FERS & CSRS Disability Retirement for Federal and USPS Workers: New Faces

Old timers will often smirk cynically and observe:  Time will cure them of such a naive perspective.  Or, to paraphrase a famous line from a well-know Christmas movie, Youth is wasted on the young (hint:  the scene were Jimmy Stewart is throwing a rock at the old abandoned house).  Youth and inexperience are often accompanied by enthusiasm and a fresh perspective. Lack of knowledge is compensated — some would say “overcompensated” — by an eagerness which sees no boundaries or obstacles.

There are clearly some new hires at the U.S. Office of Personnel Management as of this date, and their unique approach in viewing and evaluating a Federal Disability Retirement application, whether under FERS or CSRS, must be contended with.

The fundamental problem with newcomers is not that they don’t know what they are doing; rather, it is often the converse — they think they do know what they are doing, and when girded by a list of criteria which is applied in an inflexible fashion, one often gets blinded by the confusion of the forest while having a myopic view of an individual tree.  The great equalizer in countering lack of knowledge, fortunately, is the law itself; and while a list of applicable criteria provided to a fresh face may well assist the OPM employee to evaluate a claim, it can never replace the necessity of knowing the law.

For anyone filing a Federal Disability Retirement application with the U.S. Office of Personnel Management, now constitutes the time to employ all of the tools which the compendium of cases decided, and statutes reinforced, accord in arguing one’s case.  Time will certainly tell, but for the present, it is advisable to dot all I’s and cross each T, carefully and with great scrutiny.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for US Government Employees: Meeting the Statutory Minimum

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, the Federal or Postal employee must prove, by a preponderance of the evidence (that burden of proof which is fairly minimal in the order of difficulty, requiring that a Federal or Postal employee show that he or she is “more likely than not” entitled to Federal Disability Retirement benefits under FERS or CSRS) that the compilation of the evidence meets the statutory requirements such that one is eligible and entitled to Federal Disability Retirement benefits.  

Thus, it is the cumulative set of evidence which is reviewed by the Office of Personnel Management, and not merely a single piece of evidence.  Yet, the manner and methodology of how OPM reviews the evidence is revealed in any given denial letter issued by the claims representative, or the “Legal and Administrative Specialist” assigned to any particular case.  

It is a methodology of (A)  listing whatever medical evidence which was submitted by naming the doctors, thereby giving an appearance of a full and thorough review of the documents, and (B) selectively extrapolating statements made by the Applicant, the Supervisor, the doctor(s) and anyone else in attempting to undermine the conclusion that the statutory criteria for eligibility has been met.  In laymen’s terms, this is called, “Taking potshots” at something.  If meeting the criteria for eligibility is to show a sequence of connecting dots from point A to point B, then OPM’s view is that if there are enough potshots which sever the line between the points, then OPM has shown that a Federal or Postal employee is ineligible for Federal Disability Retirement benefits.  

This is the approach; it is up to the applicant who is preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS to ensure that any weak links in the line are sufficiently reinforced.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Applicant’s Statement — from the Generic to the Specific

In preparing, formulating, finalizing and filing a Federal Disability Retirement application under FERS or CSRS, one must (of course) describe and delineate the “bridge” between one’s medical condition(s) and how it impacts or prevents one from performing one or more of the essential elements of one’s job.  This is done on the Applicant’s Statement of Disability (Standard Form 3112A, both for Federal and Postal employees under FERS or CSRS).

In formulating and describing the impact upon the essential elements, or core job duties, of one’s position, it is often an intelligent approach to begin with the generic, then to provide some specific examples.  This is more of an issue of “form” over “substance”, of course, but is often effective, nonetheless.

By way of this approach in describing one’s medical conditions and their impact upon the essential elements of one’s job, it provides a clarity of understanding for the clerk at the Office of Personnel Management — of first being provided with an “overview” of what the job entails, then to be given specific examples within the context of the overview.

