OPM Disability Retirement: Differing Perspectives

The old adage, “Walk in your fellow man’s shoes for a mile” is a saying which is meant essentially to teach a child (and many adults) to have a different perspective than one’s own, self-centered universe.  In practicing law, it is a good idea to attempt to obtain a perspective from the multitude of differing “shoes” — and this is especially important in putting together a Federal Disability Retirement application under FERS or CSRS. 

The gathering of such differing and different perspectives — that of the treating doctor; that of the applicant; that of the Agency (the Supervisor and the Agency in its determination that accommodation or reassignment is not available or appropriate for a given employee, given the particular medical conditions and the type of positional duties of the specific job which the Applicant must perform, as well as taking into account what constitutes “efficiency” in the Federal Service, etc.); and further, that of the Office of Personnel Management. 

It is the job of the Attorney representing a Federal or Postal employee in preparing a Federal Disability Retirement packet under FERS or CSRS, to pull together the various perspectives; write up and prepare, and gather the information from the multiple and differing perspectives; to neutralize those perspectives which may impact negatively upon the Federal disability retirement application; then to present the fullness of the different perspectives such that it meets the legal criteria and “perspective” of the Representative from the Office of Personnel Management:  that “ultimate” perspective which determines a “yes” or “no” in determining the viability of a Federal Disability Retirement Application.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability: The Federal and Postal Worker

As with most attorneys, I try to maintain an appearance of detached professionalism. It is my job to provide sound legal advice; to guide the client/disability retirement applicant with logical argumentation, rational perspective, and legal foundations as to the strength or weakness of a case, and to guide my client over obstacles, around legal landmines, and through the briars and thickets of “the law”. I try to remain aloof from the inherent emotionalism which arises from the human story of my clients, because not to do so would be to defeat the essence of why a client hires me: to maintain and retain an objective perspective, in order to provide the best legal advice possible. However, to maintain that wall of professionalism is not always possible.

The human story of the Federal and Postal employee is indeed one of encompassing a juggernaut of loyalty, professionalism, dedication, hard work, and the driving force behind and undergirding the economic might of the United States. Yes, of course the United States is built upon the economic principles of the free market system of the private sector; but the services which the government provides are not accomplished by some faceless or nameless entity; each such service — from the letter carrier through “rain, sleet or snow”, to the Special Agents who investigate and put criminals behind bars; from the border patrol agents who guard our security, to the IT Specialist who safeguards our internet viability — is provided by a competent and dedicated worker. That is why I am often humbled by my clients; because, truth be known, the disability retirement applicants who come to me have come to a point with his or her medical condition, where there is no other choice. It is never a question of dedication or hard work; the Federal and Postal Worker has already proven his or her dedication and hard work through the decades of service provided, prior to coming to me.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability: An Art Form (Part I of II)

As with all effective submissions — pleadings, motions, legal memorandums and, alas, Federal Disability Retirement applications — it should never be approached in a mechanical, one-to-one ratio-like, mathematical manner.  Of course it should contain the technical terms, the medical terms, and the legal arguments.

However, disability retirement under FERS & CSRS — especially the Applicant’s Statement of disability and any legal arguments — should not be matter of matching up a one-to-one correspondence between the medical condition and the particular essential elements which it prevents or impacts.

Certainly, the effect and the conclusion should contain that conceptual correspondence; however, as all good writing contains a technical side, it is also important to weave the story of the human condition and see the writing as an “art” form.

The impact of the human story is important in convincing and persuading the OPM representative to not only understand the medical condition, but to get a sense of empathy for what the applicant is going through.  It is a delicate balance to achieve; yes, the hard legal arguments should be made in order to “force” OPM to see that, legally, they are obligated to approve a disability retirement application; at the same time, if you can touch the empathetic nature of the OPM representative, so much the better.

Sincerely,

Robert R. McGill, Esquire

 

See also: ”An Art Form (Part II)

OPM Disability Retirement: OWCP & Federal Disability Retirement

I often tell my clients that OWCP/DOL is not a retirement system. It is a system which was meant to address the medical injury resulting from a work-place accident or occupational hazard resulting in a medical issue arising, such that compensation is allowed for a period of time during a process of recuperation.

