Federal Disability Reconsiderations & Additional Medical Information

The denial comes in the mail; it is a further delay, a negation of prior efforts; for many, it undermines and constitutes a condemnation of sorts, and a refusal of an affirmation sought in places and from people where none is offered.  It is, after all, another piece of correspondence which negates the negative:  the medical condition itself and the loss of one’s ability to perform one or more of the essential elements of one’s job, represented the first foundation of negation; now, a denial from the U.S. Office of Personnel Management merely confirms, via a second negation, the loss of positive forces inherent in failure and Federal bureaucracies.

But all things in life must be kept in their proper perspective, and a reaction of disproportionate magnitude must be kept in check; life is often a series of mishaps; yes, it just seems that such unfortunate events happen to certain individuals, and as the old adage goes, when it rains, it pours.  Once the initial shock of the denial is withstood, then the trepidation and cautious perusal, followed by an obsessively careful scrutiny, of the reasons for the denial issued by the U.S. Office of Personnel Management, is engaged; but the futility of such efforts will become apparent.

The monotony and disinterested voice behind the volume of verbiage and almost bellicose verbosity becomes more than apparent: either the administrative specialist at the U.S. Office of Personnel Management did not read the medical file or, more likely, selectively chose to extrapolate statements and findings out of context in order to justify the denial of one’s Federal Disability Retirement application.

At this Second Stage of the process of trying to obtain Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether the Federal employee is under FERS or CSRS, it matters not what the words say with respect to the denial issued by OPM; the file is immediately transferred to a general, unassigned file, awaiting further instructions from the person to whom the denial has been issued:  if left unanswered, the file will disappear within the cauldrons of bureaucratic warehouses; if a Request for Reconsideration is timely filed, then it will ultimately be assigned to someone in the Reconsideration Division at OPM; but, in either case, it is no longer the responsibility of the OPM representative who issued the denial, and no amount of phone calls, venting or sending of additional information to that person will make a whit of difference, until (a) the Request for Reconsideration is timely filed, and (b) the Federal or Postal employee addresses some of the concerns brought up in the denial itself.

The Reconsideration process itself is fraught with dangers and potential pitfalls; it confirms that perhaps the Federal or Postal employee should have sought the advice, counsel and guidance of an attorney who specializes in Federal Disability Retirement law, but moreover, as most mistakes are correctable, it may be a wise avenue of choice to seek legal assistance, finally.

In any event, time factors must be considered, and the time lost today by extension of a denial, further confirms the oldest adage of all, that being penny wise is to be pound foolish,  a saying that is often attributed to Benjamin Franklin, but can be traced to those earlier.

Sincerely,

Robert R. McGill, Esquire

 

OPM Disability Retirement: The Response to the Denial & Properly Reading the Signs

Responding to an OPM Disability Retirement application denial is fraught with dangers of addressing the right issue; whether such a response does so adequately; and the determination of the extent of what constitutes “adequacy” in such a response.  Properly reading the “road signs” is the key to a successful response.  For, to begin with, cogency and brevity are not characteristics which are common in an OPM Disability Retirement denial.

The U.S. Office of Personnel Management utilizes multiple templates in referring to the sufficiency of legal and documentary proof, and will often shift arbitrarily in declaring why, and to what extent, a Federal or Postal disability retirement application did not meet the standard of proof required, which is governed by a “preponderance of the evidence”.  They will, of course, often cite various legal “criteria”, and number them accordingly, as in:  “You did not meet Criteria Number 4 in that…”

In responding, it is important to address the critical issues which OPM regards as central to its decision, and as all roads lead back to Rome, so it is with a response to a denial from the U.S. Office of Personnel Management in a Federal Disability Retirement case: All roads lead back to the original nexus of whether a Federal or Postal employee can perform all of the essential elements of one’s job within the context of the severity and extent of one’s medical conditions, and to the issue of whether or not a “reasonable” accommodation could have been provided by the individual’s agency.

Broken down into its foundational components, the pathways can be ultimately discerned, and the proverbial fork-in-the-road leading one to the right way back to Rome will often depend upon how the traveler interprets the signs.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: Keeping it Simple

Simplicity merely covers the complexity behind the beauty of the uncomplicated.  Indeed, one only has to look upon an Apple product, or a modern automobile, to recognize the underlying complexities which went into the production of such simplicity.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, there is often a desire to respond to an OPM denial by attempting to understanding the apparent ‘complexity’ of the denial.  By ‘apparent’ is meant the following:  Most, if not all, of OPM’s denials are regurgitated templates from thousands of previous denials, and quotations of alleged legalese notwithstanding, the basic components of a Federal Disability Retirement case do not change just because the language used attempts to complicate matters.

