Federal Disability Retirement Representation: Substance and Process

In any bureaucratic, lengthy administrative process, one can become embroiled in the procedural aspects of an endeavor, and overlook the substantive elements which form the foundation of any case.  Conversely, one can make the mistake of approaching a case and declare to one’s self, “This is so obviously a good case,” and take shortcuts in the process of putting together an effective and persuasive case.

Either approach is one fraught with grave errors, and for Federal employees and Postal workers who are beginning the process of preparing, formulating and filing for Federal Disability Medical benefits, first through one’s own agency (if still on the rolls of the Federal agency or the U.S. Postal Service or, if separated, for not more than 31 days), and ultimately submitted to the U.S. Office of Personnel Management in Boyers, Pennsylvania (directly, if the Federal employee or U.S. Postal worker has been separated from Federal service for more than 31 days), it is important to keep the balance between the substance of a case, and the process of the case.

Substantive issues involve everything from the factual, informational content required on all standard forms (SF 3107, along with Schedules A, B & C, and the required attachment of one’s DD 214 showing prior active military service; SF 2801 for CSRS employees; and the substantive content of the description of one’s medical conditions to be considered, as required in SF 3112A, etc.), as well as the medical documentation needed to provide the evidentiary support for one’s case.

“Process” issues involve the timeframe in filing a case, the administrative procedures of where the disability application must be submitted through, as well as the myriad of sequential steps required for satisfaction of accommodation issues with one’s agency.

Substance and process — they are the necessary sides of a single, inseparable currency of an administrative reality known as Federal OPM Disability Retirement, and both must be attended to in order to reach the heights of efficacy mandated for a successful outcome in the preparation, formulation and submission of an OPM Medical Retirement application.

Sincerely,

Robert R. McGill, Esquire

 

OPM Disability Retirement: The Administrative Process

Ultimately, Federal Disability Retirement must be viewed as a “process“, as opposed to a singular procedure whereby a triggering mechanism automatically allows for receipt of benefits.  The former requires an affirmative approach which involves submission of proof, argumentation, an expectation of resistance (in many cases), and an analysis by the U.S. Office of Personnel Management as to whether or not all of the legal criteria have been met.  The latter is merely a formality of filing.

As a process, filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management has various steps, procedures, and Stages for appeals.  There is, first and foremost, the initial application Stage, where one has the opportunity and right to submit proof of eligibility, and make legal arguments for entitlement.  If one’s Federal Disability Retirement application is denied at the first Stage of the process, then one has a right to have it “reconsidered” by filing a “Request for Reconsideration” within 30 days of the date of denial, or receipt of the letter of denial from OPM, whichever is later.  If denied a second time, then the Federal or Postal employee who is filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management has a right to file an Appeal to the U.S. Merit Systems Protection Board.

There are, in addition to the 3 stages described, two (2) additional stages of appeal, but the three main stages of filing are what have been previously described.

With such a “process” in mind, it is wise to prepare for the long haul.  An expectation of a quick and easy approval, even if obtained, should not be embraced at the outset, precisely because one must take into consideration the potential length of time which the entire process may take, and prepare accordingly.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: The Psychological Process

One of the reasons why the Federal or Postal employee contemplating filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, should view the entirety of the administrative process as just that — a “process” as opposed to an entitlement to benefits — is because (a) that is in fact what it is and (b) to fail to view it from that perspective would be to refuse to adequately prepare for the long and arduous procedural pitfalls which are inherent in each case.

This is not an entitlement where a specific trigger of an event results in the automatic calculation and issuance of compensation.  Reaching a certain age does not result in the granting of Federal Disability Retirement benefits (although it may end it and be recalculated at age 62); attaining a certain number of years of service will not qualify one for Federal disability Retirement benefits (but again, upon reaching age 62, it may result in a beneficial calculation of benefits for having a greater number of years of service).

Rather, Federal Disability Retirement is an administrative, legal process in which one must prove by a preponderance of the evidence that one is (1) eligible, in that one meets certain minimum requirements, such as 18 months of Federal Service under FERS, or 5 years under CSRS, and (2) entitled, by proving that one has met the legal requirements under the statutes, regulations and case-law.

