FERS Medical Disability Retirement: A Fair Hearing

It is a common complaint against the Office of Personnel Management that the particular Claims Representative who reviewed the file and issued a denial in a Federal Disability Retirement application failed to look at, or review, the medical evidence; that the denial letter was merely a restatement or regurgitation of a template referring to a 7-part criteria, and makes statements which could easily have been “cut and paste” from a thousand other such disability denials.

Indeed, there have been times when references to a denial were clearly (and mistakenly) extracted from another file, where the names of doctors and medical documents are referred to which have no relation to the particular individual, and are clearly mixed in from another case.

To be fair, a counter-argument to such criticism is that there is no bureaucracy, with so many cases to review and properly evaluate, and with so few personnel and staff to undertake the massive workload, that could or should “reinvent the wheel” each time a case is set to be reviewed.

Obviously, certain language that is applicable in all (or most) cases will be re-stated, and templates used where such have been standard language used in the past.  Applicable language and statements which merely reiterate the legal and statutory criteria; introductory remarks; conclusory statements — they are all part of a paradigm and template which any administrative bureaucracy may apply.

But the criticism goes much deeper than that:  It is often the case that, clearly, the OPM Disability Claims Representative who wrote the denial did not even read his or her own denial.  Proofreading is an essential part of reviewing, writing, and issuing a decision.  OPM must ultimately realize that each decision is an important, crucial, and often critical point of importance in the life of the applicant.

It is a Federal or Postal worker who has previously dedicated many years of his or her life to a career with the Federal Sector, and the applicant for FERS Disability Retirement benefits deserves a fair hearing.  A fair hearing is defined by a careful evaluation of the particular case.  That is not too much to ask for.

Sincerely,

Robert R. McGill, Esquire

 

Medical Retirement for Federal Workers: A Proper Sense of Objectivity

In preparing, formulating and filing a Federal Disability Retirement application under FERS & CSRS, one might ask the legitimate question as to why a “proper sense of objectivity” is even necessary, given the obvious fact that:  A.  The applicant is identical to the person whom the application is about and B.  

From the Merit Systems Protection Board cases touching upon the types of evidence which the Office of Personnel Management is required to accept and review, subjective evidence of pain is acceptable and must be considered.  While both of these statements (A & B) are true, the problem comes about when the focus of the discussion concerning the basis and reasons for granting of a Federal Disability Retirement application under FERS or CSRS are without a proper discussion of the medical conditions which should be discussed in the medical reports and records themselves.

This is where the bridge between the applicant’s own narrative of the medical condition and a proper perspective and balance of a discussion concerning the medical evidence being submitted, is often lost when the applicant for Federal Disability Retirement benefits is unrepresented, and is therefore one and the same as the person who is preparing the application.  

Some sense of emotion is never harmful; some sense of passion and strength of conviction is certainly preferable; too much of the “I” will, however, often result in the loss of the proper sense of objectivity in the formulation of a Federal Disability Retirement application under either FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: Logical Argumentation

Reading a denial of a Federal Disability Retirement application under FERS or CSRS from the Office of Personnel Management is often a fascinating exercise in attempting to imply, infer, “read between the lines”, assume and presume what the basis of the denial is/are.  Just as gathering a 6-inch thick set of medical records and attaching them to a Federal Disability Retirement application does not constitute a logical, persuasive argument that you are entitled to Federal Disability Retirement benefits, conversely, referring to submitted medical documentation and acknowledging their existence, then concluding:  “You have not submitted sufficient medical documentation to be eligible for Federal Disability Retirement benefits” — does not constitute a sufficiently informative denial.  As the applicant must meet the legal criteria, the Office of Personnel Management has a duty and obligation to review it fairly, evaluate it objectively, and apply the laws and legal criteria.  If OPM decides that the application does not meet the legal criteria, then OPM has an obligation to provide a sufficient explanation that is clear, cogent, and logically persuasive.  Anything less would not meet the statutory obligation that OPM is under.

Sincerely,

Robert R. McGill, Esquire