OPM Disability Retirement: The Meaning of Separation from Service

The 1-year rule, or more properly, the Statute of Limitations, continues to be confused at various levels.  The beginning point in understanding the rule must always be to first clarify what constitutes the trigger-point; for, if one does not know what represents the first day of the year, how can one calculate the remaining 364 days?

First, in negative form:  Being on LWOP, Sick Leave, or any time of leave, does not constitute a separation from service.  Indeed, logically, if one reflects upon it for a moment, the very fact that one is on some type of leave would imply that one is on leave “from” an agency, thereby inferring that no separation from service has yet occurred.  Thus, separation from Federal Service is an event which occurs when a Federal or Postal employee affirmatively resigns; is issued a termination or separation letter; or is issued a personnel action on an SF Form 50 or PS Form 50, showing that Federal or Postal employment has been terminated.

For Postal employees, if you continue to receive a “0”-balance pay stub, it likely means that you have not yet been separated.

Obviously, for Federal Disability Retirement purposes, whether under FERS or CSRS, knowing whether or not you are separated from Federal Service is important, because the Office of Personnel Management will not make a determination on the substantive basis of a Federal Disability Retirement application if it has been filed in an untimely manner (i.e., after a year has passed from the date of separation).

Then, of course, there is also the “other” 1-year rule, of showing that one’s medical condition will last for a minimum of 12 months.  But let us not get ahead of ourselves and confuse and conflate the two.

Sincerely,

Robert R. McGill, Esquire

Federal Worker Disability Retirement: Extrapolating Carefully from “The Law”

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, it is important to recognize the major legal cases (those “landmark cases”) from which many other cases derive their foundational basis.  Such cases form the fundamental and overriding criteria of a legal arena, and this is no different in arguing for Federal Disability Retirement benefits under FERS or CSRS, either for Federal or Postal employees.  Furthermore, in citing a case to argue for one’s position of eligibility and entitlement, it is equally important to have read the cases carefully, and to argue the merits of an issue persuasively and accurately.  

One of the worst things that a lay, non-lawyer applicant can do is to mis-cite a case or a statute, and its meaning and ancillary conclusions.  For, when the Office of Personnel Management reviews a case and refutes a particular issue, and further points out that a legal precedent or statutory authority has been mis-applied, one’s credibility as to the substance of the application is not only undermined, but further, the viability of one’s legal argument has been subverted.  As such, it is normally advisable to leave the law to lawyers — and in Federal Disability Retirement cases under FERS or CSRS, to leave it to lawyers who specialize in the field. For, to do little or no harm to one’s self is certainly better than to saw off the branch which one has grasped onto, no matter how tenuous the position to begin with.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: “The Grab-bag”, “Volume” and the “Last Minute” Case

Procrastination leads to filing a Federal Disability Retirement application under FERS or CSRS at the last minute, which leads one to simply attach a volume of medical documentation and list a grab-bag of medical conditions

Sometimes, such an approach is thought to be the only way of preparing, formulating, and filing a Federal Disability Retirement application, especially when there is little or no time left in which to meet the statutory deadline for filing (a Federal or Postal employee must file within 1 year of being separated from Federal Service).  It may well be the only way to file, given that a Federal or Postal employee has only days left to submit the Federal Disability Retirement application

The fact is, one can only argue the merits of a case if, and only if, one has met the Statute of Limitations; if one fails to file in a timely manner, then there is simply no opportunity at all to argue the substantive basis for the Federal Disability Retirement application.  Yet, even in “Last Minute” cases, it is important to pause and attempt to streamline a case.  Why?  Because once a case has been filed, and the Statute of Limitations has passed, a Federal or Postal employee is unable to change or otherwise amend the stated and identified medical conditions, as listed on Standard Form 3112A

As such, even at the last minute, the grab-bag volume case should be — and can be — prepared and formulated with some thought.  In the end, it will serve the Federal or Postal employee who is filing for OPM Disability Retirement benefits under FERS or CSRS, well.

