OPM Disability Retirement: The Human Element & Application of the Law

It may well be that technological advances will one day allow for imputed algorithms to precisely calibrate and decide everything in life; but for the time being, we must all deal with the human element in the process of decision-making.  

Comparative stories abound about how X obtained disability retirement benefits with minimal documentary proof, and even less of an actual medical condition.  It is always an anomaly as to how one can possibly answer the query which involves the following:  “X told a friend of Y, who knows of Z who filed and got his Disability Retirement benefits approved within T-amount of time”.

The particulars of each case must always determine the outcome of the case; some stories become inflated with the telling of the narrative when passed through third parties multiple times; but, on the other hand, there is the possibility that the final narration of the story is entirely true.  The reason is because the human element is still the determinative factor in any Federal Disability Retirement application.  

There is no computerized algorithm which is applied in making a determination at the U.S. Office of Personnel Management.  And, so long as human beings continue to remain a part of the administrative, bureaucratic process in scrutinizing a Federal Disability Retirement application, by analyzing the content and substance and applying the relevant laws, there will never be a perfect continuity or consistency of application.  

In some ways, this is a good thing; for, as each human being is unique, so the story of each medical condition and the impact upon one’s inability to perform all of the essential elements of one’s positional duties, in preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, is also particularized and unparalleled.  May it be so in the future, lest we ourselves become mere drones in this world of conventionalized perspectives.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: A Word about Approvals

It is the general policy of the Office of Personnel Management to withhold releasing of information concerning a pending Federal Disability Retirement application, whether under FERS or CSRS, via telephone.  

This is a good policy, in that a potential conflict and mistake can occur between an action taken on a case (i.e., an approval or a denial) and what is inputted into the computer system; or, as has been the case in the past, where the secretary or receptionist divulges the decision over the telephone — and is mistaken.  

Generally, one must wait for the Office of Personnel Management to send the hard copy of the decision on a Federal Disability Retirement application.  Receipt of the actually letter of approval or denial of a Federal Disability Retirement application, whether under FERS or CSRS, from the Office of Personnel Management, constitutes the official notification of the decision on a pending Federal Disability Retirement application.  If the Federal or Postal employee’s representative or attorney receives the decision of approval or denial from the Office of Personnel Management, that also constitutes official notification.  

The problem of telephone notification of an approval is that, if what is told over the telephone differs from the actual notification and decision rendered by the Claims Representative who is handling the case, then obviously that would be an upsetting matter to the Federal or Postal employee who is anxiously awaiting the decision.  

For the Federal or Postal employee who has waited many, many months for a decision on a pending Federal Disability Retirement application from the Office of Personnel Management, waiting a few more days in order to receive the actual approval letter (or a denial letter, whichever the case may be) is well worth the wait.  

It is better to wait a few more days to get the decision in person.  As the old adage goes, “A bird in hand is worth two in the bushes”…

Sincerely,

Robert R. McGill, Esquire

Medical Retirement for Federal Workers: The Office of Personnel Management

The Office of Personnel Management (OPM) , located in Washington, D.C., is the agency which makes the decision on all Federal Disability Retirement applications, whether under FERS, CSRS or CSRS-Offset.  They are the responsible agency for the first two “stages” of the process of attempting to show eligibility and entitlement to a Federal Disability Retirement annuity.  By “stages” is merely meant the initial application stage of the process, as well as the second, “Reconsideration” stage of the process — where a Federal or Postal employee has the right to, within 30 days of an initial denial of a Federal Disability Retirement application, request that his or her case be “reconsidered”, and further have the right to submit any additional medical or other supporting documentation for review and consideration. 

If the case is denied a second time by the Office of Personnel Management, then the Federal or Postal employee who has filed the Federal Disability Retirement application, or the attorney representing the Federal or Postal employee, has a right to file an appeal to the Merit Systems Protection Board.  The Office of Personnel Management is taking quite a long time in making a decision on a Federal Disability Retirement application, and although they are attempting to get caught up with their workload, the volume of cases filed and received by OPM on a weekly basis has made such an attempt difficult.  As has been stated by this author many times, Patience is a virtue, and as such, Federal and Postal employees must be the most virtuous of all, because patience is what is needed to endure and survive the process.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for US Government Employees: Office Notes

The Office of Personnel Management will often request that a doctor’s “office” or “treatment” notes be attached for approximately the last 1 – 2 years.  What is the purpose of this request?  Normally, to compare whether or not the doctor’s treatment notes reveal the consistency with what is stated in the narrative report prepared by the doctor.  This is often unfair, of course, because the purpose of office notes is quite different from the purpose behind a narrative report requested to support a Federal Disability Retirement application under FERS or CSRS.  

Office notes often reflect a cursory overview of the type of treatment rendered, and will sometimes contain statements of the positive advances and treatment responses of the patient/applicant, including any progress made in response to therapy, surgery, treatment, and medication regimens.  Thus, statements such as, “patient is showing good progress” or “Patient comes in today feeling much better” may be used by the Office of Personnel Management to deny a Federal Disability Retirement application under FERS or CSRS, and yet such statements must always be seen within the context of treatment, and in no way are inconsistent with a medical narrative report which clearly and unequivocally shows that a Federal or Postal employee is no longer able to perform one or more of the essential elements of one’s job.  Next:  How to overcome OPM’s unwarranted focus upon the Office/Treatment notes.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Workers: Summer & OPM

It seems that one merely jumps from cycle to cycle; from a furious work cycle to a period of delay; and government agencies, including the Office of Personnel Management, is no different.  The summer is almost over, and the Office of Personnel Management should be getting into “full throttle” for decision-making in Federal Disability Retirement cases under FERS or CSRS.

 This can be both a good or bad thing, depending (obviously) upon the decision which is made upon each individual Federal Disability Retirement case.  If an individual’s specific Federal Disability Retirement application is approved, then the world appears as it should — efficient, with the future secured, and the governmental agency having accomplished what it was created to do.  

On the other hand, if an individual’s Federal Disability Retirement application is denied, then the world becomes a compartment of dire circumstances, with increasing doubts and thoughts of unfair treatment.  The key to the latter is the try and keep everything in its proper perspective, which is sometimes difficult to do.  It is the job of an attorney who represents a Federal or Postal Worker in obtaining Federal Disability Retirement benefits under FERS or CSRS to attempt to remain objective, calm, and methodical.  The client may be upset, but if the attorney becomes upset in parallel fashion, then that attorney is not doing his or her job that he/she was hired to do.

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

CSRS & FERS Disability Retirement: OPM Decisions

One would like to think that the Office of Personnel Management takes each case independently, reviews each case according to the merit of that particular case, and that, based upon a fair, independent and careful evaluation process, a decision is made for an approval or disapproval.  When a decision from OPM reaches a Federal Disability Retirement applicant under FERS or CSRS, that applicant will see such a decision, and that decision alone.  When an attorney who specializes in OPM Disability Retirement sees such a decision, it is clearly based upon a template, and after viewing thousands of such template-based decisions, a pattern begins to develop. 

Templates are not in and of themselves a negative thing; one need not “reinvent the wheel” each and every time.  It is only when a template does not “fit” a particular case, or where it is clear that a decision contradicts the substantive content of the disability retirement application or the documentary attachments, that there is any negative issue with a template.  Fortunately, most OPM decisions are fair and properly evaluative; every now and then, however, it is evident that a template-driven decision has been issued without thought or fair analysis.  That is when a true problem has arisen.

Sincerely,

Robert R. McGill, Esquire