Because the essence of an OPM Disability Retirement Application under FERS or CSRS goes to the symptomatologies and their impact upon one’s ability or inability to perform one or more of the essential elements of one’s job, it is therefore important to weave throughout the narrative of one’s Statement of Disability the symptoms, the impact, the descriptive events, which impact one’s ability/inability to perform the job.  Thus, while listing specific diagnosed medical conditions shoulder certainly be a part of any such application, the narrative itself should include the description of multiple symptoms resulting from the diagnosis.  Further, while the applicant is disallowed from “adding” any new medical conditions once it has been received by the Office of Personnel Management and assigned a CSA number, nevertheless, the applicant is not a medical doctor, and if a medical condition which later develops or becomes clarified during the process of review needs to be supplemented with an additional medical report or results of a diagnostic test, if the medical condition can be reasonably related to a described symptomatology or description in the original statement of disability, then in all likelihood, it will be allowed in for review.

Sincerely,

Robert R. McGill, Esquire

If an individual who has filed for Federal Disability Retirement benefits under FERS or CSRS later finds, during the process of waiting for a decision or, between the time of an initial denial and during the Reconsideration Stage or an appeal to the Merit Systems Protection Board — that a previously unlisted medical condition has worsened, can he “add” that medical condition to his Federal Disability Retirement Application?  Can he file an “amended” SF 3112A, Applicant’s Statement of Disability?  The general answer is, “No”. 

However, one can certainly submit a medical report concerning such “previously-unlisted” medical condition if one can reasonably argue that the previously-unlisted medical condition was in fact listed, right there for everyone (i.e., the Office of Personnel Management) to see.  This issue comes up often enough to be of concern, especially because of the valuable time lost in being forced to “withdraw” an application for OPM Disability Retirement and to start all over again in order to add a “new” medical condition.  To safeguard against such a potential event, it is wise to read through the multiple medical conditions when putting together an OPM Disability Retirement packet, and decide which primary diagnoses to include, and at the same time, to “weave” into the narrative of the description of medical conditions, symptoms and areas of pain which can be reasonably interpreted to encapsulate potentially underlying medical diagnoses which may later become prominent and require greater focal emphasis.

Sincerely,

Robert R. McGill, Esquire

The rule on an application for Federal Disability Retirement benefits under FERS or CSRS is that, once the application is filed with the Office of Personnel Management, the application cannot be amended or modified with respect to the “list” of medical conditions.  Thus, on the Applicant’s Statement of Disability (SF 3112A), one must list the medical conditions upon which the entire application for eligibility is based.  Once it is filed with OPM and a CSA Number is assigned to the case, you are restricted from being able to “add” to the list of medical conditions which are delineated on your statement.  This is fair enough, if one stops and reflects upon it, for a number of reasons.  For one thing, it would be unfair to have the right to change the basis upon which one has filed for Federal Employee Disability Retirement benefits under FERS or CSRS.  For another, OPM must be able to begin the process of evaluating the eligibility of a case without the potential for modification of the medical conditions, or the adding or subtracting of the underlying basis of the claim.  However, the mere fact that one cannot “add” to the list of medical conditions, does not prevent one from submitting additional supporting medical documentation (even from a previously-unnamed medical provider) which would support the already-listed medical conditions. 

Sincerely,

Robert R. McGill, Esquire

It is one thing to provide an explanation of the process of filing for Federal Disability Retirement benefits under FERS or CSRS to the treating doctor; that is simply not enough.  Providing an explanation “disarms” the health professional.  While such explanation and helping the doctor to understand the process is certainly helpful, ultimately the treating doctor needs more than information; he or she needs guidance in order to “arm” one’s self with the tools necessary to help the patient. 

Fortunately, most doctors are professional, compassionate, and eager to help.  Writing medical reports are an administrative aspect of the practice of medicine which is not only a headache, but takes the doctor away from the valuable and limited time for actually treating the patient.  It is therefore important for the Federal or Postal employee who is applying for Federal Disability Retirement benefits under FERS or CSRS to “arm” the doctor with the necessary tools needed in order to successfully prepare, formulate and construct a sufficient and effective narrative report in order to “pass muster” with the Office of Personnel Management.  The first and primary rule in helping to prepare the doctor is to always protect and maintain the integrity of the doctor.  Truth in every endeavor, and especially in filing for Federal Disability Retirement benefits under FERS or CSRS, should be the ultimate guiding light.  How that truth is stated, however, is where the guidance, tooling and “arming” comes into play.