Sincerely,

Robert R. McGill, Esquire

Federal Worker Disability Retirement: The Irony of Favorable Laws

In certain areas of “the law”, statutes, regulations and case-laws have developed which tend to favor the individual seeking to obtain a benefit through such laws.  For the Federal or Postal Worker who is seeking Federal Disability Retirement benefits under FERS or CSRS, one could easily argue that the laws governing the process of seeking Federal or Postal Disability benefits from the Office of Personnel Management “favor” the applicant.  

Think about it:  a Federal or Postal worker (under FERS) needs only 18 months of minimum eligibility; light duty, or modified duties, do not preclude one from obtaining Federal Disability Retirement benefits; one has up to a year after being separated from Federal Service to file for the benefit; a Federal or Postal Worker who suffers from a medical condition only has to show that it prevents one from performing one or more of the essential elements of one’s job; one does not need to show “total disability”, but only disability as to one of the critical elements of one’s job; and so on.

The irony of such “favorable” laws governing Federal Disability Retirement under FERS or CSRS is, however, that such favor often invites greater scrutiny.  Thus, the fact that the substantive laws governing a legal process may provide an advantage to the seeker, does not in any way mean that the process itself is any easier.  On the contrary, one could argue that because the substantive laws governing a legal process favor the applicant, that the process itself is made all the more difficult.  Such ironies often arise in various facets of life, and it certainly seems to be the case for Federal and Postal workers seeking to obtain Federal Disability Retirement benefits under FERS & CSRS.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Reminder on the 1-Year Statute

Just a reminder, which is given because of continuing and repetitive questions about the 1-year statute of limitations.  Remember that those who wish to file for Federal or Postal Disability retirement benefits under FERS or CSRS must do so either (A) while a Federal or Postal employee (18 months minimum under FERS; 5 years minimum under CSRS), or (B) within 1 year of being separated from Federal Service.  By “separated” it means actually being terminated from the Federal Agency, whether by resignation or by Agency action.

The 1-year statute of limitations does not begin to toll except when you are separated from Federal Service.  Thus, being on LWOP does not begin to toll the statute; being injured or on OWCP does not begin to toll the statute.  By “toll the statute”, what is meant is that the right to file for OPM Disability Retirement benefits for FERS or CSRS employees does not begin to “count down” unless and until you are actually separated from Federal Service.  This is meant as a continuing clarification of the issue, written because of the questions which have been asked of me over the past month or so.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Why Up to 1 Year?

In filing for Federal Disability Retirement benefits under FERS or CSRS, why should a person be given up to 1 year after separation from Federal Service, to file for the benefits?  The underlying legal rationale can be conflicting, but there are multiple pragmatic reasons why such a statute allowing for a person to file for Federal Disability Retirement benefits up to 1 year after separation from service, is “reasonable” and “sound in judgment”. 

Often, Federal and Postal employees get fired before the proper forms or medical documentation can be completed or gathered; proposed terminations and determinations on the proposals can come about quickly; a Federal or Postal employee who is focused upon getting treatment (surgery; psychiatric treatment, etc.) can be left with a sense of being overwhelmed, and incapable of filing for a benefit which requires rational thought, procedural organization, and an ability to be systematic in approaching the entire process; a person may not fully comprehend or appreciate the extent of a medical condition, and may quit, resign, or file for early retirement with a lesser annuity, feeling isolated and beset with a sense of hopelessness in not “having any other choice” but to walk away from the Federal or Postal job he or she loved; suffer from a Reduction-in-Force (RIF), and think that because of the RIF that disability retirement was not an option (it often is); and many other reasons.  Indeed, there is a rational and logical basis for allowing for the 1-year timeframe of filing for Federal Disability Retirement benefits under FERS or CSRS, after the Federal or Postal worker has been removed or separated from Federal Service.  On top of it all, to allow for it is simply “fair”.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Case of Fibromyalgia

Fibromyalgia is one of those medical conditions that the Office of Personnel Management systematically “targets” as a condition which is prima facie “suspect”. This is despite the fact that there are cases which implicitly “admonish” OPM from engaging in the type of arbitrary reasoning of denying a disability retirement application because they “believe” that “no objective medical evidence” has been submitted, or that the “pain” experienced (diffuse as it might be) is merely “subjective”, or that the chronicity of the pain merely “waxes and wanes”, and a host of multiple other unfounded reasonings. Yet, cases have already placed a clear boundary around such arbitrary and capricious reasonings.

