Tag Archives: the federal employee disability administrative judicial review stages

Disability Retirement for U.S. Federal Workers: The Second Bite at the Apple

Rarely in life does one have a second chance; in important matters, an opportunity will often present itself, and depending upon the option chosen, one must live with the consequences of such a choice, or live the remainder of one’s life with grumblings of quiet regret and remorse.

In the legal arena, the process of what the public views as “endless appeals and procedural maneuvers” allows for the litigant to have multiple chances, and not just a “second bite at the apple”, but often a third, fourth…and seemingly infinite opportunities.

For Federal and Postal employees filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, there are multiple chances at filing for and obtaining Federal Disability Retirement benefits.  The only obstacle is if the Statute of Limitations has come and gone — the filing deadline of 1 year from the date of separation from Federal Service.  Even that hurdle contains some exceptions — as in a Federal or Postal employee being deemed incompetent by a psychiatrist to file within the timeframe.

For those who have filed and been denied, and for some reason failed to file for Reconsideration or an appeal to the MSPB — you can refile.  For those who filed and were denied at every level — you can refile. Does OPM still keep your previous file?  Yes. Will they review your old file along with the new filing?  Yes.  But if the new filing is stronger and better prepared, you stand the same chance as a Federal or Postal employee who has just submitted an initial application.

Rarely does one get a second bite at the apple; fortunately, under our system of legal procedures, the taste of the fruit is within reach for another time, and often the taste is more satisfying than the first encounter.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for US Government Employees: Sounds Good

There are various stages of the administrative process designated and defined as “Federal Disability Retirement” — the initial application stage of the process, where one must attempt to prove by a preponderance of the evidence that one is eligible for Federal Disability Retirement benefits; if disapproved and denied, then the Reconsideration Stage of the process (where one may submit additional medical and other documentary evidence to persuade the Office of Personnel Management to reverse themselves); an appeal to the U.S. Merit Systems Protection Board, where the Federal or Postal applicant’s Disability Retirement application is taken out of the hands of OPM and transferred to an Administrative Judge, who will hear the case anew, without regard to what OPM has decided in the past; a further appeal to the Full Board of the MSPB in the event that the Administrative Judge issues an Initial Decision which affirms and upholds OPM’s denial of the case; and a further appeal to the Federal Court of Appeals for the Federal Circuit.

Throughout this process, and especially in the administrative stages before the Office of Personnel Management, one should make a distinction between “sounding good” and “being right”.  Hopefully, the Federal or Postal employee who has filed for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, is both right and sounding good. But there is a distinction to be made.  For example, OPM will often — in their denial letter — “sound good” but be completely wrong on the law.  They will cite medical textbooks which skew the legal standard of review; creep into the discussion of a denial letter such terms as “no significant disability rating to speak of,” or that you don’t suffer from a disability which “incapacitates” you.  It all “sounds good”, but it is not true precisely because it is not the applicable standard of law to be applied.

At the initial stages of the process, OPM can get away with such nonsense, because most people don’t recognize the untrue and inapplicable standard of law being applied.  In the later stages of the process, however, when an Administrative Judge hears a case, it becomes important not only to “sound good”, but to also apply the right legal criteria.

Appearance versus reality — it is the argument of Western Civilization from the pre-Socratics onward.  As Alfred North Whitehead once observed, all of philosophy was already written by Plato and footnoted by Aristotle.  That statement both sounds good, and is indeed right on point.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: Simplicity v. Complexity

Each Stage in the process of proving eligibility for Federal Disability Retirement benefits under FERS or CSRS requires a unique approach and methodology of response.  It requires the combination of responding to, and thoroughly completing, forms required to meet the criteria at the initial stage of the process; of responding to any perceived lack of evidence in responding to a denial at the First Stage of the process, issued by the Office of Personnel Management, and therefore requiring a Request for Reconsideration; and finally, an ability to persuade an Administrative Judge at the Merit Systems Protection Board of the completeness of the application for Federal or Postal Disability Retirement, as well as to prepare the case well for submission of further evidence.

There are, in addition to the three stages mentioned, two further stages of the process (a Petition for Full Review to the Merit Systems Protection Board, which is comprised of a panel of administrative judges; and then to the U.S. Court of Appeals for the Federal Circuit), but both such appeal stages will only review the issue of whether or not there was an “error of law” committed by the Administrative Judge at the third stage of the process.  

The entirety of the process is comprised of inherent complexities — involving issues of medical (obviously), legal, administrative, agency, credibility, etc. — issues impacting each Federal Disability Retirement application in its own unique and specific manner.  One can try to simplify the process by breaking each component down into its basic elements, but the complexity of the whole process cannot be avoided.

Understanding each relevant component, addressing the specific issues, dissecting each, then compiling the evidence from each to make up the whole, results in wading through the complexity while maintaining the simplicity of each component part.  Keep the application simple, concise, and to the point.  

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: Against Reason

One can put in all of the necessary and requisite effort into preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, obtain a comprehensive medical narrative report with supportive office and treatment notes, verifying MRIs and other diagnostic evidence, follow the informational guidelines from various research sources — and provide a compelling case based upon rational and reasoned argumentation — and still get a denial from the Office of Personnel Management.  

This happens often enough, and one must conclude that, even when a Federal Disability Retirement application is prepared with the utmost of care and effort, a decision of denial can be issued against reason, or the reasons provided are selectively chosen and manufactured.  It is therefore well to understand the entirety of a Federal Disability Retirement process as necessarily involving multiple stages, with internal checks and balances to ensure the “fairness” of the administrative procedure.

Thus, the first two stages of the process (the Initial Stage; then the Reconsideration Stage) are internally reviewed by the Office of Personnel Management.  The Third and Fourth Stage of the process (an appeal to the Merit Systems Protection Board; a Petition for Full Review) may be considered as “administrative judicial review” stages.  Then, an appeal to the U.S. Federal Circuit Court of Appeals.  

Each stage allows for a “check” upon the other stages of the process, and by imposing the right of the disability retirement applicant to access such “checks”, it allows for the “balance” of the process — thereby (hopefully) negating and nullifying what may have initially been an irrationally-based decision.  

As Western Culture has a history of recognizing the power of rationality, it is well that an institutionalized process of “checks and balances” attempts to supersede legal decisions which go against reason.

Sincerely,

Robert R. McGill, Esquire