OPM Disability Retirement: The Federal Workplace (Part 2)

In filing for FERS or CSRS Federal Disability Retirement benefits with the Office of Personnel Management, it is important to stay away from issues which may explicitly or implicitly characterize the particular medical condition as being “situational” in nature.  However, this does not mean that the medical condition cannot have originated from, or been exacerbated by, the workplace environment.  Remember that OPM disability retirement is not like OWCP/Worker’s Comp — the issue of causality, or whether the medical condition occurred as a result of your occupation, is not important to prove.

However, sometimes, it is simply an indisputable fact that the medical condition originated from the workplace, or was exacerbated by conditions in the workplace.  Such origination or exacerbations, once it takes on a “life of its own” and becomes chronic and pervasive such that the medical condition impacts a person both at the workplace as well as outside the workplace, then it has transformed into a medical condition beyond being merely “situational”.  Thus, that which originated as a “situational” medical condition may well no longer be a situational one.  In such cases — and that is normally the case in almost all medical conditions which begin as a situational disability — there would be no problem with filing for OPM disability retirement benefits.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: OPM’s Detailed Denial

Neither length nor detail constitutes legitimacy.  The spectrum of the types and styles of denial letters issued by the Office of Personnel Management in Federal Disability Retirement cases under FERS & CSRS range from a short paragraph under the “Discussion Section”, to 3 – 4 pages of apparent references to doctor’s notes, reports, etc. — with a lengthy lecture about the need for “objective” medical evidence, and about how a particular medical condition “may be” treated by X, Y or Z treatment modalities.

Don’t be fooled.  One may think that, because OPM provides a seemingly “detailed” explanation of why a particular disability retirement application was denied, that such lengthy detail means that it is somehow “substantive”.  In fact, I often find the opposite to be true:  the shorter the denial, the greater the substance.

The lengthy denial letters contain “substance”, all right — but substance of the wrong kind.  They contain:  Mis-statements of the law; mis-statements of the criteria to be applied; inappropriate assertions of medical opinions (contrary to what one might think, the OPM representative does not normally have a medical degree, let alone a law degree), and a host of other “mis-statements”.

Sometimes, the weightier the denial, the more confusing as far as how to respond.  And, perhaps, that is one methodology as to how OPM wants to approach the case:  If it seems long and complicated, maybe the applicant will sigh, give up, and go away.  Don’t.

Sincerely,

Robert R. McGill, Esquire