A case in point, of course, is Vanieken-Ryals v. OPM, a U.S. Court of Appeals for the Federal Circuit case, decided on November 26, 2007. In that case, it clearly circumscribes the fact that OPM can no longer make the argument that an Applicant’s disability retirement application contains “insufficient medical evidence” because of its lack of “objective medical evidence”. This is because there is no statute or regulation which “imposes such a requirement” that “objective” medical evidence is required to prove disability. As long as the treating doctor of the disability retirement applicant utilizes “established diagnostic criteria” and applies modalities of treatment which are “consistent with ‘generally accepted professional standards'”, then the application is eligible for consideration. Further, the Court went on to state that it is “legal error for either agency (OPM or the MSPB) to reject submitted medical evidence as entitled to no probative weight at all solely because it lacks so-called ‘objective’ measures such as laboratory tests.” Statues are passed for a reason: to be followed by agencies. Judges render decisions for a reason: for agencies to follow. Often, however, agencies lag behind statutes and judicial decisions. It is up the an applicant — and his or her attorney — to make sure that OPM follows the law.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: The Complexity of the Simple

Federal disability retirement law, the statutes and regulations which govern eligibility; the multiple case-law opinions from Administrative Judges and Federal Circuit Judges interpreting the governing statutes and regulations; the lawyers who argue different aspects and attempt to “fine-tune” existing law (including this lawyer) — the entirety results in “making complex” that which was essentially simple.

There is an old adage that the King who declared the first law of his Kingdom was really attempting to reduce the unemployment figures by creating the need for lawyers. Indeed, “the law” is often made more complex by lawyers. However, while the multiple issues governing Federal disability retirement law under FERS & CSRS may appear, at first glance, “simple”, it is such simplicity which engenders the complex, precisely because laws which reflect a simple conceptual paradigm require extensive interpretation in order to explain the simpleness of the simplicity. That is why law itself is complex. Don’t let the complex confluse you. As you prepare a disability retirement application, recognize that it is a complex process; at the same time, make sure to explain your medical condition and how it impacts your ability to perform the essential elements of your Federal or Postal position in an easy-going, simple and straightforward manner. Don’t make it complex; keep it simple; but recognize the complexities.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: Don’t Rely Upon the Waiver Statute to Be Able To File

If an individual fails to file for Federal disability retirement within one (1) year of being separated from Federal Service, he/she loses the right to file forever, unless the individual is able to show mental incompetency – and that is indeed a very high standard to meet. The relevant statutory provision is found at 5 U.S.C. Section 8453; to wit:

A claim may be allowed under this subchapter only if application is filed with [OPM] before the employee or Member is separated from the service or within 1 year thereafter. This time limitation may be waived by [OPM] for an employee or Member who, at the time of separation from service or within 1 year thereafter, is mentally incompetent if the application is filed with [OPM] within 1 year from the date of restoration of the employee or Member to competency or the appointment of a fiduciary, whichever is earlier.

Note the heavy burden of relying upon this statute if you failed to file for disability retirement within the 1-year statutory timeframe: First, note the discretionary nature of the statute – that even if incompetency is found, the time limit “may be” waived – not a certainty, but discretionary (now, it is true that as the Board in Barton v. OPM, DC-844E-03-0366-I-1, 2004 decision, stated, the Board will review a decision by OPM “to see if OPM abused its discretion or if its decision was wholly unwarranted” – but again, no one should want to rely upon such a review to be able to file for disability retirement).

Second, you would need to have strong medical evidence that you were “mentally incompetent” within the 1-year timeframe after separation from Federal Service. Third, even if you were found to be mentally incompetent, the 1-year statutory timeframe to file begins to run either when a fiduciary is appointed, or when the person is found to be competent, whichever comes first.

