CSRS & FERS Disability Retirement: OPM May Say So, But… (Part 2)

Then, of course, there are the multiple “other” issues which the Office of Personnel Management “says so”, such as failure to pay the full amount of back-pay due; failure to compute the average of the highest-3 consecutive years correctly; reinstating the full amount of FERS once a person becomes no longer eligible for Social Security Disability benefits; arbitrarily and capriciously deciding that the medical report is not “good enough” in answering a post-disability approved, Medical Questionnaire; failing to compute the earned income in any given year properly, and thereby informing the disability retirement annuitant that he or she earned over the 80% limit of what the former federal employee’s former job currently pays; and a host of other issues.  My specialty is in obtaining disability retirement benefits for my clients; I only selectively get involved in post-disability annuity issues, but the point here is that the Office of Personnel Management has a track-record of being in error, in multiple ways, on multiple issues, in volumes of cases.

It is thus important to recognize that the Office of Personnel Management is not an infallible agency.  Far, far from it, they are merely made up of people who are subject to error, but often stubbornly so — unless you counter their denial in an aggressive, but calm and rational manner.  If a denial comes your way, do not get distressed; prepare your case well, and lay out the groundwork necessary to win.

Sincerely,

Robert R. McGill, Esquire

 

See also: OPM May Say So, But… (Part 1)

OPM Disability Retirement: Long, Longer & Longest View

I have often spoken of the need to take the “long-term” view in filing for Federal Disability Retirement benefits under FERS & CSRS — both in terms of having patience for the inherently long process in terms of time, as well as in terms of preparing a case for not just the First Stage of the process, but further, for the second Reconsideration Stage, as well as for an Appeal to the Merit Systems Protection Board.

This “long-term” view is meant to prepare a potential applicant for what it means to file for Federal Disability Retirement benefits; to not be overly concerned if you are denied at the first, or even the second stage of the process; and to be prepared financially to weather the “long haul”.  In short, it is meant to prepare the potential applicant for the long, and longer, view of filing for Federal Disability Retirement benefits.

It is also necessary, however, to prepare one’s self for the “longest” view — that of maintaining and keeping safe the disability retirement benefits once it is approved — by preparing to be randomly selected every two years or so with a periodic “review” with a Medical Questionnaire.  The Medical Questionnaire is an innocuous looking form, asking for an “update”, and giving you 90 days to respond.

Be cautious.  Be aware.  Take it seriously.

Don’t wait for the 89th day to begin responding to it.  None of my clients who have gotten his or her Federal Disability Retirement benefits has ever lost it; people who have gotten Federal Disability Retirement benefits on their own and have later lost the benefit, have come to me to regain it; I have been successful in recovering the benefit, in every case.  However, it is not always easy — if only because the disability annuitant initially thought that it was an “easy-looking” form.

Preparation for the “longest view” begins not upon receipt of the Medical Questionnaire; it begins at the very, very beginning — when one first decides to file for Federal Disability Retirement benefits.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement and Paradigms for the Future

In attempting to decide to file for Federal Disability Retirement Benefits, it is often the case that Social Security disability benefits must be considered (not just “considered”, obviously, for FERS employees, because it is a requirement to file for it), and how seriously and vigorously; and further, whether to pursue, or to continue on, OWCP temporary total disability benefits.  These are “paradigms” that must be considered for the future.  By “paradigm”, I mean that they represent “models” of how a person wants his or her future to be based upon.

For instance, let’s take the paradigm of Social Security disability benefits.  Because FERS employees who file for Federal Disability Retirement benefits must also file for Social Security disability benefits (to see if they qualify; and, if qualified, the offsetting features will apply), one must take into consideration whether or not a Federal or Postal employee will actually want Social Security disability benefits.  This question arises because Social Security has a “cap” in which a person who receives Social Security disability benefits can make ancillary earned income (roughly no more than $12,000 per year in 2013).

Because of this, one must think of the future paradigm of one’s life:  If a person on FERS disability retirement wants to go out and get a part-time job, or start on a path for another career, where he or she makes 15, 20, 25,000 per year or more (because remember, a person can make up to 80% of what a person’s former Federal or Postal job currently pays), then he or she may not want to get Social Security disability benefits.

