Tag Archives: OPM Representative

FERS Disability Retirement: Why is mine denied?

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There are always multiple (unverified) stories of people who have filed for Federal Disability retirement benefits under FERS, based upon what appears to be a “minor” medical condition (at least “minor” in comparison to the medical conditions which were rejected by the Office of Personnel Management per a denial letter), which was approved; yet, you filed a FERS Disability Retirement application based upon multiple major medical conditions, which was denied.

Why me?

Remember that “fairness” is not the criteria in determining the viability of a disability retirement application.

Comparisons of medical conditions with other applicants or co-workers rarely provide any fruitful insight; the point is, the “other guy” got his disability retirement application approved, and you did not.  It may be several factors beyond your control:  Your Supervisor tried to “get back at you” by declaring that all reasonable medical accommodations were provided; the OPM representative which was assigned to your case was overworked and wanted to clear some of the workload, and yours was one of them; one of your doctors made statements which came perilously close to making your case one of “situational disability”.

Whatever the reasons, you should not worry about factors beyond your control; instead you need to focus upon those factors over which you do have control:  You need to have a strategy on how you will counter the initial denial.

Sincerely,

Robert R. McGill, Esquire
Postal & Federal Employee Retirement Attorney

 

OPM Disability Retirement: The Denial at the First Stage

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Many individuals who have tried to file for Federal Disability Retirement benefits under CSRS or FERS get the disability retirement application denied at the Initial Stage of the process.  Would I rather have had that person come to me at the First Stage and have me prepare & file it?  Yes.  Are the mistakes made by the unrepresented Federal or Postal Worker irreversible?  No.  Would the disability retirement application been approved at the First Stage had it been prepared and filed by me?  Probably.  This is not to say, however, that all of my cases get passed through at the First Stage.  However, many of the mistakes which I see over and over, made by unrepresented individuals, could — and should — have been avoided. 

Further, many people who call me after getting the initial denial are surprised to hear me tell them that I don’t care what the OPM denial letter states.  While making for interesting bedside reading, the fact of the matter is that once you have read one such denial letter, you’ve essentially “read them all”.  Rarely is there anything new in an OPM denial letter.  OPM representatives use a template, and fill in dates and references to various medical reports and doctor’s records; but the conclusion of the denial letters are fairly identical:  the medical evidence is considered “insufficient” to meet the legal criteria to be eligible for disability retirement benefits.  It is the job of the attorney to go back to the doctors, get the proper medical documentation, then argue the law to the Office of Personnel Management.  The Second (Reconsideration) Stage of the process is a critical stage — for, if it is denied at this level, the next level takes it a “notch” higher — before an Administrative Judge at the Merit Systems Protection Board.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Responsibility of the Office of Personnel Management

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Perhaps it is an anomaly to even speak about the issue of “the responsibility” of the Office of Personnel Management — at least, from the general consensus of experiences as told by countless individuals who have filed for disability retirement benefits from the Office of Personnel Management, especially in recent years, one might conclude that OPM is slow to respond, or often refuses to respond at all.

However, to be fair, OPM — as with all other Federal Agencies — is made up of individuals; and the “good” or “bad” of an Agency is entirely dependent upon such individuals.  Most of the disability retirement specialists at OPM are, in my opinion, of the “good” sort.  Without naming names, there are a few of the “bad” sort.  Of course, that says very little, because such a generalized statement could be true of all Federal Agencies.

Moreover, OPM is presently short-staffed, overworked, and way behind on the processing of disability retirement claims.  What used to be a 60-day wait at the initial application stage is taking 90 – 120 days; and at the Reconsideration (2nd) Stage, what used to take 90 days is now taking 120 – 150 days, in many cases.