By having the proper psychological perspective, one is better able to prepare for the long haul before starting the process of preparing, formulating and filing for Federal Disability Retirement benefits, whether under FERS or CSRS, from the U.S. Office of Personnel Management.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Time

Attempting to order life in accordance with a schedule which one has manufactured is often an impossible task to perform; when dealing with a Federal bureaucracy, it is moreover an unwise thing to attempt.  

Preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS necessarily and inherently takes time.  In addition to time, it requires foresight into possible delays, both predictable as well as unintended.  While a general timeline of 8 – 10 months from the start of the process (meaning, the initial gather of the medical documentation and narrative reports, compiling the evidentiary documentation necessary to prepare a case; formulation of the Applicant’s Statement of Disability, etc.) to the time when an approval letter is issued by the Office of Personnel Management in response to the First or Initial Stage of the Process, is a realistic assessment of the time involved, there are multiple events, issues and intervening pitfalls which can interrupt and disrupt such a generalization.  

A cushion of time should always be considered.  More than that, however, the Federal or Postal employee who becomes frustrated with the lengthy process avoids thinking about the months and months of delay and procrastination which was engaged in at the “front end” of the entire process — where, for months and months, the Federal or Postal employee kept putting off starting the process to begin with.  

Remember that preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS is a process involving a Federal bureaucracy and, as such, the inevitable virtue of patience must be stored in plentiful quantities, to be harvested during the waiting time.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: The Entirety of the Process

There is a common understanding, based upon comments and statements made by people over several years, that when an individual files for Social Security Disability benefits, most such cases are denied at the initial stage.  It is almost understood as an “automatic” denial at the first stage of the process. 

Whether this is true or not or, more importantly, whether or not there are some who get it approved at the initial application stage and therefore betray the truth of such a belief, is besides the point.  What is important is the perception that it is so, and therefore, the approach which individuals take in filing for Social Security Disability benefits is altered and adapted accordingly. 

Similarly, in preparing, formulating and filing for Federal Disability Retirement benefits under FERS or CSRS, whether or not most cases get approved at the Initial Stage of the Process, or at the Second, Reconsideration Stage of the process, is ultimately besides the point.  It is important to understand and approach the entirety of the administrative process with a proper frame of mind:  a denial at the Initial Stage of the process of filing for Federal Disability Retirement benefits under FERS or CSRS is not the end of the process; rather, it is just the beginning. 

By approaching the entirety of the process with a correct frame of mind — and reference — one can maintain one’s sanity while waiting for the conclusion of the long and arduous process to unfold.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement for Federal Workers: The MSPB and Beyond

An application for FERS Disability Retirement benefits should always be prepared for the “long haul”.  Thus, it should be formulated, argued and prepared as if it will be denied at each stage, and will end up before the Merit Systems Protection Board.

Does this take any “special” preparation?  To some extent, the answer is “yes”, inasmuch as the stages beyond the Initial Application stage before the Office of Personnel Management, then the Reconsideration Stage of the FERS Disability Retirement process, then a Hearing before an Administrative Judge at the MSPB, involves whether or not an “error of law” was made.

As such, because each of the preceding three stages of the administrative process would essentially involve foundations for a later stage of an administrative appeal, it is obviously important to know what “the law” is.  One can hardly argue in the later stages what “errors of law” were made if one is not familiar with what “the law” is comprised of in the first place.

By establishing certain key foundations, and inserting legal precedents and arguments throughout the process, one has a better chance at arguing that legal errors were made by the Administrative Judge.  While a Federal or Postal worker should certainly expect that his or her Federal Disability Retirement application should be approved at any given level because it has been properly prepared, it is always wise to look beyond the present, and prepare for future contingencies.

Sincerely,

Robert R. McGill, Esquire

 

Medical Retirement Benefits for US Government Employees: Building Blocks

The analogy or metaphor in preparing, filing, and waiting (for a decision) in a Federal Disability Retirement application for FERS or CSRS employees, submitted for review before the Office of Personnel Management, is of a child with square building blocks. If at the first try, the outcome is a nod of approval, nothing further needs to be accomplished.  If, however, a third party (the Office of Personnel Management) comes along and knocks down the building blocks (analogy:  a denial from OPM), then the child must rearrange the building blocks anew, and perhaps add one or two more for reinforcement.