Most people who are on Federal disability retirement are simply disabled from performing one or more of the essential elements of the particular job; they are not “totally disabled”, and therefore are able to go out and start a second career.  This is the “paradigm” for the future which must be considered, and such a model for the future must be carefully thought through.  Next:  the OWCP paradigm.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: Pre and Post

Issues revolving around the initial application stage, during the application stage, and after the approval, are often of equal importance.  This is because the approval of a Federal Disability Retirement application under FERS or CSRS will ensure the financial and economic survival and viability of the Federal or Postal employee.  Thus, in the pre-approval stage of the process, it is often good to engage in some future planning:  How hard will I fight for Social Security Disability?  Will I be getting a part-time job to supplement my income?  Where will I live?  During the process of obtaining disability retirement, there is the long wait, and the ability to remain financially afloat while receiving little or no financial support.  Post-approval, there are issues of the potential for receiving a Medical Questionnaire from the Office of Personnel Management.  Whether the current doctor will continue to be supportive, or will I move and need to find another doctor?  Because getting Federal disability retirement benefits is a life-long process, it is important to get sound legal advice from a competent attorney throughout the process — pre, during, and post process.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: The Frustration of Dealing with OPM

The Office of Personnel Management is a large bureaucracy which handles thousands of cases, including disability retirement applications.  Lately, more and more frustrating post-approval issues are appearing, including: sudden interim payments without any prior notice of approval of a claim (not a bad thing to happen, certainly, in comparison to a denial); non-receipt of a letter from OPM, whether approving it or denying it; no communication from OPM after an approval, for months on end; and other problems ad infinitum, ad nauseum.

Unfortunately, once a disability retirement application has been approved, there is very little that an attorney can do, anymore than the client can do. Persistence is the key; courtesy is the keyhole; finding the right, competent person at the Office of Personnel Management, and being courteous and persistent, often opens the door. Remember that there is a wide chasm of qualitative difference between “rudeness” and “persistence”; the former will never get you anywhere; the latter can be accomplished with courtesy, and get you very far.

When contacting someone at the Office of Personnel Management, keep three (3) things in mind: (1) Be courteous (2) get the name and telephone number of the individual you are speaking with, and (3) try to obtain a specific date on which you will call that person back, and be clear as to what action it is that you want taken, and why. Persistence, courtesy, and further persistence.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: Other Stories of Success

There are obviously many, many pitfalls in the attempt to obtain disability retirement benefits from the Office of Personnel Management. Sometimes, I get calls from individuals who tell me that they “heard from a friend” that another employee prepared the disability retirement packet him/herself, and got it through within ___ months (you can fill in the blank with an unbelievably low number — say, 1, 2 or 3), and that there was no need for an attorney, and so why should anyone need an attorney?

I really have no response for such an inquiry; I am always suspicious of such “too good to be true” stories, but on the other hand, inasmuch as I don’t have any facts to refute or otherwise disbelieve such stories, I cannot comment on them.  I can only convey facts, circumstances, and experiences which I have with my own clients (don’t worry — all information received from and on behalf of my clients is protected by attorney-client confidentiality, and I never — ever — divulge personal information; I relate such experiences only in a generic sense, with no names ever mentioned), and indeed, each case is different and unique, and I try and treat each case based upon the specific facts, circumstances, and individual complexities inherent in each.

I really cannot comment on “that other story” that is heard through a chain of mouths and ears, only to be transformed into an unidentifiable success story.

People who come to me and ask for my legal guidance and expertise know that, to the extent I am able, I will answer each question based upon my professional experience; that I try to give a realistic assessment of each case, without embellishment; and my clients remain my clients for life.  Indeed, I get calls almost every week from people who I represented many, many years ago.  If a Medical Questionnaire is received, I am here to guide the recipient so that he/she will be able to retain the disability retirement benefits we fought so hard to obtain.  I have no idea about those “other success stories”; my goal is to satisfy the legal needs of my clients — those who have entrusted their cases in me, and for whom I have a special care and trust for.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Future Perspectives

People often act without forecasting prospective issues. In filing for disability retirement, it is important to take into account the emphasis and basis upon which one files for Federal Disability Retirement, because when an approval is given by the Office of Personnel Management, OPM identifies the specific medical disability upon which they granted the approval.

As such, it is important for the applicant to base the application upon the medical condition/disability, in the sequence of importance, the most serious to the least serious.