Sincerely,

Robert R. McGill, Esquire

The problem with an unrepresented Federal or Postal employee who files for Federal Disability Retirement benefits from the Office of Personnel Management, is that because this is the one and only encounter with OPM, any response from them will be a narrow, one-dimensional perspective.  Thus, if the Office of Personnel Management denies the Federal or Postal disability retirement application, such a denial, the manner in which it is written, the content, the apparent delineation of “the law”, and the loosely-stated declarative statement while vaguely referring to the insufficiency of one’s medical documentation, will result in a narrow perspective, in a vacuum of reality created by OPM.  OPM’s denial letters are notorious for its selective reality.  Such selective reality will completely ignore all medical statements which seem to support the OPM disability retirement application, while selectively focusing upon every tidbit of medical notations which favor the denial.  Thus, be careful if on any given day, you arrive at the doctor’s office and the doctor asks you how you are feeling, and you respond with, “I’m feeling pretty good, today.”  Such a conversational statement may nullify the fact that, in its proper context, what the reality of your statement meant to convey was:  “I’m feeling better today in comparison with yesterday and the entire month before, but in no way could I perform my job even today.”  But OPM will selectively pick upon that one statement, and run with it — to a complete and total basis in denying your Federal Disability Retirement application under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

Hume’s exposition on causality is both interesting and instructive in terms of looking at the validity of an argument.  In this instance, we are obviously making an analogy with how the Office of Personnel Management, and to a larger degree, people in general who make a causal argument and declare that it is a ‘valid’ argument.  David Hume’s argument on causality essentially states that there is nothing in the world other than two independent events (which we merely deem as ’cause’ and ‘effect’), which we repetitively witness.  However, because there is no ‘meta-factor’ beyond the independent events, what he terms as a ‘necessary connection’, therefore there is no certainty beyond a repetition of events.  Thus, Hume argues that we actually never see anything ‘new’ — no ‘necessary connection’ between cause and effect, in the 100th time we observe an event, any more than the first time. 

This is, indeed, analogous to how the Office of Personnel Management views rendering a denial in a Federal Disability Retirement application under FERS or CSRS. Look at the lack of logical argumentation in an OPM denial.  It is a series of independent events, delineated and categorized in some semblance of chronological order (perhaps the order that the OPM Representative read the medical documentation):  Dr X says this; Dr. Y says that; then the effect:  “The medical evidence fails to meet the criteria for eligibility for Federal Disability Retirement.”  Like Hume’s description of the world, there lacks a ‘meta-factor’.  Whether the stated causes have any connection (see the analogy?  It is like Hume’s reference to “necessary connection”) to the “effect” is entirely irrelevant.  Events do not need to justify the decision.  It is acceptable to merely refer to medical documents and then come to a conclusion, without any need to justify the validity of an argument.  But, then, that seems to be how most people in the general population formulate an argument these days — based upon how one “feels”.

Sincerely,

Robert R. McGill, Esquire

Sometime, read Anton Chekhov’s short story, Grief.  It is about a man whose son has just died.  As with any person with a tale to tell, it must be told.  So it is with any Federal or Postal employee who suffers from a medical condition which impacts one’s ability to perform the essential elements of one’s job.  There is a story to tell.  At the same time, however, the Attorney who represents a person to obtain disability retirement must focus the story itself; to do otherwise ends up failing to serve the client’s best interest — the focus upon what will end in ultimate victory:  an approval from the Office of Personnel Management granting the Client his or her Federal Disability Retirement benefits under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

On the other hand, there is no such thing as a “lost cause” case.  To assert such a conclusion would be to presumptively admit defeat.  In Federal Disability Retirement cases, there is always a good chance of prevailing, whether or not a mistake was made; whether or not a doctor annotated, on a particular day in a moment of hope, that the patient showed “hopeful improvement”.  Yes, it is the job of the Office of Personnel Management to cling onto such peripheral statements, and to magnify such statements such that they appear to encompass the essence of the medical condition. 

It is always with some amusement that I hear an agency Human Resources person state something to the effect of:  “Well, you know, Mr. McGill, this is not an adversarial process.  We and the Office of Personnel Management are merely here to determine the eligibility of the Federal worker, and to make sure that he or she fits the criteria.”  Not an adversarial process?  Is the Office of Personnel Management “there” to help you?  Is that why, in their template denial letters, they latch onto the most peripheral of issues and emphasize those points which allegedly present a problem, and ignore the rest of the medical evidence?  Any Federal or Postal employee who is contemplating filing for Federal Disability Retirement benefits under FERS or CSRS would be wise to see the entire Federal Disability Retirement process as one of an “adversarial process”.  If you don’t, you proceed at your own peril.  On the other hand…

Sincerely,

Robert R. McGill, Esquire

Sincerely,

Robert R. McGill, Esquire

Thus, many people will tell me that they were “informed” by their Human Resources personnel that they must file with Social Security first before they can file for OPM disability retirement under FERS (not true); or, that they must have a decision by Social Security before they can file under FERS (even more untrue); or, that OPM will not even look at a federal disability retirement application unless you have first filed with Social Security (again, untrue).  The bottom line:  Yes, you must file for Social Security, but OPM doesn’t need to see a receipt showing that you filed, until the day they approve your OPM disability retirement application.  So, sometime before the Federal Disability Retirement application gets to OPM, or, in those cases where one has procrastinated for too long, even after the application gets to OPM, you need to file for Social Security disability benefits, and have a receipt ready to show OPM.

