CSRS & FERS Disability Retirement: OPM’s Rationale

Too much time is often spent on the “rationale” or “reasons” for a denial from the Office of Personnel Management, under the “Discussion” Section of a denial letter.  By “time spent”, however, is not meant that one should not selectively rebut, refute and address some of the reasons delineated in an OPM denial letter; rather, what too many people do is to complicate matters by “reading into” the reasons given for the denial.

One of the jobs of an attorney who specializes in Federal Disability Retirement law under FERS & CSRS is to prepare an application for Federal Disability Retirement benefits, rebut a denial, or file an appeal to the Merit Systems Protection Board, based upon one’s experience, wisdom and sense of that which OPM is looking for.

This is accomplished by having learned from a myriad of sources:  from seeing the types of prepared disability retirement packets which have been successful in the past; from learning from past legal arguments and rebuttal arguments as to which have been most persuasive for OPM; and from having conducted multiple Hearings before the Merit Systems Protection Board and learning exactly what the Administrative Law Judge has been most persuaded and convinced by.

Further, having read countless denial letters by people who have attempted to file for Federal Disability Retirement benefits at the first stage without an attorney, it is important to focus upon the relevant issues which OPM is seeking, and to disregard those issues which are peripheral or irrelevant.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: Denials II

It is, indeed, frustrating when a governmental agency makes life-impacting decisions which seem to be spurious and capricious. A review of a disability retirement application by the Office of Personnel Management is supposed to be thorough, with sound reasoning and a fair application of the law. And, in all fairness, the majority of cases appear to meet that standard. It may well be, of course, that since all approval letters of disability retirement applications are standard templates, with boilerplate language and instructions, and since most of my cases are approved at the first level, the impression left is that OPM does a good job in reviewing the cases.

When a case is disapproved, however, it is often the case that the denial is based upon factors which defy logic, which appear to have little or no rational basis, and which selectively focuses upon a narrow reading of the medical reports and records. Thus, often the OPM Representative will take a statement out of context, and declare that the doctor stated X when a full reading of the medical report shows that the doctor actually stated Y. This is unfortunate, and does not reflect the careful review, analysis, and fair rendering of a decision made by most OPM representatives, but occurs often enough to be of concern. On the bright side, however, is that there is always the ability to take it completely out of the hands of OPM, after a second denial — and allow an administrative judge to review it objectively, at the Merit Systems Protection Board. That is why the MSPB was created and exists — to have a third party, objective body review the decision-making process of the Office of Personnel Management.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability: The Attorney

I often get calls from people who have filed for Federal Disability Retirement benefits, from people who are represented by an Attorney but who, for one reason or another, are not satisfied with the work that the attorney has performed.  It is not, in my opinion, proper for an attorney to criticize or judge the work of another attorney, because each attorney has his or her particular methodology in the practice of law.  The fact that another attorney’s methodology of practicing a specific area of law (in this case, Federal disability retirement law) may differ from mine is not a basis for me to criticize another attorney.  The mere fact that a disability retirement application, prepared and submitted by another attorney, is denied by the Office of Personnel Management, is not a basis for concluding that the application packet was prepared in less than a professional manner.  Indeed, if that were the case, I would be subject to the same type of criticism each time one of my client’s disability retirement application was denied at any given stage of the process.  Further, and more to the point, it is a waste of time to criticize the past; what another attorney did or failed to do is besides the point.  The focus needs to be:  What is necessary to move forward, compile additional supporting documentation, and help get the disability retirement packet approved at the next stage of the process.  As to whether or not an individual should switch attorneys mid-stream, that is not for me to say; as with everything in life, such determinations must be made based upon consideration of all of the facts and circumstances of the case, and the client must do what is in the best interest of his or her future.
Sincerely,
Robert R. McGill, Esquire

I often get calls from people who have filed for Federal Disability Retirement benefits, from people who are represented by an Attorney but who, for one reason or another, are not satisfied with the work that the attorney has performed.  It is not, in my opinion, proper for an attorney to criticize or judge the work of another attorney, because each attorney has his or her particular methodology in the practice of law.  The fact that another attorney’s methodology of practicing a specific area of law (in this case, Federal disability retirement law) may differ from mine is not a basis for me to criticize another attorney.  The mere fact that a disability retirement application, prepared and submitted by another attorney, is denied by the Office of Personnel Management, is not a basis for concluding that the application packet was prepared in less than a professional manner.  Indeed, if that were the case, I would be subject to the same type of criticism each time one of my client’s disability retirement application was denied at any given stage of the process.  Further, and more to the point, it is a waste of time to criticize the past; what another attorney did or failed to do is besides the point.  The focus needs to be:  What is necessary to move forward, compile additional supporting documentation, and help get the disability retirement packet approved at the next stage of the process.  As to whether or not an individual should switch attorneys mid-stream, that is not for me to say; as with everything in life, such determinations must be made based upon consideration of all of the facts and circumstances of the case, and the client must do what is in the best interest of his or her future.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: OPM’s Specific Denial II

