FERS & CSRS Disability Retirement for Federal and USPS Workers: New Faces

Old timers will often smirk cynically and observe:  Time will cure them of such a naive perspective.  Or, to paraphrase a famous line from a well-know Christmas movie, Youth is wasted on the young (hint:  the scene were Jimmy Stewart is throwing a rock at the old abandoned house).  Youth and inexperience are often accompanied by enthusiasm and a fresh perspective. Lack of knowledge is compensated — some would say “overcompensated” — by an eagerness which sees no boundaries or obstacles.

There are clearly some new hires at the U.S. Office of Personnel Management as of this date, and their unique approach in viewing and evaluating a Federal Disability Retirement application, whether under FERS or CSRS, must be contended with.

The fundamental problem with newcomers is not that they don’t know what they are doing; rather, it is often the converse — they think they do know what they are doing, and when girded by a list of criteria which is applied in an inflexible fashion, one often gets blinded by the confusion of the forest while having a myopic view of an individual tree.  The great equalizer in countering lack of knowledge, fortunately, is the law itself; and while a list of applicable criteria provided to a fresh face may well assist the OPM employee to evaluate a claim, it can never replace the necessity of knowing the law.

For anyone filing a Federal Disability Retirement application with the U.S. Office of Personnel Management, now constitutes the time to employ all of the tools which the compendium of cases decided, and statutes reinforced, accord in arguing one’s case.  Time will certainly tell, but for the present, it is advisable to dot all I’s and cross each T, carefully and with great scrutiny.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Government Employees: Logical Fallacies

The problem with logical fallacies is that the people who make them rarely recognize such errancy (otherwise they wouldn’t repeatedly make them), and further, are often the same people who refuse to recognize them even if it is kindly pointed out.

For example:  In a Federal Disability Retirement case, when the doctor’s report clearly and unequivocally points out that the Federal employee’s medical condition is “permanent”, one would logically infer from such a statement that the condition therefore will last a minimum of 12 months (the legal requirement in a FERS or CSRS Federal Disability Retirement case), and therefore would satisfy the legal requirement concerning that particular issue.

However, the U.S. Office of Personnel Management will often fail to make such an inference, and claim that the legal requirement that one’s medical condition must “last a minimum of 12 months” has not been satisfied.

Now, one essentially has three (3) choices in responding to OPM’s claim at the Reconsideration Stage of the process (or, if made a second time with a denial at the Reconsideration Stage, then to the Administrative Judge at the MSPB):  (1)  Ignore the logical fallacy, (2) Argue that OPM has made the logical fallacy and failed to make the correct inference, or (3) Have the issue restated in any updated medical documentation.

Of the 3, the last is probably the preferable, if only because one should expect that any failure to recognize such an obvious inference will likely reoccur again within the same organization (the U.S. Office of Personnel Management), and therefore clarity of statement (or restatement) would be the most effective course of action.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for US Government Employees: Insufficiency Test

The validity of allegation that there is an insufficiency of X is partly determined by an objective standard, and partly (if not mostly) derived from a judgment as to the nexus between X and the standard to be applied.

In Federal Disability Retirement cases the basis of most Federal Disability Retirement denials is that there is an insufficiency of proof, whether as to issues of light duty or accommodation, medical opinion, medical documentation; questions about deficiency of service; and multiple other specified areas — but all will ultimately be determined to have a “lack” of something such that it fails to meet a “sufficiency” test.  But sufficiency can only be determined by comparing what exists (i.e., what has been previously submitted to the Office of Personnel Management) to what the legal standard of proof requires.

Further, since the overriding legal standard is based upon a “preponderance of the evidence”, which requires that something be ‘more likely than not’, the narrow gap between human involvement in the judgement of sufficiency, and a truly objective basis for such insufficiency, is susceptible to human error.  Because of this, appearance of quantity in addition to quality is often what is required.

As decisions by OPM are rendered by a wide range of people whose judgment, competence and approach in evaluating a case differ greatly, it is unfortunately necessary to take into consideration the foibles of human error.  Until a precise algorithm is invented which applies fairly and accurately in all cases across the board, we must continue to deal with human beings, the their errors of judgment.

Sincerely,

Robert R. McGill
FERS Disability Lawyer

 

Medical Retirement for Federal Workers: Understanding a Differing Perspective

Sometimes, all that one can do is scratch one’s head.  That common statement — to “scratch one’s head” — is meant to convey puzzlement or disbelief over an action, statement, or occurrence which belies rational explanation.  As rationality has been the foundation of thoughtfulness and considered formulations of explainable actions, so logic and reason have been the joists which provide the bridging support for acceptable discourse.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, one assumes that there will be a fair and reasoned review of each Federal Disability Retirement application.

