Tag Archives: reviewing the opm disability denial letters

Disability Retirement for Federal Workers: Responding to OPM Templates

One can readily discern a template-based letter; it attempts to appear as if the denial is tailored to the particular set of circumstances and unique medical submissions of the Federal or Postal employee to whom the letter is addressed, but upon closer inspection, most of the language could to interchangeably utilized for anyone or everyone.

There may be a paragraph or two which quickly identifies or otherwise lists certain specific medical reports, with names of doctors and the dates of their reports; aside from such references, however, the rest is merely a template of language which is cut and pasted for purposes of justifying a denial.

Such is the administrative, bureaucratic approach of the U.S. Office of Personnel Management.  And, indeed, templates in and of themselves are not necessarily indicative of anything negative; for, as reinvention of the wheel should not be performed for each task engaged, so every Federal Disability Retirement application must meet a certain set of legal criteria, and to that extent they are “all the same”.  The problem in responding to a template-based denial from the U.S. Office of Personnel Management, however, is the disadvantage one is placed in for responding to such a Letter of Denial.  For, the template can contain multiple points which seemingly require a response, and which may appear overwhelming.

Don’t be fooled.  To address each and every point of contention is often to get mired into a level of minutiae which need not be engaged.  Take a wider view of things, and get some guidance and advice.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: Legal Sufficiency Test

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, one is required to meet the legal sufficiency of the eligibility criteria as set forth by statute, expanded by regulations and clarified by cases which have come before Administrative Judges at the Merit Systems Protection Board.  

Whether one meets the legal sufficiency test in the presentation of medical and other supporting evidence, is the area of disputable territory, which is why the entirety of the administrative process has been put in place.  From the perspective of the Office of Personnel Management, they are mandated to review each case and make a determination as to legal sufficiency.  Often, however, they are not concerned with, ignore, or otherwise remain oblivious to, the legal standard of proof, of whether the applicable criteria has been met by a standard of “preponderance of the evidence”. Indeed, in many denial letters, they have instead indicated a much high standard of review, including whether the evidence is “compelling”, or whether the medical condition “prevents the Federal or Postal employee from coming to work altogether”.  

Unfortunately, the first two (2) stages of the process — the initial application stage, then the Reconsideration Stage — is reviewed by the Office of Personnel Management, with the potential for mis-application of the proper burden of proof.  

Legal sufficiency is not a standard which is applied until it enters into the “legal arena” — that of the Merit Systems Protection Board before an Administrative Judge.  Because of this, it is often a good idea to cite legal opinions in order to “apprise” the Office of Personnel Management of the applicable legal criteria, and to remind them of what extent of evidence meets the legal sufficiency test.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: Sometimes, It’s “The Law”

An assumption is often made that the “Disability Specialist” at the Office of Personnel Management who reviews the Federal or Postal Disability Retirement application understands, comprehends, and applies the laws governing Federal Disability Retirement applications.

Now, such an assumption may be logical and reasonable, to the extent that one thinks (A) that those who aspire to working in a specific specialty have some knowledge or understanding of the specialty, and (B) if a decision is made which involves discussing “the law”, one presumes that the mere discussion of it proves some knowledge of it.

The problem with such reasoning, however (apart from the popular tripartite acronym which originates from the word “********-u-me”), is that it betrays the facts:  often, from reviewing the denial letters generated from the Office of Personnel Management, it is painfully clear that the administrative specialist, the legal specialist, or whatever other “specialist” designation has been embraced by the worker at the Office of Personnel Management, simply fails to apply all of the applicable laws which govern Federal Disability Retirement applications.

This is understandable, to this extent:  OPM representatives (other than those representing OPM at the MSPB level) are not lawyers, and as such, do not keep up with the latest evolution of the laws governing Federal Disability Retirement issues.  Whether that is a good thing or a bad thing, is another matter altogether.

Sincerely,

Robert R. McGill, Esquire