Sincerely,

Robert R. McGill, Esquire

On the other hand, if an individual was removed for reasons other than medically-based reasons — i.e., as a hypothetical, let’s say he was removed “for cause” — an act of dishonesty; failure to follow certain agency procedures; or whatever the case may be.  Does such a removal tip the scale the other way?  Not necessarily; however, it makes gathering the proper medical evidence that much more important, and what I often do is to try and tie in the underlying behavior which resulted in the removal “for cause”, with the medical basis — if at all possible.

Sincerely,

Robert R. McGill, Esquire

It is thus important to recognize that the Office of Personnel Management is not an infallible agency.  Far, far from it, they are merely made up of people who are subject to error, but often stubbornly so — unless you counter their denial in an aggressive, but calm and rational manner.  If a denial comes your way, do not get distressed; prepare your case well, and lay out the groundwork necessary to win.

Sincerely,

Robert R. McGill, Esquire

I used to be amazed at such answers, but after some thought, it makes sense.  As an attorney, my first instinct (both trained and natural) is to always take something to the next level, with the firm belief that I will prevail just by pure persistence, and by using the law as “a sword” in the process of fighting for my clients.  But most people are not lawyers (some would say, thank goodness for that, we have enough lawyers in the world), and when the Office of Personnel Management writes up a denial letter, then allegedly cites “the law”, and makes bold conclusions such as, “You do not meet the eligibility criteria under the laws governing disability retirement…”  It all sounds convincing.  It all sounds like any further action will be an act of futility.  But just because OPM “says so” doesn’t make it true, doesn’t make it right, and certainly doesn’t make it unwinnable.  They may say you don’t meet the eligbility criteria; I would argue otherwise.

Sincerely,
Robert R. McGill, Esquire

When the Office of Personnel Management reviews a Federal Disability Retirement submission under FERS or CSRS, the OPM Representative will review your disability retirement packet until it is approved — and no further.  Approval comes about upon a finding that one of your listed medical conditions disables you from performing one or more of the essential elements of your job.  Now, sometimes OPM will find that a combination of 2 or 3 medical conditions disables you together:  meaning that OPM perhaps found that while a single one did not disable you under their criteria, a combination of two or three did. 

Furthermore, it is important to understand that, because the medical conditions and disabilities upon which OPM makes their decision on will be the basis for future continuation of your disability retirement annuity (in the event that you receive a Medical Questionnaire in the future), it is important to limit the listing of one’s medical disabilities on the SF 3112A to those conditions which will likely last for more than 12 months. 

Conclusion:  It is important to sequentially prioritize the medical disabilities, in the order of severity, chronicity and duration.  Further, it is important to NOT list the minor medical conditions which, while they may be aggravating, and have impacting symptoms, may not necessarily prevent one from performing the essential elements of your job.

Sincerely,

Robert R. McGill, Esquire

Sincerely,

Robert R. McGill, Esquire

Such intersecting difficulties also arise in what the Postal Service has initiated in the last few years — the “National Reassessment Program” — a euphemism for a massive attempt to get rid of anyone and anyone who is not fully productive.  Under this program, the Postal Service is essentially getting rid of all light-duty assignments; and, of course, such a program intersects with Federal Worker’s Comp, because many light-duty or “modified duty” employees are under the umbrella of OWCP-offered work assignments and modified positions and duties.  People are sent home with the reason given that there is no longer any “light duty” jobs; they are then instructed or forced into filing for OWCP benefits; whether Worker’s Comp will actually pay for temporary total disability is a big question mark. 

Ultimately, I believe that the answer will be found in filing for OPM Federal Disability Retirement benefits. The NRP (National Reassessment Program) is simply a macrocosmic approach of a large agency (the U.S. Postal Service), mirroring a microcosmic approach (the approach of most agencies towards individual Federal or Postal employees who have a medical condition which prevents him or her from performing one or more of the essential elements of one’s job) in dealing with “less than fully productive” Federal or Postal employees.  Then, of course, there is the intersecting issue of filing for Social Security Disability benefits, which you have to do anyway, under FERS — but whether one actually gets it, is another issue.  All of these issues intersect; rarely are these issues isolated; the consequential impact of all of these issues need to be viewed in a macro manner.

