Tag Archives: additional evidence to sustain your fers disability claim

Federal and Postal Service Disability Retirement: Patience is a Necessity

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I have said this many, many times:  If patience is a virtue, then Federal employees must be the virtuous of all people, especially those who are filing for Federal Disability Retirement benefits and waiting upon the Office of Personnel Management to make a decision.

Then, even after it is approved, it is often months and months until one’s case is finalized and taken out of the “interim” pay status to final pay status; or, if the case is denied at the First Stage and you have to file a Request for Reconsideration, submit additional medical and other evidence, file a Memorandum of Law to try and convince the Second Stage Representative that, indeed, contrary to what the First Stage Representative had argued, you have been in full compliance and meet with all of the criteria for eligibility for FERS or CSRS disability retirement benefits — which can take an additional 120 – 150 days.

Then, of course, if it is denied at the Reconsideration Stage of the process, you must file an appeal within thirty (30) days to the Merit Systems Protection Board, where the Administrative Judge is mandated by statute to conclude a case from the time of appeal within 120 days.

The entire “process”  — and this is precisely why I refer to the administrative procedure of filing for Federal Disability Retirement benefits under FERS or CSRS as a “process” — requires and demands patience.

Sincerely,

Robert R. McGill, Esquire

 

OPM Disability Retirement: The “Process” at the Reconsideration Stage

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It is important to understand that the “process” of filing for Federal Disability Retirement, when it comes to the Second, or “Reconsideration” Stage, encompasses two factual prisms:  (1)  The application has now been denied (obviously, and for whatever reason — most likely because of “insufficient medical evidence”) and (2) it is the stage in the process prior to an appeal to the Merit Systems Protection Board. 

This dual prism of the stage, while self-evident, is important to keep in mind, because it requires a duality of duties:  A.  It requires (for the Disability Retirement Applicant) a duty to show something beyond what has already been shown, while B.  It requires the Office of Personnel Management to be careful in this “process” of review, because if OPM makes a mistake at this stage, then the likelihood is great that they will be required to expend their limited resources to defend a disability retirement case before an Administrative Judge, and if it becomes obvious that the case should have been decided favorably at the Second Stage, it reflects negatively upon the Agency.  OPM is an agency made up of people (obviously); as such, just as “people” don’t like to look foolish, OPM as an Agency made up of people, does not like to look “badly” or “foolish”.  This duality of factual prisms is important to understand when entering into the Second, Reconsideration Stage of the “process”.

Sincerely,

Robert R. McGill, Esquire

FERS Disability Retirement: Attorney Representation

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I am still often asked about whether or not, or how helpful, legal representation would be in a Federal or Postal Disability Retirement case.  To ask an attorney such a question is often unhelpful, for there is always the question as to how much “self-interest” an attorney has in answering such a question.

What I can state, however, is the following:  Remember that everyone believes that his or her case is a “sure thing” — this is natural, because the very individual who is filing for disability retirement is the one who is suffering from the medical condition, and so it is a very “personal” matter, and a sense of objectivity is difficult to maintain in these matters.

Second, remember that when you hire an attorney, you are not just hiring someone who “knows something” about CSRS or FERS Disability Retirement; instead, you should be hiring that lawyer for his or her reputation, his knowledge of the administrative & legal process with the Office of Personnel Management and the Merit Systems Protection Board, and how well he is “thought of” by OPM (i.e., how long has he been practicing in the field of Federal Disability Retirement law, does he know the people at OPM, and more importantly, does OPM know him/her?).

Finally, always keep in mind that, while attorneys can be expensive, you must always do a cost-benefits analysis, and look at the benefit you will be receiving (or not receiving) if you do or do not hire an attorney.  OPM Disability Retirement benefits are essentially a means of securing one’s financial future, and as such, the benefit to be secured is important enough to consider hiring an attorney.

Sincerely,

Robert R. McGill, Esquire

 

Federal Disability Retirement: SSA Approval, Part II

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In order for an SSA approval to have an impact upon a Federal disability retirement application, the Social Security Administration’s decision letter granting benefits must provide a detailed explanation as to the basis for the approval, delineating the medical basis, the medical conditions upon which the decision was made, etc.  Thereafter, the applicant can submit the decision letter, but this is where it is important to have an attorney provide the proper legal & foundational argument — to provide the contextual applicability.

The legal basis, to start with, is found in Trevan v. Office of Personnel Management, 69 F.3d 520, 526-27 (Fed. Cir. 1995), in which the Federal Circuit Court found that in making a determination of eligibility for disability retirement, the Board (and thus, by analogy, OPM) must consider an award of SSA disability benefits together with medical evidence provided by the appellant to OPM, and other evidence of disability.  This is when an attorney’s tools of “argument by analogy” and pointing out the significant contextual language in an SSA decision letter comes in handy.  Next:  What if an SSA decision letter is not immediately forthcoming, or does not address the same medical conditions as that applied for in one’s disability retirement application?

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS disability retirement: Reconsideration Stage

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Sometimes, restraint is the better part of a response, as opposed to immediately responding. If an applicant’s disability retirement is denied at the initial stage of the process, an individual has thirty (30) days within which to file a Request for Reconsideration.

Upon filing such a request, however, the requestor then only has thirty (30) days to submit additional medical documentation to support the reconsideration request. Thus, take the following scenario: A person receives a denial on day 1; he files a Request for Reconsideration on day 2; he has until day 32 to file supporting medical documentation. If, on the other hand, the requestor had waited until day 25 to request reconsideration (while, in the meantime, on Day 2, he had written to the doctor for additional input/response/records, etc.), then the individual essentially has 45 days to make his case, as opposed to 32 days.

When dealing with doctors, it is often a pragmatic methodology to do it this way, because doctors rarely respond within 30 days. Thus, it is wiser to refrain from responding immediately; it is sometimes difficult to show restraint, because one’s natural impulse is to quickly file a request for reconsideration. For pragmatic reasons, it is almost always better to wait.

Sincerely,

Robert R. McGill, Esquire

Merit Systems Protection Board: Hearings are not inevitable

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The third step in the process of filing and obtaining disability retirement from the Office of Personnel Management is to appeal the case to the Merit Systems Protection Board. This is initiated after a disability retirement application has been denied twice: First, at the initial stage, then, upon a request for reconsideration and an opportunity to submit additional medical and other documentation, if the Office of Personnel Management denies the application a second time, then the Applicant has the right to file an appeal with the Merit Systems Protection Board.

Such a case is then set to be heard by an Administrative Judge, and mandated to be completed within 120 days from the time it is appealed. Many applicants who go into this third stage have the unwarranted belief that a Hearing is an inevitability, and that there is no further opportunity to convince OPM to reverse themselves, or change their minds. That is simply not the case. Often, the OPM representative at the MSPB level is much more attuned to the evidentiary level required, and will entertain the receipt and review of an updated medical report, or additional diagnostic tests, or more detailed treatment notes, etc. The mere fact that OPM denied the application at the first two stages, and the fact that the jurisdictional landscape has now changed from OPM to the MSPB, does not mean that OPM’s mind cannot be changed. The key is to listen carefully at what OPM’s representative is saying at a Prehearing Conference, or even earlier if contact is made with him/her. By listening and complying with a reasonable request, it can save the applicant needless time and expenses (for the testimony of a doctor can, indeed, be expensive), and have the ultimate outcome that the applicant desires: approval of a disability retirement application.

Sincerely,

Robert R. McGill, Esquire