Ease of understanding and a compelling force in telling a narrative story of one’s personal experience in having a medical condition, and its impact upon one’s professional life, will enhance the chances of an approval at the First Stage of the process in fling a Federal Disability Retirement application under FERS or CSRS, at the Office of Personnel Management.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: The Denial Letter

During this Holiday Season when Federal and Postal employees who have filed for Federal Disability Retirement benefits under FERS or CSRS, who are anxiously awaiting the decision from the Office of Personnel Management, a denial letter from OPM can appear disproportionately devastating.  Christmas and the New Year tend to bring difficulties precisely because it is seen as a season of celebration, when families get together, where work continues, but an expectation of being “joyous” pervades.  At such a time, a denial of a Federal Disability Retirement application from the Office of Personnel Management can be a seeming conclusion to a long wait.  It is not.  

Do not become discouraged just because someone at OPM has “decided” that your Federal Disability Retirement application did not “meet” the legal criteria.  Set the denial letter aside for a day or two (so long as it is not nearing the 30-day period to either file for Reconsideration or an appeal).  Then, proceed to fight it.  

Don’t let the Holiday Season become confused with the right to file for, be eligible for, and be entitled to Federal Disability Retirement benefits under FERS or CSRS.  The filing of an application for Federal Disability Retirement benefits is a process which may take 6 – 8 months, or longer if it is needed to go to the Reconsideration Stage, or to the Merit Systems Protection Board.  

Do not get discouraged; instead, fight for your benefits.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Unequivocal Doesn’t Mean That One Is “Right”

In a denial letter from the Office of Personnel Management, the Claims Specialist/Representative will often make statements in confident, unequivocal terms.  “You have not…”   “The medical evidence fails to show…”    “Your doctor never…”   “The law requires that you…”  Such a voice of unequivocal confidence often leaves the impression that there is no room for argument; that the case is lost; that there really is no point in even attempting to argue with the Office of Personnel Management.  Nothing could be further from the truth. 

Merely because an individual makes statements in an unequivocal manner, is not a basis for determining the truth or falsity of his or her argument.  In a Federal Disability Retirement application under FERS or CSRS, there is almost always room for disagreement.  We are speaking about interpretation of medical documents, the significance of what is said, etc.  We are talking about the different and proper application of the OPM Disability law, and the multitude of case-law which would be applicable.  Don’t let the voice of a statement fool you as to the validity of the statement.  In a Federal Disability Retirement case, the Office of Personnel Management is rarely right; they just like to sound like they are.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Complex Case

It goes without saying that each case of preparing and filing a Federal Disability Retirement application under FERS or CSRS is a “complex case”.  There are multiple intervening issues, including peripheral issues encompassing OWCP filings; issues with SSDI and whether to aggressively pursue it even with the offset and the lower cap for earnings; EEOC filings and collateral issues which may or may not have a direct impact upon the issues which must be focused upon in filing for Federal Disability Retirement benefits.  It is the job of an OPM Disability Attorney to tailor the issues, such that the peripheral issues do not overwhelm and dictate the centrality of a case; and to ensure that the central focus remains like a magnifying glass upon those issues which are relevant, not only to the client and to the entire process, but most importantly, to the person reviewing the case at the Office of Personnel Management.  Whenever an inquiry begins with the statement, “Mine is a rather complex case,” I realize that the primary job is to try and simplify the complexities, and that begins with narrowing the issue down to the single focus of the reason why the caller is calling in the first place:  the medical condition, and how that medical condition impacts one’s ability to perform one’s job.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Continuing Patience

It is difficult to be patient.  The Office of Personnel Management, in reviewing and evaluating each case, takes its time.  One can attempt to “read into” each day, as to whether the longer wait is more beneficial than a decision which is to be made in short order.  Calling to check on the “status” of the case can have a negative effect upon a decision, although it is not “supposed to” do so. 

Often, the response by OPM’s representative is that a decision will be made “this week” or “next week” or “by the end of the month”.  Time passes, and there is no decision.  These past couple of weeks, OPM has sent out many decisions that were long-in-waiting.  When the decision is a favorable one, then of course the burden of the wait is suddenly lifted.  When the decision is a denial, then the response is often one of anger, disbelief or discouragement.  Once the emotions are set aside, then one must accept the reality of further waiting.  Yes, patience is a virtue, and Federal and Postal employees must be the virtuous of all people.  But those are empty, vacuous and meaningless words when one must wait to see what the future holds. 