More than the “time” it takes, however, just remember that the primary responsibility of OPM is to take a careful and serious look at your disability retirement application/packet.  Also, remember that those disability retirement packets which are streamlined, logically constructed, and coherently argued, are the ones which will likely be quickly processed.  Don’t just strap a volume of medical records onto an application and hope for approval; in this day and age, it might be a wise investment to hire an attorney to “streamline” your packet.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Long View

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What I find when individuals have attempted to file on their own, and get it rejected, is the lack of preparing for the “long view.” Many people hear stories about how “such and such” obtained a disability retirement approval for “far less than the medical conditions I have.”

Fair enough. Those stories may be true (I never engage in a discussion about the validity or truth of such stories; they are what they are — stories); nevertheless, there are multiple factors which are considered at each stage of the process of filing for disability retirement: Who the OPM Specialist is that will be reviewing an application; the subjective application of which criteria are applied in a given case; the personal and professional differences that arise between different bureaucrats at the Office of Personnel Management (no, don’t believe in the story that there is an “objective” methodology of applying the law when reviewing each disability retirement application); and multiple other factors, including whether or not your particular disability retirement packet was reviewed by someone at the Office of Personnel Management when he or she had a “bad day”.

To counter all of the multiple factors over which we don’t have any control, one must always take the “long view” — the view that it may take two denials, and end up before a Judge at the Merit Systems Protection Board. At that point, it is important for the Judge to see how well-documented the case has been prepared; that legal arguments have already shown that OPM was unreasonable in its initial decision and its Reconsideration Denial; and how, despite additional attempts at fulfilling OPM’s requests for additional medical documentation, that OPM continued to be unreasonable. By preparing for the “long view”, a disability retirement packet not only has the best chance of getting it approved in the “short run”, but also at the Merit Systems Protection Board.Sincerely,

Robert R. McGill, Esquire

FERS Disability Retirement: The Process & the Office of Personnel Management

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The “British Rule” is that “good manners will always get you through any and every form of trouble.”  The process at the Office of Personnel Management is a long and arduous one.  When the disability retirement packet finally arrives at Boyers, PA, it will often sit for approximately thirty (30) days, before it is finally assigned a CSA number (for CSRS employees, it will begin with the number “4”; for FERS employees, it will begin with the number “8”).

The Applicant will receive a form letter from OPM in Boyers, PA, informing you that you have been assigned a CSA number, and that it has been forwarded to the OPM office in Washington, D.C.  This is when patience and good manners must come to the fore.

Of course, there is nothing wrong with calling OPM and inquiring about the status of your case.  However, always remember to be courteous; inquire as to the time-frame that the adjudicating disability specialist is expecting; and ask if it would be okay to call periodically, and to let him/her know that if any further documentation is needed, to give you a call — or, if you are represented, to call your attorney.  Whatever you do, do not get angry, and keep it professional — and courteous.

Sincerely,

Robert R. McGill, Esquire

 

OPM Disability Retirement: More on the MSPB Stage

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While I believe that an attorney versed in the Federal Disability Retirement process can be helpful at all stages of the process, at the Third Stage — the Merit Systems Protection Board stage — the input, assistance, and representation of an experienced attorney can be invaluable.  This is essentially the “last” stage of the three-stage process.  Of course, there are two additional stages, but both concern an appeal — in the event that the Administrative Judge rules against the disability retirement applicant at the MSPB.

During the process at the MSPB, the Appellant will have what is called a “Prehearing Conference”.  At such a conference (held over the telephone), the Judge will go over with both parties (the applicant and the OPM representative), certain basic essentials about the law, to include the standard of proof, witness list, preliminary legal matters, etc.  What is important at such a Prehearing Conference is to carefully listen to the Judge.  As each Judge is human, and thus different, it is important to listen and carefully be attentive to what the Judge is looking for.  If more medical documentation is needed, exactly what is the Judge looking for?  If there is a concern about a certain legal issue — say, the issue of accommodation — what exactly is the Judge concerned about?  By being attentive to the questions of the Judge, and fashioning the Hearing to address those concerns, the applicant greatly enhances his or her chances of winning at this crucial stage of the process.