If a Federal Disability Retirement application is approved, then of course the level of rational discourse need not be extensive — for, implicit in the approval itself is an acknowledgement that the legal nexus between the medical conditions described and the statutory criteria required to be met, have been adequately constructed.  But in a denial, one would expect a well-reasoned discourse of “why”, as opposed to a standard template of identifying various documents submitted, and multiple declarative statements (with barely a rational explanation) of, “You do not meet criteria No. X”.

Often, it is a waste of time to try and understand the perspective of OPM.  The Office of Personnel Management is an agency which is busy and overwhelmed with a volume of cases.  Time constraints often betray the proper application of the law.  It is well that the old saying did not refer to scratching one’s back; for, there are many places where one simply cannot reach in order to scratch, and that is the sense one is left with in reading some of OPM’s denials.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Government Employees: Language and Reality

In most circumstances of life, the chasm and divide between language and the reality which such language is meant to reflect, is wide and irreconcilable.  The problem is often that language over-states and overpowers reality.

When it comes to a medical condition, however, it is often the case that the opposite is true:  language is inadequate to effectively, properly, or sufficiently describe the severity, pain, extent and scope of the medical condition being suffered.  Language is meant as a tool; a conveyance in order to communicate an X as reflected in the world of Y.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, it is important to close the expansive divide between the reality of one’s medical conditions and the words, ideas and concepts which are utilize in an attempt to communicate the experiential phenomena which one is undergoing.  Suffering; mental lapses; suicidal ideations; lethargy; chronic and diffuse pain; panic attacks; such conceptual paradigms must be sufficiently conveyed by the elasticity of language.

While sympathy and empathy are not required components to evoke in an Applicant’s Statement of Disability, it is a goal to strive for.  Yes, there is the legal criteria to attempt to meet in a Federal Disability Retirement application, and the objective assessment and evaluation of a Federal Disability Retirement application does not require that the Case Worker at OPM have any feelings of sympathy or empathy — but it often helps if the narrative form contains some emotive content of such evocation.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for US Government Employees: Meeting the Statutory Minimum

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, the Federal or Postal employee must prove, by a preponderance of the evidence (that burden of proof which is fairly minimal in the order of difficulty, requiring that a Federal or Postal employee show that he or she is “more likely than not” entitled to Federal Disability Retirement benefits under FERS or CSRS) that the compilation of the evidence meets the statutory requirements such that one is eligible and entitled to Federal Disability Retirement benefits.  

Thus, it is the cumulative set of evidence which is reviewed by the Office of Personnel Management, and not merely a single piece of evidence.  Yet, the manner and methodology of how OPM reviews the evidence is revealed in any given denial letter issued by the claims representative, or the “Legal and Administrative Specialist” assigned to any particular case.  

It is a methodology of (A)  listing whatever medical evidence which was submitted by naming the doctors, thereby giving an appearance of a full and thorough review of the documents, and (B) selectively extrapolating statements made by the Applicant, the Supervisor, the doctor(s) and anyone else in attempting to undermine the conclusion that the statutory criteria for eligibility has been met.  In laymen’s terms, this is called, “Taking potshots” at something.  If meeting the criteria for eligibility is to show a sequence of connecting dots from point A to point B, then OPM’s view is that if there are enough potshots which sever the line between the points, then OPM has shown that a Federal or Postal employee is ineligible for Federal Disability Retirement benefits.  

This is the approach; it is up to the applicant who is preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS to ensure that any weak links in the line are sufficiently reinforced.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Workers: The Second Denial

The Second Denial — a denial from the Office of Personnel Management of a Federal Disability Retirement application under FERS or CSRS — often fails to annotate or delineate an extensive basis for the denial, but simply reiterates that they believe the original decision was correct based upon a re-review of the application.  

It means nothing more than that another Claims Representative in a separate “branch” of the same Agency decided to support the original Claims Representative in denying the application.  No greater validity is obtained merely because two different people looked at the application, as well as any additional medical or other supporting documentation, and came to the same conclusion.  Two people can be wrong about the same issue, and indeed, OPM is normally wrong about issues concerning Federal Disability Retirement applications, precisely because many OPM Representatives (if not most) do not keep up with the Court opinions and evolving case laws rendered by the Merit Systems Protection Board and the Federal Circuit Court of Appeals cases.  Moreover, most Claims Representatives at OPM support their fellow Claims Representative.  

