CSRS & FERS Medical Disability Retirement: OPM & SSDI

In filing an application for Federal Disability Retirement benefits under FERS (Federal Employees Retirement System), the applicant must file for Social Security disability benefits (SSDI) sometime prior to the approval of a Federal Disability Retirement application.  This is because the “system” of FERS is tied to the Social Security System, and the Federal Government wants to see whether or not a FERS disability retirement applicant is concurrently eligible and entitled to Social Security Disability benefits.  Those Federal or Postal Workers who are still under the “old system” (CSRS — Civil Service Retirement System) — and you are getting rarer and fewer each year — need not apply.  Those who are of a “hybrid” nature (CSRS offset, etc.) also should apply.

 There is an inconsistency in the way the Office of Personnel Management “requires” the filing for SSDI.  Sometimes, OPM will insist that a FERS Federal Disability Retirement applicant file for SSDI and obtain a receipt only after he or she has been unemployed or separated from the Federal Agency; other times, OPM will be fully satisfied with a receipt of an SSDI filing obtained even while employed by the agency, even though it would mean that an SSDI denial was based upon employment, and not upon whether a person was disabled or not.  In any event, an applicant who is filing for Federal Disability Retirement benefits under FERS should comply with the requirement by filing for SSDI, and getting a receipt showing that one has filed.  

Sincerely,

Robert R. McGill, Esquire

Medical Retirement for Federal Workers: Agency Procedures

It is an argument which cannot be won, and one which is avoided, if possible, but nevertheless I find myself engaged in from time to time.  It is the argument of one’s historical background, and whether one has the viable power to justify the improper action (or inaction), and it goes something like this:  “The Agency requires that…”   Response:  “Yes, but that is not what the Office of Personnel Management requires, and it is OPM who is the final arbiter in the matter.”  “Well, that may be, Mr. ___, but I have been doing this for over 10 years and that’s the way it’s always been done.”  Response:  “Well, I have been doing this for over ___”   “We are just trying to help.”  Beware of the “helpful” agency.  

In filing for Federal Disability Retirement benefits under FERS or CSRS, if an individual has not been separated from Federal Service for more than thirty one (31) days, the entire packet must go through the Federal Agency for which the applicant is working or was working.  Even if the separation occurred over 31 days prior to the filing, certain Standard Forms must be obtained from the former agency.  In “dealing” with the Agency, one often gets into the “back-and-forth” game of how a certain procedure needs to be followed, and that is when the childish playground game of “who has the greater historical experience” is often engaged in.  At bottom, it all comes down to a power game.  It is best to avoid it.  It is best to be courteous and civil.  But when the Human Resources person says, “I’m just trying to be helpful,” beware.  You have probably just lost the game.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Overlooking an Essential Element

Potential applicants who are considering filing for Federal Disability Retirement benefits under FERS or CSRS will sometimes ask the question, What are the essential elements of one’s job?

Sometimes, the answer to the question is often easy to identify, especially if there are unique and distinct features to a particular type of Federal or Postal job.  Other elements are sometimes so obvious that they are overlooked — such as the fact that one must be able to work full time at a job.

Thus, the fact that a Federal or Postal worker is able to work 4 hours a day, or 6 hours a day, and be able to perform all of the other essential elements of his or her job, does not preclude one from being eligible for Federal Disability Retirement benefits under FERS or CSRS.

Further, if the Agency is being “nice” and “accommodating” by allowing for the remainder of the hours to be covered by sick leave or even LWOP, does not preclude the Federal or Postal employee from filing for, and being eligible for, Federal Disability Retirement benefits under FERS or CSRS.

Being able to work full time in a full time position is an essential element of the job.  Don’t overlook the obvious; the obvious is often the gateway to success.

Sincerely,

Robert R. McGill, Esquire

 

Federal and Postal Disability Retirement: The Frustrating Process

As with most administrative dealings with the government (Federal, State or local), the process itself is a frustrating one.  Filing for Federal Disability Retirement benefits under FERS or CSRS is a process which necessarily entails patience, and along with it, a quiet frustration because of the multiple levels of administrative procedures which one must undergo.  

I recently went and watched the De Caprio movie, Inception, which involves a complex and convoluted plot-line of attempting to convince an heir to a great business fortune, to break up the company.  The way to convince the young heir was to involve him in a dreamworld of mental constructs without his knowing it, and to plant an idea into his subconscious that he should break up the company, and thereby fail to compete with another company.  If the short “telling” of this plot line is confusing and convoluted itself, you may imagine how the movie itself is.  Yet, at an IMAX Theater, it was enjoyable, and my son certainly enjoyed it.  