Sincerely,

Robert R. McGill, Esquire

FERS Disability Retirement: The Frustration of Dealing with OPM

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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 Cases: Presenting the Case to OPM

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Fortunately, most of my cases which are submitted before the Office of Personnel Management at the Initial Stage are approved. It is important to step back and understand, first and foremost, how the approval/disapproval process works. Remember that the submission to the Office of Personnel Management is a “paper submission”, and as with any bureaucratic presentation, it is important to make sure that it is neat, understandable, and “presentable.” You want to make your particular submission stand out from the thousands which are submitted. Neatness and streamling accounts for much. Merely gathering up a thousand pages of medical documentation and hoping that the sheer volume and weight of the medical records will be proportionate to the seriousness which the OPM representative will view your case, is a foolhardy approach.

I attempt to streamline the case for the OPM representative, by annotating, identifying the medical documentation, explaining the relevance of the documentation, and identifying both statutory and case-law citations which are relevant in supporting the fundamental basis for the disability retirement application. It is important to make a proper presentation. It makes the life of the OPM Representative that much easier, and if the OPM Representative can review the application, read the synopsis, clearly understand the relevance of the medical documentation, be able to analyze the applicant’s statement and do it almost effortlessly, then one is more often than not rewarded with an approval, rather than the dreaded “denial letter”.

Sincerely,

Robert R. McGill, Esquire

FERS Disability Retirement: Symptoms versus Diagnosis

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If FERS Disability Retirement were merely a matter of determining the proper diagnosis of a medical condition, and having a doctor ascribe a percentage rating of disability, then the process of a disability retirement application would substantively be altered, and perhaps there would be far fewer cases to adjudicate at the Merit Systems Protection Board level.  For, if the criteria were that ‘cut and dry’, there would be little for OPM and the applicant & the applicant’s lawyer to argue over.

However, it rarely is that ‘cut and dry’ — because the major battle is rarely over the diagnosis; it is rarely over an issue concerning a percentage ascription of disability; rather, it is over the symptoms manifested, the significance of such symptoms upon the type of work one does, and in the impact such symptoms have upon the essential elements of one’s job.

That is why descriptive terms are important in disability retirement law. It is not so important ‘what it is’, as opposed to ‘how it is characterized’.  From this perspective, it is important for a FERS Disability Retirement Attorney to be more of a poet than to be cold and analytical — although, the best approach would be to have a little bit of both.

Remember to always know the context — the applicant will not be standing in front of an OPM representative showing how terrible the applicant’s medical condition is; there will be no visual presentation; everything is based upon a narrative — the applicant’s statement of disability, the medical documentation, the legal memorandum of the attorney, etc.  Thus, it is all-important for the Federal Disability Attorney who represents a disability retirement applicant to have a good command of the English language.

Sincerely,

Robert R. McGill, Esquire

 

OPM Disability Retirement: The Purpose of Case Law Citation

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Is it necessary for a Federal Disability Retirement Applicant to cite relevant case-laws and statutory authority when filing for disability retirement? Or, should the medical evidence be sufficient? Certainly, there is no statutory requirement that “the law” be referenced when filing for disability retirement. And, further, it is normally not a good idea for a non-lawyer Federal or Postal employee to refer to case-law or relevant statutory authority, if only because non-lawyers often mis-state the law, or misinterpret relevant case-law authority.

The primary purpose why I refer to, and cite relevant statutory authority and case law, even at the initial administrative stage of filing for disability retirement on behalf of a Federal or Postal employee (normally, I will prepare a lengthy legal memorandum for each case), is because I want to preempt any mis-statement of law to the benefits specialist reviewing the application packet.

It is important at each stage of the process to point out the relevant law, the applicable case-law, the judicial opinions which have addressed the multiple issues which can deter or potentially derail a disability retirement application. While the benefits specialist at the Initial Stage of the process may not be fully aware of the applicable laws, it is the job of the Attorney to point out the law, and demand that the Office of Personnel Management conform to the relevant, current judicial constraints which should be adhered to.

Sincerely,

Robert R. McGill, Esquire