This is important not only for purposes of winning disability retirement cases, but further, with a view to the future:  when the random Medical Questionnaire is sent to a disability retirement annuitant, if the medical condition upon which you were approved for was a minor, “least serious” medical condition, then 5 years or 10 years down the road, it may well have “resolved”, which puts you in danger of losing your disability retirement benefits.

This is why it is important to have a view to the future, and guidance and advice from an attorney is important in securing that future investment.  For, ultimately, obtaining disability retirement benefits which could potentially be the primary source of income for the next decade or two, is an investment for the future.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Which Disabilities To List

When I look at a potential disability retirement case, I find it helpful to look at the case not only prospectively, but retrospectively. While not a “rule” cast in stone, when the Office of Personnel Management approves a disability retirement case, it will normally attach a page which identifies which disability — normally one, often two, sometimes three — was/were the basis for the approval.  Thus, it is important when preparing a disability retirement packet and application, to identify which medical disabilities will be listed and depended upon; and further, once is it approved, it is helpful to look to the future, for there is a random chance that every 2 years or so, you will be selected to answer a Medical Questionnaire to determine if you are still disabled.

Thus, if you list a minor medical condition, and you get approved for that minor medical condition, if you recover from that condition, you can potentially lose your disability retirement benefits in the future. (Note:  for those of you who are my clients, please do not worry; no client of mine who has received a Medical Questionnaire has ever lost his/her disability annuity).   Thus, it is important to identify those medical conditions which are the “most serious”, and base your medical disability retirement packet upon the most serious, long-term disability first –before listing secondary or additional medical disabilities.  This is not to say that you should not list more than one medical disability; indeed, in preparing my packets for my clients, I will often list more than one, but I do it in sequential fashion, and when I put together my legal memorandum in arguing my case on behalf of my client, I constantly refer back to the central medical disability.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: OPM’s Methodology (Part II of II)

When the Office of Personnel Management approves an OPM Disability Retirement application, as I stated in the previous article (OPM’s Methodology), they will normally choose to approve it based upon only one of the listed disabilities. This is because, from OPM’s viewpoint, if the applicant lists multiple medical disabilities, once OPM reaches any one of the listed disabilities and finds that one of them is a basis for an approval, there is no further need for OPM to review the remaining medical conditions.

This methodology requires that future applicants consider the consequences of such a method: it is essential that the applicant base a disability retirement application upon only essential, significant medical conditions, normally best to list them in the order of significance, and further, to document a case in the order of severity.

While I have not heard of a disability retirement application being approved based upon a non-essential, minor medical condition, it is wise not to rely upon the off-chance that OPM might base an approval upon a medical condition that is somewhat “thrown in” as an afterthought, into the applicant’s statement of disability. In other words, it is not a good idea to “throw in the kitchen sink” at the last moment, thinking that by multiplying the quantity of medical conditions listed, that OPM will see how “serious” one’s medical condition is.

Remember, it is not the totality of many medical conditions that is important; rather, it is the list, however small, of those medical conditions that prevent one from performing one or more of the essential elements of one’s job.

Sincerely,
Robert R. McGill, Esquire

Federal Disability Retirement: OPM’s Methodology (Part I of II)

When the Office of Personnel Management (OPM) approves a Federal Disability Retirement application, a separate page from the approval letter will often be attached, which states the medical basis upon which the disability retirement application was approved.  The separate page will often state something to the effect of: “You submitted an application for disability retirement based upon medical conditions, A, B, C & D; however, your application was approved for medical condition B only.”

The concern here, of course, is that if you are later selected to answer an OPM Medical Questionnaire asking you to re-establish your medical disability for continuation of your disability annuity some years later, that you make certain that you answer such a Medical Questionnaire based upon that very medical condition upon which you were approved.  This is obviously important.

Some have questioned whether or not you can appeal the approval letter based upon the fact that you believe OPM should have approved you based upon a different medical condition.  In my view, this is not an appealable issue, and if you question OPM as to whether they should have considered you disabled based upon another medical condition, you may be in greater danger by OPM reversing themselves based upon a re-review of your case.

It is best to leave “well enough alone”.  Accept the approval letter based upon the identified medical condition, and inform your treating doctor that you may need his input in the future — to address that very medical condition for which you were approved.

Sincerely,

Robert R. McGill, Esquire