The point here is that the convoluted process of getting from point A to point B, is to take a simple conceptual paradigm and make it into a confusing morass of a long and involved movie.  Filing for Federal Disability Retirement has that same sense of the absurd; of a process which is convoluted beyond a simple concept; and the waiting part is the most frustrating of all.  Then, when the end comes, either with an initial denial or an approval, it is anti-climactic.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Denial at the First Stage

Many individuals who have tried to file for Federal Disability Retirement benefits under CSRS or FERS get the disability retirement application denied at the Initial Stage of the process.  Would I rather have had that person come to me at the First Stage and have me prepare & file it?  Yes.  Are the mistakes made by the unrepresented Federal or Postal Worker irreversible?  No.  Would the disability retirement application been approved at the First Stage had it been prepared and filed by me?  Probably.  This is not to say, however, that all of my cases get passed through at the First Stage.  However, many of the mistakes which I see over and over, made by unrepresented individuals, could — and should — have been avoided. 

Further, many people who call me after getting the initial denial are surprised to hear me tell them that I don’t care what the OPM denial letter states.  While making for interesting bedside reading, the fact of the matter is that once you have read one such denial letter, you’ve essentially “read them all”.  Rarely is there anything new in an OPM denial letter.  OPM representatives use a template, and fill in dates and references to various medical reports and doctor’s records; but the conclusion of the denial letters are fairly identical:  the medical evidence is considered “insufficient” to meet the legal criteria to be eligible for disability retirement benefits.  It is the job of the attorney to go back to the doctors, get the proper medical documentation, then argue the law to the Office of Personnel Management.  The Second (Reconsideration) Stage of the process is a critical stage — for, if it is denied at this level, the next level takes it a “notch” higher — before an Administrative Judge at the Merit Systems Protection Board.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: The First Denial

Your Federal disability retirement application was well-prepared:  perhaps it was prepared with the help of an attorney; the medical documentation seemed solidly unequivocal; the doctor made the necessary connections between one’s medical conditions and the type of essential elements of one’s job; the packet, by all accounts, should have been approved, and by all expectations, the approval should have been reasonably expected. 

Instead, you receive a letter stating that your disability retirement application was disapproved, and a “Discussion” section follows, explaining why the Office of Personnel Management denied your application.  Why did this happen?  There are multiple reasons why such a denial can occur:  the OPM specialist could be a person who lacks a clear understanding of the applicable laws governing disability retirement applications (more often than not, this is the case, and what you actually get in the so-called “Discussion” Section of the denial letter is merely a regurgitation of the statutory criteria for eligibility for disability retirement, without a recognition of the interpretation of such criteria by Federal Judges for the Federal Court of Appeals or by Administrative Judges from the Merit Systems Protection Board); it could be as simple as the OPM representative selectively choosing to read the medical reports and records, and disregarding or ignoring supportive portions of the medical records and reports; or it could be that additional medical reports and records need to be obtained in order to “shore up” the application. 

In any event, whatever the reason for the denial, one should not panic.  It is merely one step in a long, administrative process.  The mere fact that OPM denies your disability retirement application does not mean that they are “right” in doing so; indeed, in my opinion, they are rarely right.  That is why one has the right to have it “reconsidered”, and the opportunity to make further legal arguments, and obtain further medical documentation in support of your claim.  And, beyond that, you have the right to file an appeal to the Merit Systems Protection Board — and beyond.  Never give up; always take it to the next step.  In most cases, it will prove that OPM was in error, and in fighting the denial, you will have secured some semblence of financial security for your future.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: The First Denial

One should not be overly panicked when the Office of Personnel Management denies a disability retirement application at the initial stage of the process.  Certainly, the denial needs to be taken seriously; the basis for the denial (which is often couched in confusing terms, based upon conflicting — almost contradictory — assertions and claims) must be identified and addressed; additional medical documentation may be needed; the proper legal authorities must be cited.

 To put it bluntly:  while it is almost always a good idea to prepare, present, and file a Federal Disability Retirement application with the assistance, guidance and counsel of an attorney, it is essential that an OPM disability retirement denial be rebutted by an attorney who is familiar with the process, the laws, and the compelling arguments necessary in answering the reasons as stated in the “Discussion” section of OPM’s denial letter.  To panic is merely to waste time; to prepare is the wise course; to map out a cogent plan on how to win at the Reconsideration Stage — and, if necessary, the next stage of appeal, the Merit Systems Protection Board — is the wisest approach.  As Easter is a time of renewal, and Spring is now upon us, during the next few weeks, I will be “going back to basics” and reviewing  the process, the law, and the methodology of effectively applying to obtain Federal Disability Retirement benefits for FERS & CSRS employees.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Affirmative Approach

The road which leads to one’s future financial security is irreversibly tied to the extent of how affirmatively one takes one’s future into one’s own hand (now, that was indeed a mouthful).  By this, I mean merely that, in preparing an application for Federal Disability Retirement, there are going to be all sorts of “outside forces” which pull you towards every different direction.  Friends will tell you one thing; your Agency will tell you something else; your coworkers will give you stories (both good and bad); your Human Resources Department may give you advice; ultimately, you must take an affirmative approach and make sure that your application is coherent, logically structured, and medically supported. 