As unfortunate as it is, Worker’s Comp has become synonymous with “harassment” and “difficult”, where approval for wage compensation, for medical treatment (including necessary surgery) has meant months and months — and often years — of wrangling and fighting; of having an OWCP case manager or adjuster being rude, failing to respond, failing to return telephone calls, and just when it seems as if something may be done, the OWCP caseworker is switched to someone else who is equally unresponsive.

Then of course there is the intrusiveness — of the OWCP nurse who sits in with you and your doctor, in a context where it is as if the “enemy” is watching that relationship which is supposed to be sacred and private:  a conversation between a doctor and the patient.  It is, as I have often told clients, “a hard road to travel.”

Yet, where the medical condition, injury or disability arises as a result of a work-place accident, obviously it is financially beneficial because it pays more.  That is the bottom line.  Further, it is tax-free.  But it is not a retirement system.

Disability retirement pays less; it matters not whether the injury or medical condition occurred “on the job”; you are not required to be examined by a “second opinion doctor”; you do not have to obtain prior approval from a case manager to go and seek medical treatment.  But the benefits are much lower; it is taxable.  However, is it disability retirement.

In such a retirement, you are meant to go out and to do other things in life, including other work.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: Confusion About the 1-Year Rule

I am receiving too many questions about certain issues, which leads me to believe that a clarification is again in order.

First, concerning the Statute of Limitations on filing for Federal disability retirement benefits.  A Federal or Postal Employee must file for federal disability retirement benefits within one (1) year of being separated from Federal Service.  Thus, if you have been on LWOP, or on OWCP, or on sick leave, but you are still receiving “zero-balance” paychecks which show that you have NOT been separated from service yet, then your 1-year statute of limitations has not yet even begun.  The 1-year Statute of Limitations begins from the effective date of your separation from Federal Service. Your SF 50 (or, for Postal employees, PS Form 50) would reflect that date of separation.

Second, some of the questions which have been posed to me suggest that there is a misunderstanding as to the substantive requirements of the law, as well.  A Federal or Postal worker does NOT have to have been medically unable to perform one’s job for a full year before filing for disability retirement.  Rather, the requirement is prospective — that your medical condition must last for at least 1 year.  Thus, normally after a few months of treating with your doctor, your doctor should be able to make a reasonable medical determination that your medical condition is going to last for at least a year, and more often than not, for much longer.

The distinction which I am attempting to clarify can make a tremendous difference: Federal and Postal workers filing for federal disability retirement do not have to wait a year after learning of his or her medical condition — that would be foolish, especially because the process of obtaining disability retirement can itself often take 6 – 8, sometimes 10 – 12 months.  Rather, a Federal or Postal worker can file soon after learning about a medical condition, so long as the treating doctor can provide a reasonable medical opinion that the condition will last for a minimum of 1 year.

I hope that this will help clarify any confusion people may have about the “1-year” rule — both as it applies to the ability to file for federal disability retirement benefits, as well as to the issue of how long the medical condition must last.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Federal Disability Retirement: Psychiatric Disabilities

I am often asked, on an initial interview/consultation of a potential client, whether or not psychiatric medical disabilities (Major Depression, Generalized Anxiety Disorder, PTSD, panic attacks, Bi-polar disorder, etc.) are “more difficult” to prove than physical disabilities. This question is similar, of course, to the question often asked of certain other kinds of disabilities, like Fibromyalgia, chronic fatigue syndrome, Irritable Bowel Syndrome, and other similar (often designated as “auto-immune” disabilities) medical conditions.

In my experience, there is no single generic answer to the question of whether or not a particular medical disability is “more difficult” to prove than another. In my experience, I have gotten approved an application for Major Depression based upon a single-page note from a Psychiatrist; on the converse/inverse experience, I have had cases rejected at the First Stage of the process (but, fortunately, had the same cases approved at the Second, Reconsideration Stage) showing chronic, failed-back syndrome cases where prior surgical discectomies, multiple diagnostic MRIs showing incontrovertible basis for severe and radiating pain, and multiple specialists verifying the client’s clear and irrefutable inability to perform the essential elements of his/her job. In preparing a Federal disability retirement retirement application, my many years of experience has taught me a number of elementary & foundational lessons: First, a clear and concise presentation of providing a direct nexus between the particular medical condition and the type of job that the Federal/Postal employeee performs, is very important; Second, it is very rarely the volume of records which is convincing; rather, it is the quality of the medical report which is paramount; and Third, it often depends upon which OPM Disability Specialist it is assigned to, which sometimes “makes the difference” between approval and denial.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The “No Other Choice” Case

