Tag Archives: OPM Initial Stage

FERS Disability Retirement: Applicant’s Statement of Disability

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In most instances, when I am asked to represent an applicant at the Reconsideration Stage, after he or she has attempted to obtain an approval at the Initial Stage without an attorney, I find that the prevailing mistake made is the exaggerated verbosity of the statement itself. The old adage from Shakespeare, which (I know) is too often quoted (and misquoted), from Hamlet, Act 3, Scene 2, where Queen Gertrude responds by saying, “The lady doth protest too much, methinks,” is indeed appropriate and applicable to this issue.

While the Applicant’s Statement of Disability must be detailed, complete, and accurate, it must not be “overstated”. It should reflect the factual and medical integrity of the medical opinions and findings as delineated in the medical records, documents and notes; it should never exceed the medical evidence in assertions, claims or scope. Overzealous self-advocacy is often the problem in cases of Federal Disability Retirement where the disabled individual represents him or herself. To this, of course, another common adage is applicable: “A person representing himself in court has a fool for a client.”

Sincerely,

Robert R. McGill, Esquire
Federal Disability Retirement Lawyer

Federal and Postal Service Disability Retirement: Each Level of the Process

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Disability retirement, as I have often written about, is a process.  Each stage of the process has certain “requirements” which should be met — by “requirements”, I mean that each stage of the process (the Initial Application Stage, the Reconsideration Stage, and the Third Stage of the Process, a Hearing before an Administrative Judge at the Merit Systems Protection Board) has certain aspects of proof, certain methods of approaching the level of satisfying the burden of proof, etc.

There are, of course, the further stages of Appeal — at the Full Review at the MSPB, and the Federal Circuit Court of Appeals — but these appellate stages deal only with whether or not the Administrative Judge applied “the law” properly or not.

Thus, at the first three stages of the process, there is the necessary requirement of “winning” by submitting the proper medical and other evidence, to persuade the Office of Personnel Management and the Administrative Judge that your Federal Disability Retirement application under FERS or CSRS meets the legal criteria for eligibility.

This is the season for Reconsiderations; the Office of Personnel Management will often make many of its decisions just before Christmas, and just before the end of the year.  If an applicant under FERS or CSRS gets denied at the Initial Stage, just make sure that you hire an attorney who knows what he or she is doing, and isn’t just a “general practice” lawyer who is as blind as the next person, and will merely be one blind person leading the blind.

Each Stage of the process requires a level of expertise to meet the “requirements” necessary to satisfy that particular level; just make sure that you will be led by an attorney who not only knows what those requirements are, but further, knows how to meet those requirements.

Sincerely,

Robert R. McGill, Esquire

 

CSRS & FERS Disability Retirement: Denial at the First Stage

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I would like to state that none of my cases have ever been denied at the Initial Stage of filing for Federal Disability Retirement benefits; not only would such a statement be untrue; it would also be unbelievable.

And yes — even the cases that I file on behalf of my clients, get a similarly formatted denial:  a restatement of the criteria for eligibility for Federal Disability Retirement under FERS & CSRS; a discussion with an elaborate reference to doctor’s notes, dates of treatment, targeted extrapolations of statements by the doctors which are not only selectively chosen in a narrow manner to favor the decision of denial, but further, which are often taken out of context.

Some might wonder:  Doesn’t OPM have greater respect for Mr. McGill?  The answer is:  At the First Level, the representative from the Office of Personnel Management is merely making a decision on one of thousands of files, and a template is being used to process and get rid of cases.  However, one must always remember (as I try to remind everyone) that this is a “process”.  A denial at the First Stage of the process is merely part of the greater process.

It is not something to get annoyed at, or concerned about; it is a stage and a decision which must be dealt with, argued against, and rebutted in the proper, rational, legal manner.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Long, Longer & Longest View

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I have often spoken of the need to take the “long-term” view in filing for Federal Disability Retirement benefits under FERS & CSRS — both in terms of having patience for the inherently long process in terms of time, as well as in terms of preparing a case for not just the First Stage of the process, but further, for the second Reconsideration Stage, as well as for an Appeal to the Merit Systems Protection Board.

This “long-term” view is meant to prepare a potential applicant for what it means to file for Federal Disability Retirement benefits; to not be overly concerned if you are denied at the first, or even the second stage of the process; and to be prepared financially to weather the “long haul”.  In short, it is meant to prepare the potential applicant for the long, and longer, view of filing for Federal Disability Retirement benefits.

It is also necessary, however, to prepare one’s self for the “longest” view — that of maintaining and keeping safe the disability retirement benefits once it is approved — by preparing to be randomly selected every two years or so with a periodic “review” with a Medical Questionnaire.  The Medical Questionnaire is an innocuous looking form, asking for an “update”, and giving you 90 days to respond.

Be cautious.  Be aware.  Take it seriously.