Thus, depending upon the basis of OPM’s denial (which is often either irrelevant or self-contradictory, or both), one may want to reinforce that which was already gathered and organized, for a re-presentation of both the original evidence, and additional medical or other supporting evidence.  Again, if a third party (OPM) knocks down the second set of building blocks (a second denial at the Reconsideration Stage of the process), then it will be time for further reorganization, and for gathering of additional supporting building blocks.

When it gets to the Third Level of the process, the Merit Systems Protection Board, remember that all of the original building blocks of the process will still be there for the Administrative Judge to review.  That is the point of having the perspective of the entire process as one of “building blocks” — that the entire foundation is still there to be added to and reviewed, in the end, by an Administrative Judge.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: Decisions during the Process

In making decisions during the process of filing for Federal Disability Retirement benefits under FERS or CSRS, it is obviously important to make the “right decision” at each stage of the process.  Thus, for example, if a person files for Federal Disability Retirement, at the first stage it is important to determine which medical conditions to identify and base the application upon; at the Second, Reconsideration Stage, it is important to first identify what substantive concerns which the Office of Personnel Management is proposing (in any given denial of a Federal Disability Retirement case, it is often not that obvious what the OPM Representative is actually stating), and how to go about rebutting and answering the concerns (as opposed to taking a “shotgun approach” and trying to answer each and every concern expressed by the OPM Representative), and further, at the Merit Systems Protection Board, it is vitally important to place all evidence, legal precedents, arguments and objections on the record, so that if the Administrative Judge in the case denies your claim, you have a legal basis to file an appeal.  As always, it is important to see the entire application submission, from beginning to end, as a “process”.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The "Process" at the Reconsideration Stage

It is important to understand that the “process” of filing for Federal Disability Retirement, when it comes to the Second, or “Reconsideration” Stage, encompasses two factual prisms:  (1)  The application has now been denied (obviously, and for whatever reason — most likely because of “insufficient medical evidence”) and (2) it is the stage in the process prior to an appeal to the Merit Systems Protection Board. 

This dual prism of the stage, while self-evident, is important to keep in mind, because it requires a duality of duties:  A.  It requires (for the Disability Retirement Applicant) a duty to show something beyond what has already been shown, while B.  It requires the Office of Personnel Management to be careful in this “process” of review, because if OPM makes a mistake at this stage, then the likelihood is great that they will be required to expend their limited resources to defend a disability retirement case before an Administrative Judge, and if it becomes obvious that the case should have been decided favorably at the Second Stage, it reflects negatively upon the Agency.  OPM is an agency made up of people (obviously); as such, just as “people” don’t like to look foolish, OPM as an Agency made up of people, does not like to look “badly” or “foolish”.  This duality of factual prisms is important to understand when entering into the Second, Reconsideration Stage of the “process”.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Disability Retirement: The "Process"

In my last writing, I briefly discussed why filing for Federal Disability Retirement benefits is, and must be looked upon as, a “process” as opposed to a mere “filing” with an expectation of an “automatic” approval.  This is because there is a legal standard of proof to be met, based upon a statutory scheme which was passed by Congress, and based upon a voluminous body of “case-law” handed down by the Merit Systems Protection Board and the Federal Circuit Court of Appeals.  With this in mind, it is wise to consider that, because it is a “process” with two administrative “stages” to the process, as well as an Appeal to an Administrative Judge at the Merit Systems Protection Board, then potentially to the Full Board via a Petition for Review, and finally to the Federal Circuit Court of Appeals — as such, each “step” in the process would naturally have a different and “higher” level of the laws governing Federal Disability Retirement. 

Because of this, it is often a frustrating experience for applicants, because a rejection or denial at the First Stage of the process often reveals the utter lack of knowledge by the OPM representative of the larger compendium of case-laws that govern and dictate how disability retirement applications are to be evaluated and decided upon.  Often, the so-called “discussion” of a denial letter is poorly written, meandering in thoughtlessness, and self-contradictory and with unjustifiable selectivity of statements from a medical report or record.  Such poor writing reflects a first-level decision-making process, and can be a frustrating experience upon reading the denial letter.  It is good to keep in mind, however, that the entire application procedure is a “process”, and each level is designed to have a greater level of competency and knowledge in the law.

Sincerely,

Robert R. McGill, Esquire