Then, of course, there are cases where an individual has “no other choice” than to file for disability retirement. Sometimes, it is a chance that is taken — the chance of paying an attorney. Yes, adverse removal actions can impact one’s chances of obtaining disability retirement benefits. A case study: A recent client was removed from a Federal Agency for criminal conduct (obviously, no names will be used, and the facts will be somewhat altered to protect the client’s confidentiality of information). The individual was nowhere near retirement age; but suffice it to say that he/she had been a loyal employee for 20 years. He/she had a medical condition — a psychiatric condition, which pre-dated the criminal conduct. He/she hired me to obtain disability retirement.

What choice did the person have? He/she really had “no other choice” other than to walk away with nothing, or take the chance of paying an attorney (in this case, me). I was blunt about the entire affair: Normally, I am able to get most of my clients approved at the first or second stage of the process, and I will normally ascribe a “success-rate” to a case; in this instance, the probable rate of success, in my opinion, was lower than my normal prediction. Nevertheless, he/she wanted to go forward with it. I contacted the doctors and guided them into writing a forthright medical report; today, the client is receiving his/her disability retirement annuity. Did the person “deserve it” despite the criminal conduct? Absolutely! His/her medical condition pre-dated the criminal conduct, and in fact was a major factor in the actuation of the criminal conduct itself. I am happy for the client, and from a professional standpoint, it is always satisfying to win a case where a client entrusted a case in which he/she had “no other choice” — but once the choice was made, to have made the right choice.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirements: The Office of Personnel Management

I once heard a pastor make a rather unremarkable statement, but profound nevertheless in its simplicity and truth: “Where there are people, there are problems.” To assume that an Agency will make a proper, objective and legally sufficient decision all the time, most of the time, or even more often than not, is probably asking too much. The Office of Personnel Management, as with any Agency, is an entity — a large bureaucracy — made up of “people”. Yes, there are laws governing disability retirement; yes, there are rules, regulations and “criteria” which form the foundational basis for the “decision-making” part of evaluating each disability retirement case; but more profoundly, there are “people” who review, interpret, and apply those rules, regulations, and legal criteria in determining the final outcome: approval or disapproval of a claim.

That is why it is important in “how” a case is presented, as much as “what” it is that is being presented. With people, there are personalities; with personalities, there are variances in how any given OPM person reviews a case and makes a decision, from one to another. Where an attorney can be most helpful, is to “elevate” a case out of being merely one case among many, to making a presentation of a case on three fundamental levels: (1) the seriousness of the medical condition, (2) the legal sufficiency of the disability retirement application, and (3) persuasion by argumentation that it would be a mistake — a misapplication of the legal criteria — to disapprove a disability retirement application. All in all, this comes down to one profound issue: Where there are people, there are problems; and where there are problems, it is often a good idea to make the best presentation possible, at the outset of a disability retirement case.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability: End of Year

The New Year is upcoming. For those who are anxiously awaiting a decision on their Federal Disability Retirement applications, remember that this is a continuing process. Thus, whether or not the application gets approved or denied prior to the coming New Year, the process of then having the Agency provide the necessary payroll information in order for interim payments to begin, will still take some time. Unfortunately, the Office of Personnel Management is a bureaucracy. Within each bureacracy, as with all such gigantic entities, there are individuals who are competent in what they do; others, less so. Once a disability retirement application has been approved, the best thing which can be done to expedite payment on an approved claim, is to be persistent (on a daily basis, and some times on an hourly basis); be cordial and professional with each person you speak with, but be firm; get the name, telephone number, and write down any “promises” which an OPM person makes or proposes to make; then get a firm date as to when the promise will be fulfilled. Also, it is helpful, if possible, to get a supervisor’s direct number. Remember, good manners and courtesy will get you a long way; “befriending” an individual will get you even further; and gaining a sympathetic ear will get you the farthest. Be persistent, patient, and a pain-in-the-behind — all at once.

Sincerely,

Robert R. McGill, Esquire