Disability Retirement for Federal Government Employees: Initial Application, Reconsideration & MSPB Appeals

Each Stage of the process in attempting to obtain a Federal Disability Retirement application under FERS or CSRS offers a distinct, yet similar, challenge.  Do not be fooled by responding to a “template” approach; while the Office of Personnel Management may respond in an indifferent, antiseptic manner, a Federal or Postal employee who must respond to OPM’s denial at each stage of the process must pinpoint what OPM is looking for, and respond appropriately.  Indeed, it is the distinction which one observes, which makes all of the difference in the case.  

Often, it is clear that OPM’s denial at the Initial Stage of the process, as well as a denial at the Reconsideration Stage of the process (which then compels an appeal to the Merit Systems Protection Board), is merely a regurgitation of thousands of previous denial letters, with some minor insertions which are meant to appear “as if” the denial letter has been tailored to a particular case.  

Thus, references to a particular physician’s letter, and even extrapolating a quotation from a doctor’s note or narrative (often something like, “Your doctor stated that you were recovering well from your surgery,” or “Your psychiatrist stated that the medications were working”) have the effect of personalizing a denial letter.  Yet, the remainder of the denial letter is in an antiseptic, template form, and it is clear that you are merely one of hundreds & thousands of responses written by OPM’s representative.  However, while OPM has the power to generate such template-driven denials, the individual Federal or Postal Worker must respond in an independent, individualistic manner.  It must be based upon one’s particular case, and thus the response must not be a “generic” one, but one based upon the uniqueness of the case.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: The Strategy of Disheartening the Opposition

When Federal and Postal employees who have filed for FERS Medical Retirement benefits and have been denied at the initial stage of the process, many are sincerely disheartened.

In my initial contact with the denied applicant, there are multiple levels of reactions, including:  the denial letter points to legal criteria which they were unaware of; it refers to doctors notations which are taken completely out of context; they have completely ignored major portions of what the doctor has stated; OPM points to legal criteria which has been met, but which OPM simply denies that it has been met.

What can be done?  This is the strategy of disheartening the opposition.

In other denials, it is simply a matter of referring to a doctor’s report here, and to a medical notation there; then to simply declare:  You have not submitted sufficient medical documentation and fail to meet the legal criteria to be eligible for Federal Disability Retirement benefits.

What can be done?  No explanation; just scant references, then a unilateral declaration.  Again, this is the strategy of disheartening the opposition.  What to do?  Don’t get disheartened.  Respond.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: An Additional Problem with Answering an OPM Denial

Spring and summer are finally upon us; the warmth of the sun finally brings some hope that the multiple series of snowstorms may be finally behind us (now that I have said it, the chances are exponentially multiplied that we will accumulate an additional 20 inches of snow in March).  Thoughts of the beach will soon become visually real, as opposed to virtually experienced.  Sand.  The metaphor of the “shifting sand” is one which is applicable to the Office of Personnel Management in its denial of a Federal Disability Retirement application under FERS or CSRS.  Those of you who have followed my stream of consciousness on the issue of templates, denial letters and the arbitrary nature of OPM’s decision-making process, will not find it surprising to find that OPM merely shifts, changes positions, and dances around (albeit, not always gracefully) any attempt to “corner” the argument which purportedly is the basis for a denial of a Federal or Postal Disability Retirement application. 

Do not, however, underestimate the importance of properly, directly, and clearly answering the concerns of an OPM denial.  It is not enough to gather more medical documentation and sending them in.  It is not enough to address, point by point, the basis of a denial letter.  One must corner, clarify, and clearly define the basis of an OPM denial, then refute them.  This way, if it is denied a second time, and the case goes before an Administrative Judge at the Merit Systems Protection Board, the AJ will see that the issues previously brought forth by OPM have already been addressed, and that any necessity for a Hearing may be avoided by clarifying any remaining concerns which the OPM representative may need to search for and articulate. 