It is important to always “define”, “corner”, and “circumscribe” any denial from the Office of Personnel Management.  If you do not, then what happens at the next level is that it becomes a “de novo” process.  Now, one might argue that all disability retirement appeals to the Merit Systems Protection Board are de novo, anyway.  That is true enough — meaning, that all of the evidence is looked at “anew” and without prejudice from any previous finding by the Office of Personnel Management. 

Yet, there is the “legal” definition of de novo, and the practical effect of de novo; often, the Administrative Judge at the MSPB will, at a PreHearing Conference, turn to OPM and say, Listen, OPM, it seems that the only reason why it was initially denied was because of X, Y & Z; the applicant certainly answered X & Y in his/her reconsideration answer; is the only thing you are looking for is Z?  What this does is to narrow the issue.  Often, to save time, face, aggravation and other things, OPM will concede the narrowing of such issues, and this is true if you respond to their administrative queries by defining what they are asking for, then providing it to them, then showing how it has been provided to them, so that they are “cornered”.  Thereafter, if it gets denied and it needs to go to the MSPB, the Hearing can then proceed with a narrower, streamlined and limited number of issues to prove.  Again, the reason why it is important to define what it is that OPM is asking for, is not only for the “present” case, but in preparation for the potential “future” case.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: OPM’s Specific Denial I

On those occasions when an OPM denial specifically (and correctly) identifies and asserts deficiencies in a disability retirement application, it is important to have a targeted response in addressing the denial.  The reason for such a targeted approach is for two primary reasons:  (1)  One should always address the alleged specific basis of OPM’s denial of a Federal disability retirement application, and (2) By specifically addressing and answering OPM’s specific basis for the denial, if the Office of Personnel Management denies the application a second time, and it is therefore appealed to the Merit Systems Protection Board, it is important to view the entire case of OPM as “unreasonable”.

In other words, it is important at the outset to “prejudice” the Administrative Judge as to the unreasonableness of the Office of Personnel Management. And there is absolutely nothing wrong with this — because the “prejudice” which the Judge may perceive is in fact based upon the truth of the matter:  OPM is indeed being unreasonable, and it is important for the Administrative Judge to see such unreasonableness.  It is important to be able to say to the Judge, Your Honor, do you see how we answered the basis of the denial — and yet, even after specifically addressing the basis of the denial, OPM still denied it?  What else can we do?  It is always important to prepare each step of the case not only for the “present” case, but also for the potential “next” case.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: Reconsideration Stage

Alas, a batch of decisions has obviously been sent out to many disability retirement applicants in the last couple of weeks, because I have gotten many calls from those who attempted to try and obtain disability retirement benefits without legal representation.  In reviewing the denial decision from the Office of Personnel Management, many who have called have observed some rather amusing things, such as:  “It seems like most of the decision is just boilerplate language”; “There were so many typos and grammatical errors in the decision”; “The OPM specialist referred to a doctor whom I never treated with”; “The decision said that I suffered from medical condition X, which I never claimed!”   “To err is human…” is a true enough adage; but to point out the mistakes of an OPM decision for the sake of pointing out the mistakes, is a pointless exercise.

Do not fret; yes, much of the language of a decision is indeed boilerplate; OPM representatives are human, and do indeed make mistakes, and insert names of doctors and medical conditions which are not part of an applicant’s narrative; and other mistakes as well.  But don’t overlook the obvious by fuming about such mistakes:  if your disability application was denied, you need to take the decision seriously, identify the substantive issues which were the primary basis for the denial; ignore the tangential errors made; then proceed to address the concerns brought to light by the Office of Personnel Management.  Time is of the essence, and those 30 days to file for reconsideration, and the additional 30 days given to obtain further medical documentation, come and go quickly.  Don’t fume about irrelevant details; focus upon strategizing a substantive approach to getting your disability retirement application reconsidered, and approved.

Sincerely,

Robert R. McGill, Esquire