Don’t rely upon the waiver provision. Once a FERS or CSRS member finds that he/she cannot perform one or more of the essential elements of the job, it is time to file.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Workers: Things You Shouldn’t Do When Filing For CSRS or FERS Disability Retirement

First, a quick clarification: I have had periodic calls concerning the time-frame in filing for disability retirement. The Statute of Limitations in filing for disability retirement is one year from the date you are separated from Federal Service — not from the date you were injured, or from the time you stopped working, etc. Next, many Federal and Postal Workers ask me to represent them in obtaining disability retirement at the Second Stage (OPM’s Reconsideration Stage), after having filed without representation. I have no problems with that — indeed, sometimes (though rarely), individuals have such a severe degree of medical disabilities that an attorney is not necessary. For the majority of Federal and Postal Workers, however, representation beginning at the initial stage of a disability retirement application is necessary. If, however, for financial or other reasons (including stubbornness), an individual insists upon filing for disability retirement without a qualified Attorney, the following are a few things which you should NOT do in preparing your application:

Do not become non-compliant in a treatment regimen, medication regimen, or any aspect of a reasonable medical regimen designed to treat the disease or injury. This is a sure way to have your disability retirement application denied. For, when an employee “is unable to render useful and efficient service because that employee fails or refuses to follow or accept normal treatment, it is wholly proper to say that the employee’s disability flows, not from the disease or injury itself (as the statute requires), but from the employee’s voluntary failure or refusal to take the available corrective or ameliorative action.” Baker v. Office of Personnel Management, 782 F.2d 993, 994 (Fed. Cir. 1986) (A word of caution: this does not mean that all surgeries must be consented to).

Do not ignore the basis of a Notice of Removal. I have previously discussed the importance of obtaining the Bruner Presumption, whenever possible, in a disability retirement case. Beyond getting the Bruner Presumption, however, is the fact that any implication of misconduct or willful failure on the part of the Federal or Postal Employee should always be appealed, if not to have it completely amended, then to at least have such a basis for removal expunged, and instead to allow for the employee to resign, thereby nullifying misconduct as a basis for separation. Never give the Office of Personnel Management an additional reason to deny your disability retirement application.

Do not have your treating doctors send in medical documentation directly to the Agency Personnel Office. Always take charge of your own disability retirement application. Have the doctors send the medical documentation to you, and personally review and inspect each page of your submission for accuracy, relevance, and applicability to your medical condition. Never blindly submit medical documentation to the Office of Personnel Management. Again, never give the Office of Personnel Management an additional reason to deny your disability retirement application. This advice, of course, goes “hand-in-hand” with my policy of never signing the SF 3112C (Physician’s Statement), which often releases all of the medical documentation directly to the Agency.

These are just three fundamental “Do Not” rules in preparing and filing for disability retirement. When a Federal or Postal Employee comes to me at the Reconsideration Stage for legal representation, I find that I must first correct several fundamental errors committed by the applicant. While I can almost always correct the mistakes already made, the damage can only be minimized, and never completely eradicated, because the error is already known to the Office of Personnel Management. Still, I am normally able to convince the Office of Personnel Management to approve the disability retirement application.

In the course of representing Federal and Postal Workers to obtain disability retirement benefits, I have always tried to emphasize the fact that, while it is each individual’s choice as to whether or not to hire an attorney, you should always proceed with the greatest tool available — knowledge. Disability Retirement is a benefit accorded to all Federal and Postal Employees under FERS and CSRS. However, as with all benefits, the right to it remains unclaimed unless one proves, by a preponderance of the evidence, that one is legally entitled to it. To prove your claim, you must go at it from a position of strength — and this requires knowledge. Like the Mother Rabbit who cautions her bunnies, do not allow lack of knowledge to be your stumbling block.

My name is Robert R. McGill. I am an attorney who specializes in disability retirement claims for Federal and Postal Employees. If you would like to discuss your particular case, you may contact me at 1-800-990-7932, or email me at federal.lawyer@yahoo.com.