Tag Archives: Responding to an Initial Federal Disability Retirement Denial of Benefits

Federal and Postal Disability Retirement: Responding to Stupidity

Sometimes, one’s initial reaction in a situation — professional setting, social discourse, event gathering, etc. — requires a momentary pause; and it is precisely that couple of seconds of gathering one’s thoughts which saves one from further putting fuel upon a potential fire.

Perhaps you have every right to have responded with a drip of sarcasm; or others would have approved of the lashing back; and still others would say that the response was appropriate and deservedly given.  But the greater question should always be:  how effective was the response; did it evoke the necessary end; and for whose benefit was the aggressive retort given — for the benefit of truth, or for one’s own satisfaction?

In a professional context, of course, it is probably never appropriate to respond in an unprofessional way, if merely by definition alone.  Similarly, in a FERS or CSRS Federal Disability Retirement context, when one receives a denial from the U.S. Office of Personnel Management, there are statements made — whether one pertaining to mis-application or mis-statement of the law; or perhaps a wrong reference to a medical report; or even more egregious, a selective use of a statement from a medical report or record taken out of context — which can deservedly provoke a response involving sarcasm, a deluge of epithets, or worse, a barrage of ad hominem attacks — and in each case, it would be neither appropriately given, nor proper in a professional sense.

Fortunately, paper presentations and paper responses have the advantage of time over social discourse and person-to-person contact.

Holding one’s breath and counting 3 seconds, or 10, or perhaps an eternity, is an effective way of avoiding catastrophe.  Writing a diatribe of what one wants to say, then trashing it, is also acceptable.  On the other hand, beware of that “send” button; and, moreover, never push that “send to all” button.

That would indeed be unprofessional.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Government Employees: Someone Else’s Argument

Have you ever sat with company at a dinner table, and engaged in a conversation where it appears as if you are continuing someone else’s conversation?  Or your presence is merely a substitute for an extension of a previous debate or discussion?  Where a topic is brought up, and immediately a barrage of critical attacks — of arguments you have never made, and of statements you don’t recall disseminating (and where this is only 5 minutes into the salad and you’ve barely tasted the first glass of wine)?

The problem with unfinished business is that the transference of what one wanted to say is normally unloaded upon the wrong subject.  Conversations, debates, forums of intellectual exercises in linguistic battles — it is a rare person who has been able to convey the full force of one’s collective thoughts and beliefs on the matter, and it is more often the case that one leaves with the regretful remorse of, “I wish I had brought that point up…”  But rarely do second chances present themselves in a satisfactory follow-up forum; unless you are the unfortunate object for an unexpected dinner invitation.

In responding to a denial of a Federal Disability Retirement application with the U.S. Office of Personnel Management, whether under FERS or CSRS, the applicant — through his or her Federal Disability Retirement attorney — needs to understand that the person who issues the denial will not be the same person who will review any additional submissions or legal arguments at the Reconsideration Stage.

It will be reviewed, in legal parlance, de novo.  As such, while the basis of the denial as issued by the Caseworker at OPM at the First Level should be taken into consideration, one should approach the case in light of the following question: To what extent will the Reconsideration Branch care as to the original basis of the denial of the first caseworker?  If it is being reviewed de novo, the approach should be to go over all of the elements — and to reinforce and amend those weak points, some of which may overlap what the first caseworker pointed out, others which may not.

It may not be the best approach to argue to a dinner guest who wasn’t present at the first round of arguments; the points you are trying to make may not be heard because the bell has already rung, and the fighter in the second round has been replaced with someone upon whom you have never previously landed a punch.

Sincerely,

Robert R. McGill, Esquire 
FERS Disability Retirement Lawyer

   

CSRS & FERS Medical Disability Retirement: Responding to OPM

As different Stages in the process of preparing, formulating, and filing for Federal Disability Retirement benefits require a different response, so there is a reason why it is important to recognize and understand the procedural differences and distinctions between each stage.

Each stage in the entirety of the process is not just a difference of departments — of different “sections” of the Office of Personnel Management reviewing the Federal Disability Retirement application based upon the identical paradigm of review.  Yes, the first two stages of the process (the “Initial Stage” of the application, then the “Reconsideration Stage” of the process) involves the same agency (the Office of Personnel Management), but the underlying reviewing needs of the distinct departments are identifiably different).  

That is why it is important to understanding the underlying procedural requirements, thereby gaining an insight into the substantive needs and requests of the separate departments.  Thus, at the initial stage of the application, a Federal or Postal employee is attempting to meet, by a preponderance of the evidence, all of the criteria necessary in obtaining a Federal Disability Retirement annuity.  

