cases under FERS & CSRS range from a short paragraph under the “Discussion Section”, to 3 – 4 pages of apparent references to doctor’s notes, reports, etc. — with a lengthy lecture about the need for “objective” medical evidence, and about how a particular medical condition “may be” treated by X, Y or Z treatment modalities. 

Don’t be fooled.  One may think that, because OPM provides a seemingly “detailed” explanation of why a particular disability retirement application was denied, that such lengthy detail means that it is somehow “substantive”.  In fact, I often find the opposite to be true:  the shorter the denial, the greater the substance.  The lengthy denial letters contain “substance”, all right — but substance of the wrong kind.  They contain:  Mis-statements of the law; mis-statements of the criteria to be applied; inappropriate assertions of medical opinions (contrary to what one might think, the OPM representative does not normally have a medical degree, let alone a law degree), and a host of other “mis-statements”.  Sometimes, the weightier the denial, the more confusing as far as how to respond.  And, perhaps, that is one methodology as to how OPM wants to approach the case:  If it seems long and complicated, maybe the applicant will sigh, give up, and go away.  Don’t.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Service Deficiency & Medical Condition

The Office of Personnel Management will often use as a criteria of denial the argument/basis that despite the fact that an individual may have a medical condition such that the medical documentation states that the Federal or Postal worker can no longer perform one or more of the essential elements of one’s job, nevertheless, there has not been a showing that a “service deficiency” has occurred.  Often, agencies systematically write up performance appraisals without much thought or consideration; more often, Federal and Postal workers quietly suffer through his or her medical condition, and strive each day to meet the requirements of their duties. 

Whatever the reason for the lack of attention or perception on the part of the supervisor or the agency to recognize that the Federal or Postal worker has not been able to perform one or more of the essential elements of one’s job, such basis for a denial of a disability retirement application by the Office of Personnel Management is not a legitimate one, because existence of a “service deficiency” is not the whole story:  if it is found that retention in the job is “inconsistent” with the type of medical condition the Federal or Postal Worker has, then such a finding would “trump” the lack of any service deficiency.  That is not something, however, that the Office of Personnel Management is likely to tell you as they deny your disability retirement application.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: The Time It Takes For the "Process"

Because it is a “process” as opposed to an application to obtain an automatic service, commodity or benefit, a Federal Disability Retirement application necessarily takes time.  It takes time to properly prepare the application; it takes time to have the treating doctors properly address the multiple issues needed in order to meet the legal standards of eligibility; it takes time for the applicant’s statement of disability to be thoughtfully and in a cohesive, coordinated manner be presented in a persuasively descriptive narrative; it takes time for the H.R. office of the Agency, or the H.R. Shared Services in Greensboro, North Carolina, to complete their part; it takes time for the finance office to complete their part; it takes time for Boyers, PA to process and prep the application; then, finally, it takes time once it is sent down to the Office of Personnel Management in Washington, D.C., to receive, review and evaluate the entire packet. 

Further, right now, it just so happens that OPM seems to be “backed up” and, concurrently, has a shortage of personnel, and is taking an inordinate amount of time getting to each case.  As I often tell my clients:  If patience is a virtue, then Federal and Postal employees who file for Federal Disability Retirement must be the most virtuous people in the universe.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Process at the MSPB

When a FERS or CSRS disability retirement application has made its way in the “process” to the “Third Stage” — the Merit Systems Protection Board — then I (as an attorney) must be unequivocal in my recommendation:  You need an attorney.  I believe that individuals who file for Federal Disability Retirement benefits should retain a competent attorney at every stage of the process, but there are always considerations of financial ability, and perhaps other considerations, which prevent someone from hiring an attorney at the initial stages of the process. 

At the MSPB level, however, it is important for two (2) reasons (there are many, many other reasons as well, but for brevity’s sake, I choose the main reasons):  1.  It is extremely important to prove by a preponderance of the evidence that you meet the eligibility requirements, to an Administrative Judge, who is both a lawyer and a Judge, and therefore has the knowledge and background to make a reasoned assessment of the evidence presented, and 2.  You must be able to present the case in such a way that, if the Administrative Judge makes an error in his or her decision, you are prepared to appeal the case to the next level.  In order to be able to appeal the case to the next level, you must know the law, be able to present your evidence at the MSPB in accordance with the law, and therefore be able to argue that a decision rendered against you is in violation of the law.  In order to do this, you need an Attorney.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Which Disabilities To List

When I look at a potential disability retirement case, I find it helpful to look at the case not only prospectively, but retrospectively. While not a “rule” cast in stone, when the Office of Personnel Management approves a disability retirement case, it will normally attach a page which identifies which disability — normally one, often two, sometimes three — was/were the basis for the approval.  Thus, it is important when preparing a disability retirement packet and application, to identify which medical disabilities will be listed and depended upon; and further, once is it approved, it is helpful to look to the future, for there is a random chance that every 2 years or so, you will be selected to answer a Medical Questionnaire to determine if you are still disabled.

Thus, if you list a minor medical condition, and you get approved for that minor medical condition, if you recover from that condition, you can potentially lose your disability retirement benefits in the future. (Note:  for those of you who are my clients, please do not worry; no client of mine who has received a Medical Questionnaire has ever lost his/her disability annuity)   Thus, it is important to identify those medical conditions which are the “most serious”, and base your medical disability retirement packet upon the most serious, long-term disability first –before listing secondary or additional medical disabilities.  This is not to say that you should not list more than one medical disability; indeed, in preparing my packets for my clients, I will often list more than one, but I do it in sequential fashion, and when I put together my legal memorandum in arguing my case on behalf of my client, I constantly refer back to the central medical disability.

Sincerely,

Robert R. McGill, Esquire