A disabled Federal employee or an injured Postal worker should not become discouraged merely because a Second Denial has been issued.  Being wrong twice does not translate into a right decision.  This is not mathematics, where two negatives result in a positive conclusion.  It is merely the next “step” in the process of obtaining a Federal Disability Retirement approval under either FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: The Denial Letter

During this Holiday Season when Federal and Postal employees who have filed for Federal Disability Retirement benefits under FERS or CSRS, who are anxiously awaiting the decision from the Office of Personnel Management, a denial letter from OPM can appear disproportionately devastating.  Christmas and the New Year tend to bring difficulties precisely because it is seen as a season of celebration, when families get together, where work continues, but an expectation of being “joyous” pervades.  At such a time, a denial of a Federal Disability Retirement application from the Office of Personnel Management can be a seeming conclusion to a long wait.  It is not.  

Do not become discouraged just because someone at OPM has “decided” that your Federal Disability Retirement application did not “meet” the legal criteria.  Set the denial letter aside for a day or two (so long as it is not nearing the 30-day period to either file for Reconsideration or an appeal).  Then, proceed to fight it.  

Don’t let the Holiday Season become confused with the right to file for, be eligible for, and be entitled to Federal Disability Retirement benefits under FERS or CSRS.  The filing of an application for Federal Disability Retirement benefits is a process which may take 6 – 8 months, or longer if it is needed to go to the Reconsideration Stage, or to the Merit Systems Protection Board.  

Do not get discouraged; instead, fight for your benefits.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Government Employees: Initial Application, Reconsideration & MSPB Appeals

Each Stage of the process in attempting to obtain a Federal Disability Retirement application under FERS or CSRS offers a distinct, yet similar, challenge.  Do not be fooled by responding to a “template” approach; while the Office of Personnel Management may respond in an indifferent, antiseptic manner, a Federal or Postal employee who must respond to OPM’s denial at each stage of the process must pinpoint what OPM is looking for, and respond appropriately.  Indeed, it is the distinction which one observes, which makes all of the difference in the case.  

Often, it is clear that OPM’s denial at the Initial Stage of the process, as well as a denial at the Reconsideration Stage of the process (which then compels an appeal to the Merit Systems Protection Board), is merely a regurgitation of thousands of previous denial letters, with some minor insertions which are meant to appear “as if” the denial letter has been tailored to a particular case.  

Thus, references to a particular physician’s letter, and even extrapolating a quotation from a doctor’s note or narrative (often something like, “Your doctor stated that you were recovering well from your surgery,” or “Your psychiatrist stated that the medications were working”) have the effect of personalizing a denial letter.  Yet, the remainder of the denial letter is in an antiseptic, template form, and it is clear that you are merely one of hundreds & thousands of responses written by OPM’s representative.  However, while OPM has the power to generate such template-driven denials, the individual Federal or Postal Worker must respond in an independent, individualistic manner.  It must be based upon one’s particular case, and thus the response must not be a “generic” one, but one based upon the uniqueness of the case.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: Sometimes, It’s “The Law”

An assumption is often made that the “Disability Specialist” at the Office of Personnel Management who reviews the Federal or Postal Disability Retirement application understands, comprehends, and applies the laws governing Federal Disability Retirement applications.

Now, such an assumption may be logical and reasonable, to the extent that one thinks (A) that those who aspire to working in a specific specialty have some knowledge or understanding of the specialty, and (B) if a decision is made which involves discussing “the law”, one presumes that the mere discussion of it proves some knowledge of it.

The problem with such reasoning, however (apart from the popular tripartite acronym which originates from the word “********-u-me”), is that it betrays the facts:  often, from reviewing the denial letters generated from the Office of Personnel Management, it is painfully clear that the administrative specialist, the legal specialist, or whatever other “specialist” designation has been embraced by the worker at the Office of Personnel Management, simply fails to apply all of the applicable laws which govern Federal Disability Retirement applications.

This is understandable, to this extent:  OPM representatives (other than those representing OPM at the MSPB level) are not lawyers, and as such, do not keep up with the latest evolution of the laws governing Federal Disability Retirement issues.  Whether that is a good thing or a bad thing, is another matter altogether.

Sincerely,

Robert R. McGill, Esquire