If it is denied at the First Stage, then the Office of Personnel Management will normally indicate the deficiencies they have “discovered” in the application.  Whether true or not, whether right or wrong, it is often necessary to address — at least in part — some of the issues brought up by the initial denial.  

Then, of course, if it is denied a second time and one must file an appeal to the Merit Systems Protection Board, a response for the Third Stage of the process will require another, completely different set of responses.  Paradigm shifts occur not only in science; they occur in the administrative procedures of a Federal Disability Retirement application.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: The Initial, Reactive Response

When a denial is received at the first stage of a Federal Disability Retirement application process, the initial, reactive response is often one of two avenues, both of which are the wrong paths to venture down:  either a Federal or Postal employee immediately writes an angry, emotional response or he/she gives up and decides that the statements made, the reasons given, etc., in the denial letter from the Office of Personnel Management are too powerful and overwhelming to overcome.  

Both responsive avenues constitute the wrong approach; neither responsive approach reflects the true state of the case.  

While there may be cases where the applicant has failed to make even a minimal attempt at meeting the burden of proof in a Federal Disability Retirement application, such a case is one in which the undersigned attorney has never encountered.  For, there is a presumption (a truthful one, I believe) that filing for Federal Disability Retirement benefits is never out of choice, but always out of necessity.  

Federal and Postal workers don’t file for Federal Disability Retirement benefits without good cause.  In a denial letter from the Office of Personnel Management, the statements made and the claims of rational discourse as to the reasons for the denial, do not mean that they are true.  Just because OPM says so, doesn’t make it true. Careful thought, reflection, and thoughtfulness of strategy in responding to an OPM denial is what is needed.  Do not react — at least, not initially.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Substantive Responses

Once a Federal Disability Retirement application has been denied at any given stage of the process (at the First Stage or at the Reconsideration Stage) by the Office of Personnel Management, a Federal or Postal employee must determine the proper response.  

As stated in the immediately preceding blog, there is first the administrative response which must be satisfied, before one even gets to the issues of a substantive response.  The administrative response takes care of the timeliness issue of satisfying the administrative requirements set forth by the law — upon a first denial, one must submit a “Request for Reconsideration” within thirty (30) days of the denial; upon a second denial, one must file an appeal to the Merit Systems Protection Board within thirty (30) days of the denial, etc.  

As for the substantive response, the worst mistake that a Federal or Postal employee can make is to immediately write an angry diatribe and submit the response.  There is time enough for a thoughtful and proper response.  The issue is whether to rebut each point which the Office of Personnel Management makes, or to selectively choose one or two main points, and to focus upon those.  Normally, the latter is preferable, if only because such an approach normally addresses all of the subset, minor points of a denial in the very process of presenting one’s case.  Remember that, throughout the process, the mere fact that OPM asserts an argument, does not mean that the argument is true, or even valid.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: Proper Responses

A receipt of a denial from the Office of Personnel Management to a Federal Disability Retirement application under either FERS or CSRS is always an event which is upsetting to a Federal or Postal employee, but it is “part of the process” which occurs often enough.  

If it is a second denial (where a Request for Reconsideration has already been accomplished, and the Office of Personnel Management has denied it again), then the only appropriate response is to file an appeal to the Merit Systems Protection Board (no response is required, or even appropriate, to OPM, as it is out of their jurisdictional purview upon denying it a second time).  

If it is a “first denial“, then a “Request for Reconsideration” must be filed within thirty (30) days of the date of the denial letter (one can argue that the 30 days should be counted from the date of receipt, but it is always better to be on the safe side), and if requested, an additional thirty (30) days is automatically granted in order to have sufficient time to gather and submit further documentation to rebut and answer the denial from the Office of Personnel Management.

Submission of the Request for Reconsideration, and participation in the process of having the Office of Personnel Management reconsider the initial denial, is mandatory, not elective.  By this is meant the following:  You cannot bypass or skip the Reconsideration Stage and jump directly to the MSPB; you must first get a decision on the Request for Reconsideration before the Merit Systems Protection Board will consider your case.  

You cannot get angry or reactive and declare, “I will just file an appeal to the MSPB and have an Administrative Judge look at my case”.  You must patiently go through the proper channels of justice, and respond accordingly.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Reconsideration Response — Refrain from Reflexive Response

When a denial is received for an Application for Federal or Postal Disability Retirement benefits under FERS or CSRS, sometimes they are replete with comical “errors” and omissions.  Thus, anywhere from mistaken identities, to wrong job identifications, to the wrong doctors named; from medical conditions which were never claimed, to diagnostic tests and surgeries which were never submitted; these are just some examples of errors and omissions which one might find in the body of the “Discussion” in an OPM denial letter.

