Medical Retirement for Federal Workers: Medical Conditions & OPM

Clearly, there are certain medical conditions which the Office of Personnel Management “dislikes” or has a negative, suspicious view towards, in a Federal Disability Retirement application under FERS or CSRS.  One may attempt to rationally comprehend the innate bias towards certain groupings of medical conditions, but to do so would expend energy which, ultimately, results in an act of futility.

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, nowhere in the statute which provides for Federal Disability Retirement benefits is there notification or indication of a distinction between medical conditions.  As such, any pattern of hostility towards a particular medical condition, or a “type” of medical condition, must have evolved over time.  

The peculiar thing, of course, is the consistency in which all of the Claims Representatives at OPM have developed — of a similar pattern of reaction and behavior towards the “undesirable” medical conditions, as if they all work from a single template and have discussed, in conspiratorial hushed tones, a concerted effort to deny certain cases which are primarily based upon X medical conditions.  

That all said — and put aside as a note of interest but ultimately irrelevant — the way to rebut and overcome the inherent bias towards such medical conditions is to systematically reinforce the statutory requirements for eligibility, by explaining to the treating doctor(s) what is needed in order to overcome such bias.  Ignorance of the law is one thing; misapplication of the law is another.  Both must be overcome by guiding the treating doctor in how to meet the legal criteria, no matter what the medical condition.

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