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement & the Reconsideration Process

In the process of applying for Federal Disability retirement under FERS or CSRS, it is the “hope and wish” of each applicant that it will smoothly sail through at the initial stage of the application. However, the reality of the process is that a certain percentage of applications get denied at the initial stage (Stage 1 of the process). It is both discouraging and befuddling to receive a letter from the Office of Personnel Management informing you that your disability retirement application has been “denied”.

You are now required to Request Reconsideration of your case within thirty (30) days of the date of denial, and you must submit additional medical evidence or other supporting documentation within 30 days of requesting such reconsideration (Stage II of the process). It is, indeed, a time of disappointment to receive a denial. It is all the more so when it is unclear as to the basis for the denial. Often, a denial letter will refer to the medical evidence without much commentary beyond acknowledging the submission of a medical report, then in the last paragraph, simply make a declarative statement that the medical evidence submitted “was insufficient” to show that you are disabled. Or, more often than not, the OPM Benefits Specialist will actually mis-state the law by claiming that you have “not shown that you are so disabled as to keep you from the workplace” (no such legal standard is required under disability retirement rules, regulations or case-law).

Whatever the reasons given, it is both discouraging and disheartening to receive a denial letter from OPM. However, it is important to calmly, systematically, and with pinpoint focus reply to the letter of denial — even if it doesn’t seem to make any sense. This is done most effectively by using all of the tools required in persuading eligibility and entitlement to disability retirement benefits: the law; the medical report; the medical records; rational and legal arguments –in short, the “nexus” needed to win.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: Patience Is the Key

There is a cyclical pattern which can be identified with the passing of time, and the Office of Personnel Management is no different from other Federal Agencies, departments, or personnel “make-up”.  Summer is here; with the season of vacations and time with families, combined with an already back-logged line of cases and overworked, understaffed personnel, expect delays in receiving a decision on a disability retirement application.  Patience is the key, and Federal and Postal workers have learned by the very nature of working for the Federal Service, how to be patient.

At the same time, being dependent upon an approval of a disability retirement application is worrisome, especially where finances are tight, and the future is uncertain.  Pestering an OPM representative rarely helps to move a case along, and indeed, may even bring about a negative result.  Remember that OPM representatives are simply doing their jobs; do not unnecessarily take up their time by calling them about the status of your particular case.  It has been said that patience is a virtue; by that account, Federal and Postal workers who have filed for disability retirement must be the most virtuous of human beings, for they have endured not only the years of loyal work to the Federal Service, but beyond, while waiting for a decision from the Office of Personnel Management.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Purpose of Case Law Citation

Is it necessary for a Federal Disability Retirement Applicant to cite relevant case-laws and statutory authority when filing for disability retirement? Or, should the medical evidence be sufficient? Certainly, there is no statutory requirement that “the law” be referenced when filing for disability retirement. And, further, it is normally not a good idea for a non-lawyer Federal or Postal employee to refer to case-law or relevant statutory authority, if only because non-lawyers often mis-state the law, or misinterpret relevant case-law authority.

The primary purpose why I refer to, and cite relevant statutory authority and case law, even at the initial administrative stage of filing for disability retirement on behalf of a Federal or Postal employee (normally, I will prepare a lengthy legal memorandum for each case), is because I want to preempt any mis-statement of law to the benefits specialist reviewing the application packet. It is important at each stage of the process to point out the relevant law, the applicable case-law, the judicial opinions which have addressed the multiple issues which can deter or potentially derail a disability retirement application. While the benefits specialist at the Initial Stage of the process may not be fully aware of the applicable laws, it is the job of the Attorney to point out the law, and demand that the Office of Personnel Management conform to the relevant, current judicial constraints which should be adhered to.

Sincerely,

Robert R. McGill, Esquire