Don’t wait for the 89th day to begin responding to it.  None of my clients who have gotten his or her Federal Disability Retirement benefits has ever lost it; people who have gotten Federal Disability Retirement benefits on their own and have later lost the benefit, have come to me to regain it; I have been successful in recovering the benefit, in every case.  However, it is not always easy — if only because the disability annuitant initially thought that it was an “easy-looking” form.

Preparation for the “longest view” begins not upon receipt of the Medical Questionnaire; it begins at the very, very beginning — when one first decides to file for Federal Disability Retirement benefits.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: The Complexity of the Simple

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Federal disability retirement law, the statutes and regulations which govern eligibility; the multiple case-law opinions from Administrative Judges and Federal Circuit Judges interpreting the governing statutes and regulations; the lawyers who argue different aspects and attempt to “fine-tune” existing law (including this lawyer) — the entirety results in “making complex” that which was essentially simple.

There is an old adage that the King who declared the first law of his Kingdom was really attempting to reduce the unemployment figures by creating the need for lawyers.  Indeed, “the law” is often made more complex by lawyers.  However, while the multiple issues governing Federal disability retirement law under FERS & CSRS may appear, at first glance, “simple”, it is such simplicity which engenders the complex, precisely because laws which reflect a simple conceptual paradigm require extensive interpretation in order to explain the simpleness of the simplicity.  That is why law itself is complex.  Don’t let the complex confluse you.

As you prepare a disability retirement application, recognize that it is a complex process; at the same time, make sure to explain your medical condition and how it impacts your ability to perform the essential elements of your Federal or Postal position in an easy-going, simple and straightforward manner. Don’t make it complex; keep it simple; but recognize the complexities.

Sincerely,

Robert R. McGill, Esquire

FERS Disability Retirement: The First Denial

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Your Federal disability retirement application was well-prepared:  perhaps it was prepared with the help of an attorney; the medical documentation seemed solidly unequivocal; the doctor made the necessary connections between one’s medical conditions and the type of essential elements of one’s job; the packet, by all accounts, should have been approved, and by all expectations, the approval should have been reasonably expected.

Instead, you receive a letter stating that your disability retirement application was disapproved, and a “Discussion” section follows, explaining why the Office of Personnel Management denied your application.  Why did this happen?  There are multiple reasons why such a denial can occur:  the OPM specialist could be a person who lacks a clear understanding of the applicable laws governing disability retirement applications (more often than not, this is the case, and what you actually get in the so-called “Discussion” Section of the denial letter is merely a regurgitation of the statutory criteria for eligibility for disability retirement, without a recognition of the interpretation of such criteria by Federal Judges for the Federal Court of Appeals or by Administrative Judges from the Merit Systems Protection Board); it could be as simple as the OPM representative selectively choosing to read the medical reports and records, and disregarding or ignoring supportive portions of the medical records and reports; or it could be that additional medical reports and records need to be obtained in order to “shore up” the application.

In any event, whatever the reason for the denial, one should not panic.  It is merely one step in a long, administrative process.  The mere fact that OPM denies your disability retirement application does not mean that they are “right” in doing so; indeed, in my opinion, they are rarely right.  That is why one has the right to have it “reconsidered”, and the opportunity to make further legal arguments, and obtain further medical documentation in support of your claim.  And, beyond that, you have the right to file an appeal to the Merit Systems Protection Board — and beyond.  Never give up; always take it to the next step.  In most cases, it will prove that OPM was in error, and in fighting the denial, you will have secured some semblence of financial security for your future.

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: The Merit Systems Protection Board

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An appeal to the Merit Systems Protection Board in a Federal Disability Retirement case means that the disability retirement application has been denied twice by the Office of Personnel Management:  at the initial application stage, then at the Reconsideration Stage.  This is often considered to be the third and last try — of convincing an administrative judge (an “AJ”) that you are entitled and eligible for disability retirement.  There are, of course, two additional stages — an appeal to the Full Board and to the Federal Circuit Court — but such avenues present only the right to reverse a decision of the Merit Systems Protection Board, and no new evidence can be presented.

Thus, one might consider the Merit Systems Protection Board as the “last stop” in the administrative process.  Do not think, however, that the process must necessarily be won before the Administrative Judge in a hearing — much work and persuasive argumentation should be made to the OPM representative who is handling the case at this MSPB Stage.  The OPM representative at the Third Stage of the process is usually an attorney; they are competent; they are versed in the case-law — and thus open to be persuaded by legal argumentation.  While the administrative stages (the Initial Stage and the Reconsideration Stage) involved OPM representatives who are non-attorneys, the MSPB Stage involves seasoned attorneys who present an opportunity for persuasion and argumentation, and thus a golden opportunity to convince OPM to reverse their own decision before coming to a Hearing.  Such an opportunity should never be missed, and every effort should be made by the applicant’s attorney to have multiple contacts with the OPM representative prior to the date of the Hearing.

Sincerely,

Robert R. McGill, Esquire