Sincerely,

Robert R. McGill, Esquire

This is important to understand in the context of a client and his or her attorney; remember that the attorney’s role is to win the case; and while empathy for the client’s personal situation and, in the case of Federal Disability Retirements under FERS & CSRS, it is important for the attorney to understand the “human story” of the medical condition, the impact of such medical conditions, and how they prevent one from performing the essential elements of one’s job, remember that the primary focus of the Federal Disability Retirement attorney is, and always should be, upon applying the applicable law, and to win the case.  It is the Attorney’s job to keep the client’s focus upon those issues which will help him win the case.

Sincerely,

Robert R. McGill, Esquire

Sincerely,

Robert R. McGill, Esquire

Sincerely,

Robert R. McGill, Esquire

The fact that Social Security has a higher standard of proof — where one must be considered “totally disable” as opposed to (under the legal standards for FERS) “disabled from performing one or more of the essential elements of one’s job”) — one would think that, legally and logically, if you have met the higher legal standard of proof, then the lesser standard would have been automatically met.  Unfortunately, because the two standards are applied in different, independent agencies, the fact that Social Security Disability benefits are awarded is not a guarantee that the FERS disability retirement application will automatically be granted.  However, there is clear case-law stating that OPM must consider the approval by SSD as one factor among many in the consideration of FERS disability retirement applications.  It is important to cite such cases in support of your application for FERS disability retirement.

Sincerely,

Robert R. McGill, Esquire

Sincerely,

Robert R. McGill

Sincerely, Robert R. McGill, Esquire

I try and explain to many people that getting Federal Disability Retirement benefits should never be a judgment upon one’s career — let alone one’s life. A career can span a lifetime, or it can extend for a couple of years (i.e., at least the 18 months of Federal Service that is needed to even qualify under FERS). However long, to come to a point in one’s career where it becomes necessary to acknowledge to one’s self that certain medical conditions are directly impacting one’s ability to perform the essential elements of the job — such an admission should never be interpreted to mean that such a circumstance has somehow devalued the worth of a person.  Human beings are complex entities, bundled up by personality, uniqueness, family, job, hobbies, thoughts — a compendium of a history of one’s life.  Note that I merely inserted the concept of “job” within a sequence of many facets.  And, indeed, one’s job is important — it takes us away from the many other bundles of our lives, and forces us to expend 8, 10, 12 or more hours per day, Monday thru Friday, and some weekends, too.  But that which takes up a large quantity of our time does not necessarily or logically result in the definitional essence of a human being; the fact that we spend a great deal of time in the bathroom does not mean that such an activity defines our “essence”.  ”Worth” of a human being attaches to each of us, and is inseparable from each human being.  One’s job and career constitute only a small part of us.  Let’s keep that in mind, and in its proper perspective.

Sincerely,

Robert R. McGill, Esquire

A case in point, of course, is Vanieken-Ryals v. OPM, a U.S. Court of Appeals for the Federal Circuit case, decided on November 26, 2007. In that case, it clearly circumscribes the fact that OPM can no longer make the argument that an Applicant’s disability retirement application contains “insufficient medical evidence” because of its lack of “objective medical evidence”. This is because there is no statute or regulation which “imposes such a requirement” that “objective” medical evidence is required to prove disability. As long as the treating doctor of the disability retirement applicant utilizes “established diagnostic criteria” and applies modalities of treatment which are “consistent with ‘generally accepted professional standards’”, then the application is eligible for consideration. Further, the Court went on to state that it is “legal error for either agency (OPM or the MSPB) to reject submitted medical evidence as entitled to no probative weight at all solely because it lacks so-called ‘objective’ measures such as laboratory tests.” Statues are passed for a reason: to be followed by agencies. Judges render decisions for a reason: for agencies to follow. Often, however, agencies lag behind statutes and judicial decisions. It is up the an applicant — and his or her attorney — to make sure that OPM follows the law.

Sincerely,

Robert R. McGill, Esquire

As stated multiple times, disability retirement is essentially the linking of a “nexus” between one’s medical conditions, and one’s Federal or Postal position. By “linking” is meant the following: Does the medical condition from which one suffers prevent one from performing one or more of the essential elements of one’s job? If the answer to the question is “yes”, then you have passed the preliminary, fundamental, preconditional question.

The next question, or series of questions, of course, include the following: Do you have the minimum of 18 months of Federal Service (for CSRS individuals, 5 years)? Do you have a supportive doctor? Will your medical condition last for at least 1 year? These are just some of the basic, preliminary questions to ask, before considering the option of filing for Federal Disability retirement benefits. The questions and answers themselves are simple; as one gets more and more involved in the process, they become, in combination, procedurally and substantively a complex issue of meeting the legal criteria for approval. Underlying it all is a simple conceptual basis; the complexity comes in applying the law.

Sincerely,

Robert R. McGill, Esquire