Medical Retirement Benefits for US Government Employees: Different Denials

After having formulated, prepared and filed a Federal Disability Retirement application under FERS or CSRS, the period of long waiting ensues with the review process of the Office of Personnel Management (having survived the waiting process through the Agency).  

At this initial stage of the application, the Federal or Postal applicant will be forced to wait (anxiously) for a decision by OPM.  Thus, when the Office of Personnel Management makes a decision at the First Stage, and that decision is a “denial” of the Federal Disability Retirement application, there is a spectrum of possible responses — immediate, emotional, angry, frustrated, etc.  

Instead, however, the proper response is to recognize that this initial denial is merely part of a greater process which involves many steps, procedures, responses and replies.  Indeed, part of the reason why a Federal or Postal employee feels the pressure and anxieties is because one tends to view the application process as a “one-time” deal — where submission of an application should be reviewed by OPM and an approval is granted.  This can be true — but should be viewed as merely an anomaly, and not the standard.  

While having a Federal Disability Attorney prepare the application for Disability Retirement should increase the chances of an approval at any level of the process, it is nevertheless first and foremost a process involving multiple steps and stages, with potential pitfalls and denials throughout.  Thus, a Federal Disability Retirement application may be initially denied, then responded to, then denied a second time at the Reconsideration Stage of the process, and require a further response.  

Different denials require different responses, not because they are not all part of the same process (I know, the double negative gives one pause), but because each denial is given by different departments and personnel at the Office of Personnel Management. Remember, one must prove one’s eligibility for Federal Disability Retirement benefits from the Office of Personnel Management, and proof means that there is the potential for an adversarial component of the process.

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: Reconsiderations

When a Federal Disability Retirement application under FERS or CSRS is denied at the first stage of the process, a Federal or Postal worker who filed for the benefit has the administrative right to request that it be “reconsidered” by the Office of Personnel Management.  Once requested, the case file is turned over to the “Disability Reconsideration Branch” of the office, and will be reviewed and evaluated by a Disability Specialist — not the same person who reviewed it at the Initial Stage of the process. 

A person who has filed for Federal Disability Retirement benefits has thirty (30) days to Request Reconsideration.  While the 30-day period may arguably have some flexibility based upon when the applicant actually received the denial letter, it is nevertheless a good policy to adhere to the 30-day time-frame by counting the date of the denial letter as the “beginning” date.  Obviously, it is better NOT to be placed in a position of having to argue whether or not the applicant met the 30-day deadline.  Further, it is best to send it in via a means where confirmation of receipt can be shown.  OPM is a large bureaucracy, and things get lost in the morass of the volume of submissions.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for Federal & Postal Employees: Listing the Medical Conditions (Continued…)

If an individual who has filed for Federal Disability Retirement benefits under FERS or CSRS later finds, during the process of waiting for a decision or, between the time of an initial denial and during the Reconsideration Stage or an appeal to the Merit Systems Protection Board — that a previously unlisted medical condition has worsened, can he “add” that medical condition to his Federal Disability Retirement Application?  Can he file an “amended” SF 3112A, Applicant’s Statement of Disability?  The general answer is, “No”. 

However, one can certainly submit a medical report concerning such “previously-unlisted” medical condition if one can reasonably argue that the previously-unlisted medical condition was in fact listed, right there for everyone (i.e., the Office of Personnel Management) to see.  This issue comes up often enough to be of concern, especially because of the valuable time lost in being forced to “withdraw” an application for OPM Disability Retirement and to start all over again in order to add a “new” medical condition.  To safeguard against such a potential event, it is wise to read through the multiple medical conditions when putting together an OPM Disability Retirement packet, and decide which primary diagnoses to include, and at the same time, to “weave” into the narrative of the description of medical conditions, symptoms and areas of pain which can be reasonably interpreted to encapsulate potentially underlying medical diagnoses which may later become prominent and require greater focal emphasis.

Sincerely,

Robert R. McGill, Esquire