In the end, driving a technologically advanced automobile still requires hands on the steering wheel, and a foot on the gas pedal and the brake (hopefully, not both at the same time).  All the rest are simply “whistles and horns” to make it appear worth the price tag.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: Surprise in the Universe of Reconsiderations

Until the science of Physics can implement the ability of molecular and particle transference technology (i.e., “Beam me up, Scotty”), there is little potential of resolving the Cartesian mind/body dualism (i.e., that French Philosopher Rene Descartes, who bifurcated the world between the material and the spiritual). But such dualism in philosophical terms does not mean that we can be at two places at one time; or even attempt to be “objective” when the subjective “I” is the very same person who is attempting to appear objective.

In Federal Disability Retirement law, when the U.S. Office of Personnel Management issues a denial letter, the customary response by the denied OPM applicant, whether a Postal Worker or a non-Postal Federal Worker, is that he or she is “surprised” by the initial denial because of the strength, completeness, and thoroughness of one’s Disability Retirement packet.  But that should be a given.

No one who files with OPM should do so without meeting the requisite foundations of thoroughness or completeness.  But this is where the problem is:  the very person who determines that a Federal Disability Retirement application is sufficient, is the same person who suffers from the very medical conditions of which the application speaks about.

The subjective/objective coalescence makes for a difficult mind/body dualism, in that the one who suffers from the medical condition can hardly assess and evaluate, in an objective manner, the strength of the Federal Disability Retirement application.

Thus, the Cartesian mind/body dualism lives on, and until Captain Kirk can guide us otherwise, such bifurcated dualism will continue to pervade all Federal Disability Retirement applications, whether under FERS or CSRS, and the denials which follow will still have the familiar response of, “Surprise!”

Sincerely,

Robert R. McGill, Esquire

Postal and Federal Disability Retirement: Denials

Denials come with an unexpected force and impact; for, in every Federal Disability Retirement case, there is the expectation that the application itself merits close scrutiny and a belief that a proper review will persuade the OPM trier of facts that the Federal Disability Retirement application should be approved.

Indeed, from the perspective of the applicant, who is suffering from the medical condition itself on a daily basis, it is often a reaction of disbelief and anger when a denial is issued by the U.S. Office of Personnel Management.  But one must understand that this administrative process identified as “Federal Disability Retirement” is one which is not an “entitlement”, but rather, an adversarial process where proof, argumentation and persistent appellate procedures must be invoked at every step of the way.

That is why, in preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, one needs to always prepare a case as if it will ultimately go to the U.S. Merit Systems Protection Board.

Further, it is understandably disappointing to read an OPM denial and find that the OPM case worker does not even mention or refer to much of the substantive medical documentation submitted, but instead blindly (and generically) issues a template of tired old phrases, such as, “You did not meet the legal criteria“; “The evidence did not show that…”

With hundreds of cases assigned to each OPM Case Worker, one must understand that denials are rarely personal; but in responding to a denial from OPM, one must be diligent, forceful, and approach it with the use of all legal tools available.

Sincerely,

Robert R. McGill, Esquire

Federal Worker Disability Retirement: The Disappointment of a Denial

A Denial Letter from the U.S. Office of Personnel Management quashes the Federal or Postal employee’s plans for the future, which includes an ability to secure a stream of income, to have the recuperative period in which to recover from a progressively deteriorating medical condition, and generally to be able to “move on” in life.  As all rejections have a negative impact upon a person — in terms of emotional, psychological as well as practical consequences — so a denial letter from OPM is seen as a rejection of a compendium of submitted proof concerning a Federal Disability Retirement application.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, one becomes completely and totally involved in the gathering, compiling and submission of the documentation, statements, narratives and records in order to “prove” that one is eligible for Federal Disability Retirement benefits.

Such totality of involvement often betrays an ability to remain objective in a case; for, by definition, self-involvement diminishes the ability of an individual to be able to step outside of one’s self, and to evaluate the effectiveness of an endeavor apart from the subjective perspective which everyone brings to bear upon a project, issue, work product, etc.  But objectivity is important, because an uninvolved, detached assessment of a Federal Disability Retirement application evaluates the viability of a Federal Disability Retirement packet without the concerns already indicated — those emotional, psychological and practical consequences which form a part of a person’s being.  That is why having an advocate or legal representation is an integral part of preparing, formulating and filing for Federal Disability Retirement benefits.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement for Federal Workers: Rationality Still Exists

One may well disagrees with the U.S. Office of Personnel Management on its decision to deny a Federal Disability Retirement application, and yet find a rational basis for its denial.  Indeed, the fact that OPM may offer some rationality to its denial, does not mean that they are correct in their decision.  Often, there is a misunderstanding as to what “rational” behavior consists of.

On a recent Sunday morning talk show, a couple of political pundits were proposing the idea that certain hard-line regimes were not acting “rationally”.  The problem with such an analysis is that one assumes that if an individual or a country fails to act within certain universally-accepted normative behavior, that such actions constitute “irrational” conduct.  That is simply not true.