The reflexive temptation is to put together a string of harangues and accuse the OPM Representative of incompetence, incoherence, ineptitude, and inability to perform the essential element of his or her job.  Such a reflexive response would be the wrong tact to take, however.  One should refrain from making such “ad hominem” attacks.

Instead, the better way to go about it would be to politely point out the major errors, the omissions of any medical or other substantiating documentation, in an understated way, then to argue the main points that need to be argued to rebut the denial letter.  While the former methodology may make you feel good, in the end, it is an approval which will prove to be of lasting elation.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: The Problem with Answering an OPM Denial

A denial of a Federal Disability Retirement application under FERS or CSRS from the Office of Personnel Management always leaves the applicant and his or her attorney at a disadvantage.  This is because OPM is never answerable to any resulting consequence of a denial; at least, not directly.  Think about it this way:  In the initial application, if an OPM Disability Retirement application is properly prepared and submitted according to, and within the parameters of the laws governing Federal Disability Retirement, one would assume that it should be approved.  If it is denied, then the case is sent to the “Reconsideration” division of OPM — meaning, to another person. 

Now, taking it out of the hands of one OPM Representative into the hands of another, has both the good and the bad mixed together:  the good is that it will now be reviewed afresh by someone else; the bad is that the person who denied the original application has no further responsibility for the denial.  This is true, incidentally, with respect to the Reconsideration Stage of the process; if a second denial is issued, the person who issues the second denial also has no responsibility to answer for the basis given in the denial. 

The “light at the end of the tunnel“, however, comes when it is finally taken up by an Administrative Judge at the Merit Systems Protection Board.  While the AJ cannot hold anyone at OPM responsible for a denial which never should have been, at the very least, when the AJ reviews the record and finds that the previous denials were unfounded or rationally without legal foundation, an immediate recognition of a baseless denial can help the applicant.  Ultimately, rationality and legal integrity has a chance to prevail; it sometimes takes more than one bite at the apple.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: Responding to the Template Approach

While the Office of Personnel Management issues template approvals and denials, what must the individual applicant who receives such a template denial, do?  Obviously, it cannot be a “template” response, because any response by an individual applicant is going to be an individualized response.  Often, however, OPM’s response takes a shot-gun approach in denying a Federal Disability Retirement application — it uses every device in its template, touching upon every issue and sub-issue, without any apparent (or obvious) rhyme or reason.  Whether purposeful or not, the extent and quantity of reasons for denial become almost insurmountable, and unable to “sort out”. 

One thing that a Federal Disability Retirement applicant should not do, is to take the denial letter to his or her doctor to respond to.  It will only confuse the doctor.  Instead, the denial letter must be reduced to a comprehensible set of criteria which can be answered.  Sub-sets of issues need to be identified and consolidated; the minor (but often irritating) references to peripheral issues, often touched upon but of no real consequence, must be ignored; and the focus must be placed upon the central 2 or 3 issues which seem to be the overriding concerns in the denial letter.  In other words, the denial letter must be deciphered and extracted to be “made sense of”.  Only then can OPM’s template denial letter be answered — with reason, aggressive attack, and a rational grounding in the law.  In other words, irrationality must be met with clarity of mind.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: OPM May Say So, But…

I often wonder how many unrepresented disability retirement applicants there are who, having received a denial letter at the First Stage of the process of filing for Federal Disability Retirement benefits under FERS & CSRS, never file a Request for Reconsideration because they believe what the Office of Personnel Management stated in the Denial Letter.  Sometimes, I will get telephone calls from people who want to file, and during the course of the conversation, it will come out that they had filed a few years previously, and had been denied.  “Did you file a Request for Reconsideration, at the time?” I ask.  “No,” is the answer.  “Why not?” I ask.  The typical answer?  “Because I just thought there was no way to fight them on it.” 

I used to be amazed at such answers, but after some thought, it makes sense.  As an attorney, my first instinct (both trained and natural) is to always take something to the next level, with the firm belief that I will prevail just by pure persistence, and by using the law as “a sword” in the process of fighting for my clients.  But most people are not lawyers (some would say, thank goodness for that, we have enough lawyers in the world), and when the Office of Personnel Management writes up a denial letter, then allegedly cites “the law”, and makes bold conclusions such as, “You do not meet the eligibility criteria under the laws governing disability retirement…”  It all sounds convincing.  It all sounds like any further action will be an act of futility.  But just because OPM “says so” doesn’t make it true, doesn’t make it right, and certainly doesn’t make it unwinnable.  They may say you don’t meet the eligbility criteria; I would argue otherwise.

Sincerely,
Robert R. McGill, Esquire