CSRS & FERS Medical Disability Retirement: A Fair Hearing

It is a common complaint against the Office of Personnel Management that the particular Claims Representative who reviewed the file and issued a denial in a Federal Disability Retirement application failed to look at, or review, the medical evidence; that the denial letter was merely a restatement or regurgitation of a template referring to a 7-part criteria, and makes statements which could easily have been “cut and paste” from a thousand other such denials.  

Indeed, there have been times when references to a denial were clearly (and mistakenly) extracted from another file, where the names of doctors and medical documents are referred to which have no relation to the particular individual, and are clearly mixed in from another case.  

To be fair, a counter-argument to such criticism is that there is no bureaucracy, with so many cases to review and properly evaluate, and with so few personnel and staff to undertake the massive workload, that could or should “reinvent the wheel” each time a case is set to be reviewed.  Obviously, certain language that is applicable in all (or most) cases will be re-stated, and templates used where such have been standard language used in the past.  Applicable language and statements which merely reiterate the legal and statutory criteria; introductory remarks; conclusory statements — they are all part of a paradigm and template which any administrative bureaucracy may apply.  

But the criticism goes much deeper than that:  It is often the case that, clearly, the Claims Representative who wrote the denial did not even read his or her own denial.  Proofreading is an essential part of reviewing, writing, and issuing a decision.  OPM must ultimately realize that each decision is an important, crucial, and often critical point of importance in the life of the applicant.  It is a Federal or Postal worker who has previously dedicated many years of his or her life to a career with the Federal Sector, and the applicant for Federal Disability Retirement benefits deserves a fair hearing.  A fair hearing is defined by a careful evaluation of the particular case.  That is not too much to ask for.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Applicant Tendency

An applicant or potential applicant for Federal Disability Retirement benefits under FERS or CSRS exhibits tendencies which can range on a wide spectrum of behavior, thoughts, fears, actions and reactions.  Some individuals believe that his or her application is so self-evident and self-explanatory, that all that is necessary is to obtain the medical records, list the diagnosed medical conditions on the Applicant’s Statement of Disability, file it, and…  When the Denial letter appears from the Office of Personnel Management, there is the surprise and shock, and the:  “I thought that…” 

Then, there is the other extreme of the spectrum, where there is an almost irrational fear that unless every ache and pain is detailed in long, explanatory narratives, and pages of pages of “personal experience” diary-like formatted chronologies are submitted with the packet, with tabulated references to justify each and every medical experience from two decades before until the present, that the Office of Personnel Management will deny the application.  Remember this:  It takes just as short a time to deny the first type of application as it does the second.  The Office of Personnel Management does not read through any materials which it deems “superfluous“.  Somewhere in the middle between the two extremes is normally the correct balance.  Or, as Aristotle would say, it is important to achieve the mean between the two extremes.

Sincerely,

Robert R. McGill, Esquire