First of all, rationality — which finds its foundation in logic, whether propositional or syllogistic — depends upon the major and minor premises advanced.  Thus, if the major premise entails a person or country that cares for the welfare of his neighbor or its citizenry, then the logical conclusion may well be one which encapsulates rationality — of acting to protect its people, to safeguard human rights, etc.  On the other hand, if the major premise begins with the primary assertion of retaining authority and absolute power, then the conclusion would involve shooting or massacring its countrymen.  The latter logical trail is no less “rational” than the former. Such a mistake in defining and understanding the concept of “rationality” is often found in all areas of life.

Thus, in preparing, formulating and filing for Federal Disability Retirement benefits, whether under FERS or CSRS, the fact that there has been evidence of “irrational” behavior on the part of those parties involved in the administrative process, should not result in a conclusion that the process is “arbitrary” or dependent upon some non-legal criteria.

Ultimately, all human endeavors embrace some semblance of rationality.  While one may disagree with the analytical thought-processes of the U.S. Office of Personnel Management, which often strays far beyond what the law requires and allows for, nevertheless, one can recognize the rational analytical procedures used in every denial of a Federal Disability Retirement application, whether under FERS or CSRS — albeit, one in which radical jumps from premise-to-conclusion with gaping chasms of generous implications may have to be provided, in order to be able to say that such argumentation incorporated a rational basis of explanatory analysis.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Workers: When to file for an MSPB Hearing

Filing for Federal Disability Retirement benefits under FERS or CSRS is what is generically known as falling under “Administrative Law“.  That is, Federal and Postal employees must undergo the administrative process of filing with a Federal Agency, the Office of Personnel Management, in an attempt to prove by a preponderance of the evidence that one is eligible for, and therefore entitled to under the law, Federal Disability Retirement benefits under either the Federal Employee’s Retirement System (FERS), the Civil Service Retirement System (the “older” system, or CSRS), or its hybrid, the CSRS-Offset.

If the Agency which makes the decision on eligibility, and it denies a Federal or Postal Service employee’s application twice (both at the Initial application Stage of the process, then again at what is termed the “Reconsideration Stage” of the process), then the disability retirement case can be appealed to an Administrative legal forum specifically set up to hear such cases (as well as many other types of cases involving Federal and Postal employees).

In order to file with the Merit Systems Protection Board (the “MSPB”), one must have received a “final denial” letter from the Office of Personnel Management — and, by “final”, is merely meant the “second denial” letter.  Thus, in order for the Merit System Protection Board (MSPB) to consider an appeal for one’s Federal Disability Retirement benefits, the Federal or Postal employee must have been denied by the Office of Personnel Management on the first two tries — first, with the Initial Application, then for an appeal or the ”Reconsideration” of that application.  Only then may a Federal or Postal employee who is filing for Federal Disability Retirement benefits under FERS, CSRS or CSRS-Offset file an appeal with the MSPB.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Great Expectations

The title of this blog, borrowed (of course) from Dickens’ great novel, refers to the contrast between the reality of X and the mental projection of what should be, in the mind of an individual.

What does this have to do with filing for Federal Disability Retirement benefits under FERS or CSRS?  When an application for Federal Disability Retirement benefits under FERS or CSRS is carefully prepared, meticulously gathered, painfully delineated, and thoughtfully prepared, one has the (logical) expectation that, when it is reviewed and evaluated by the Office of Personnel Management, that a certain minimal level of intellectual discourse would be engaged in.

In other words, it should not be an unrealistic expectation that, if it is denied or disapproved, that the person who is writing the letter of denial would provide some fundamental delineation of reasons; some intellectual discussion addressing certain aspects of the Federal Disability Retirement packet; even (God forbid) a revelation of some logical discourse with a legally viable basis in making an argument.

Alas, such an expectation would be too much to bear.  The great chasm between the reality of the process and the expectation which one has, is one which will lead only to disappointment.  If a denial of a Federal Disability Retirement application comes, it is a rare event that the Office of Personnel Management engages in any justifiable discussion.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: The Chasm between Denials

From the perspective of an individual Applicant for Federal Disability Retirement benefits under FERS & CSRS, the individual applicant does not normally observe some other person’s Federal Disability Retirement application, and therefore never has the opportunity to see the “greater process” at work, or patterns of behavior on the part of the Office of Personnel Management.  Yet, there are indeed patterns, and that is why an experienced attorney who has seen literally thousands of Federal Disability Retirement cases over numerous years, has an advantage in responding to OPM’s denials.  Experience lends itself to greater observation.  Experience over time reveals certain patterns.  And patterns of behavior can reveal important principles. 

Certain OPM Representatives provide detailed and (often) irrelevant factual references which can be ignored; others like to “cite the law” and believe that such citations appear irrefutable and authoritative; and still others give scant discussion to laws or to facts.  Thus, there often appears to be a great chasm between the types of denials.  Whether or not there are such differences, an applicant who has received a denial for his or her Federal Disability Retirement case needs to respond to any such denial with a three-pronged attack:  Medical refutation; Factual correction; Legal assertion.  Such an attack will cover any chasm which might exist between the different individuals who send out a denial letter.  More importantly, it will cover the necessary elements for winning a Federal Disability Retirement case.

Sincerely,

Robert R. McGill, Esquire