By way of example, an Agency’s Human Resources Department will often insist that the Physician’s Statement, SF 3112C, is a “required” form.  It is not.  They will often give you the form with the return address of the Agency stamped in the upper blank box, for the medical report and records to be returned to the H.R. Department.  Upon receipt, the H.R. Department simply includes the medical documentation (without review or determination that it is helpful to your case), and forwards the packet to the Office of Personnel Management.  This would be the “non-affirmative” approach of doing things. 

To take the affirmative approach would be:  Make sure that the medical documentation you submit to OPM is the extent, type, and quality that you want to submit.  Remember:  the applicant has the burden of proof, by a preponderance of the evidence, to show that you are entitled to Federal Disability Retirement benefits.  Don’t let third parties (i.e., friends, coworkers, Agency, H.R. Department personnel, etc.) make the decisions for you.  Take the affirmative approach — either by yourself, or through your attorney.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: OPM Disability Retirement & Postal Service Voluntary Early Retirement (VER)

For multiple reasons, early retirement — if eligible; if offered; if … — is an option which must be considered by a Federal or Postal employee.  In the coming months, Voluntary Early Retirement will be offered to Postal Employees; each year, Federal employees who become eligible for some form of early retirement must make hard financial decisions.  In light of the present state of the economy (not good), an offer of early retirement (some not so bad) may have to be considered by the Federal or Postal employee.  In each case of such an offer, the details of any such offer must be carefully reviewed and considered — especially if, concurrently, a Federal or Postal employee is considering filing for disability retirement.  A Federal or Postal employee can only collect one or the other:  you can either receive an early retirement annuity, or a disability retirement annuity, but not both.  You can, however, consider filing for early retirement (in order to continue to have some income), then file for disability retirement within one year of being separated from Federal Service. 

If you take this route of filing for early retirement, then filing for disability retirement, you must be careful.  For instance, if a lump-sum payment is part of an early retirement package, will it have to be paid back if you file for, and are approved for, disability retirement?  Further, remember that the years that you are on disability retirement counts toward your total number of years of Federal Service, when it is recalculated at age 62.  This is an important point.  The short-term benefit of retiring early may not seem like such a good idea 10 years later when inflation eats into the annuity.  A cost-benefits analysis should look to all of the factors involved:  the annuity amount and difference between disability retirement and early retirement today; the difference of the annuity when disability retirement is recalculated, and those years while on disability retirement count towards your regular retirement; and the dollar difference calculated out to the life expectancy.  These are all considerations which must be looked at carefully — not just upon one’s short-term benefit of an early retirement (which may seem great), but more than that, for the long-term security of the Federal and Postal employee.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Long View

What I find when individuals have attempted to file on their own, and get it rejected, is the lack of preparing for the “long view.” Many people hear stories about how “such and such” obtained a disability retirement approval for “far less than the medical conditions I have.” Fair enough. Those stories may be true (I never engage in a discussion about the validity or truth of such stories; they are what they are — stories); nevertheless, there are multiple factors which are considered at each stage of the process of filing for disability retirement: Who the OPM Specialist is that will be reviewing an application; the subjective application of which criteria are applied in a given case; the personal and professional differences that arise between different bureaucrats at the Office of Personnel Management (no, don’t believe in the story that there is an “objective” methodology of applying the law when reviewing each disability retirement application); and multiple other factors, including whether or not your particular disability retirement packet was reviewed by someone at the Office of Personnel Management when he or she had a “bad day”.

To counter all of the multiple factors over which we don’t have any control, one must always take the “long view” — the view that it may take two denials, and end up before a Judge at the Merit Systems Protection Board. At that point, it is important for the Judge to see how well-documented the case has been prepared; that legal arguments have already shown that OPM was unreasonable in its initial decision and its Reconsideration Denial; and how, despite additional attempts at fulfilling OPM’s requests for additional medical documentation, that OPM continued to be unreasonable. By preparing for the “long view”, a disability retirement packet not only has the best chance of getting it approved in the “short run”, but also at the Merit Systems Protection Board.

Sincerely,

Robert R. McGill, Esquire