Medical Retirement Benefits for US Government Employees: Those Intersecting “Other” Determinations

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, it is useful to understand the impact — if any — provided by the approval of any of the “other” compensation programs available to all Federal and Postal employees.

Thus, inasmuch as a Federal or Postal employee filing for Federal Disability Retirement benefits under FERS must also file, sometime during the administrative and bureaucratic process, for SSDI benefits, in the off-chance that SSDI approves the application before OPM makes a decision on a Federal Disability Retirement application (which, because of OPM’s extended timeframe for making decisions, is less rare these days than one may think), can it have any impact in the Federal Disability Retirement process?  And what about OWCP/FECA?  Does the fact that a Second-Opinion doctor, or what is sometimes euphemistically referred to as a “Referee doctor”, rendering a medical opinion (and therefore a narrative report) stating that the injured Federal or Postal worker is “permanently” disabled, or that he or she is unable to go back to one’s job, relevant to a Federal Disability Retirement application?  How about a VA Disability Rating?  Does the determination provided by the Department of Veterans Affairs have any relevance to the Federal Disability Retirement application?

These are all potential “tools” to be used in preparing, formulating and filing for Federal Disability Retirement benefits, and the Federal or Postal employee should be aware of the case-laws which provide for persuasive impact — not determinative — to the Office of Personnel Management.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Proof, Assertion, and the Conceptual Distinction

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, it is necessary — first and foremost — to understand that the benefit of Federal Disability Retirement is not an “entitlement” under any definition of the word; there is no automatic triggering mechanism by which a Federal or Postal employee becomes a Federal Disability Annuitant, unless one proves, by a preponderance of the evidence, that one has met all of the eligibility requirements necessary to obtain the benefit.

Further, while the standard of proof established by statute is a relatively low one in comparison to others (i.e., “preponderance of the evidence” merely requires that the truth of X is more likely than not, as opposed to other, more onerous standard of proof, such as “beyond a reasonable doubt” or “clear and convincing”, etc.), nevertheless, the mere assertion of a statement of facts will not qualify the Federal or Postal employee for Federal Disability Retirement benefits.

A standard — or “burden of proof” — means exactly that:   One must prove it, and proof requires more than the mere assertion that X is so.  Specifically, in a Federal Disability Retirement application, one must prove that one is medically unable to perform one or more of the essential elements of one’s Federal or Postal position, and in order to meet that burden, medical documentation of a sufficient and persuasive nature must be submitted along with a Federal Disability Retirement application, which includes many Standard governmental forms.

Knowing and recognizing the conceptual distinction between asserting X and proving X is an important first step in preparing, formulating, and successfully filing for Federal Disability Retirement benefits.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for Federal & Postal Employees: What the Agency Can Do

It is always striking (and suspicious, of course) when an individual tells me that his or her Agency has said that they will “OK” the Federal disability retirement application.  I always remind the individual that it is not the Agency; rather, it is the Office of Personnel Management which approvals or denies an application for Federal Disability Retirement benefits under FERS or CSRS.  In many ways, the Agency attempts to assert for itself greater influence and impact than it really has.  I try and remind people all the time that a Federal Disability Retirement application is a medical retirement application — it is not an Agency retirement application; it is not a Supervisor’s disability retirement application; it is not up to the Human Resources’ Department of the Agency.  The ultimate arbiter of the entire process is the Office of Personnel Management; and the criteria for eligibility is based upon a set of statutory requirements, which must be met by a preponderance of the evidence; and the overwhelming focal emphasis concerns the medical eligibility.  Agencies are too often given too much credit for the success or failure of a Federal Disability Retirement application under FERS or CSRS.  In my view, the influence, input and power of an agency is almost always overstated.

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