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: The Problem with Answering an OPM Denial

A denial of a Federal Disability Retirement application under FERS or CSRS from the Office of Personnel Management always leaves the applicant and his or her attorney at a disadvantage.  This is because OPM is never answerable to any resulting consequence of a denial; at least, not directly.  Think about it this way:  In the initial application, if an OPM Disability Retirement application is properly prepared and submitted according to, and within the parameters of the laws governing Federal Disability Retirement, one would assume that it should be approved.  If it is denied, then the case is sent to the “Reconsideration” division of OPM — meaning, to another person. 

Now, taking it out of the hands of one OPM Representative into the hands of another, has both the good and the bad mixed together:  the good is that it will now be reviewed afresh by someone else; the bad is that the person who denied the original application has no further responsibility for the denial.  This is true, incidentally, with respect to the Reconsideration Stage of the process; if a second denial is issued, the person who issues the second denial also has no responsibility to answer for the basis given in the denial. 

The “light at the end of the tunnel“, however, comes when it is finally taken up by an Administrative Judge at the Merit Systems Protection Board.  While the AJ cannot hold anyone at OPM responsible for a denial which never should have been, at the very least, when the AJ reviews the record and finds that the previous denials were unfounded or rationally without legal foundation, an immediate recognition of a baseless denial can help the applicant.  Ultimately, rationality and legal integrity has a chance to prevail; it sometimes takes more than one bite at the apple.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: Responding to the Template Approach

While the Office of Personnel Management issues template approvals and denials, what must the individual applicant who receives such a template denial, do?  Obviously, it cannot be a “template” response, because any response by an individual applicant is going to be an individualized response.  Often, however, OPM’s response takes a shot-gun approach in denying a Federal Disability Retirement application — it uses every device in its template, touching upon every issue and sub-issue, without any apparent (or obvious) rhyme or reason.  Whether purposeful or not, the extent and quantity of reasons for denial become almost insurmountable, and unable to “sort out”. 

One thing that a Federal Disability Retirement applicant should not do, is to take the denial letter to his or her doctor to respond to.  It will only confuse the doctor.  Instead, the denial letter must be reduced to a comprehensible set of criteria which can be answered.  Sub-sets of issues need to be identified and consolidated; the minor (but often irritating) references to peripheral issues, often touched upon but of no real consequence, must be ignored; and the focus must be placed upon the central 2 or 3 issues which seem to be the overriding concerns in the denial letter.  In other words, the denial letter must be deciphered and extracted to be “made sense of”.  Only then can OPM’s template denial letter be answered — with reason, aggressive attack, and a rational grounding in the law.  In other words, irrationality must be met with clarity of mind.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Template Approach

The Office of Personnel Management essentially renders both approvals and denials of a Federal Disability Retirement application with a “template” approach.  This is not surprising, but it is little noticed, and this is why:  For disabled Federal and Postal workers who file for Federal Disability Retirements benefits under FERS or CSRS, and who are not represented by a federal disability attorney, it is their “one-and-only” exposure to the Office of Personnel Management.

Thus, if an approval is received, that approval is the first and only time of having any correspondence from the Office of Personnel Management.  Similarly, if a denial is received, then that is the first exposure and contact from the Office of Personnel Management.  There would be no way of knowing whether or not the approval letter, or the denial letter, was or was not a “standard template”.  Certainly, in a denial letter from the Office of Personnel Management, there are references to submitted medical documents, or supervisor’s statement, or some other document which was part of the Federal Disability Retirement application; but the remainder of the denial letter is in “template form”. 

However, when an attorney represents a Federal or Postal worker and receives an initial denial letter, or a denial at the Reconsideration Stage, it is an obvious issue, because any attorney who specializes in Federal Disability Retirement law has viewed hundreds, if not thousands, of such letters.  Why is it important to recognize that the format is in “template” form?  For many reasons.  The type of template; from whom the template is received; the extent of the template; the issues presented in the format; these are all helpful for any experienced Federal Attorney who specializes in Federal Disability Retirement law, to successfully answer such formatted denials.

Sincerely,

Robert R. McGill, Esquire