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Adding to the 10 Dos and Don’ts in filing for Postal Disability Retirement benefits with OPM

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It is always a good idea to review statements made, declarations asserted and advice given in spheres of influence, legal or not, just to ascertain the validity of what was stated in the past.  Then, if “updates” are necessary, or one can “add to” the value of past observations, such modifications may be fruitful and, more importantly, expand the knowledge previously gained.  The 10 dos and don’ts previously annotated in a prior article included:  Do not assume; Do not wait; Do respond affirmatively; Do ask outright of the doctor; Don’t count on bilateral loyally from the U.S. Postal Service; Do not believe everything the Postal Service tells you; Do provide a ‘totality of evidence’ approach in preparing a Federal Disability Retirement application; Do emphasize the credentials of your doctor; Do not act as your own lawyer; Do present your case in a streamlined, professional manner.  While those 10 dos and don’ts are still relevant and apply today, it is always wise to revisit and refresh the underlying rationale in following such dictates of guidance, and to add some more in preparing, formulating and filing an effective Postal Disability Retirement application, to be filed with the U.S. Office of Personnel Management.  Thus, some further Dos and Don’ts:

  1. Do become familiar with the basic criteria of Postal Disability Retirement. Your parents may or may not have emphasized the importance of doing your homework.  Such emphasis, now that you are older and wiser, should be applied when preparing one’s Postal Disability Retirement application for the U.S. Office of Personnel Management.  The basic eligibility criteria, of course, can be easily gleaned from OPM’s website:  for FERS employees, a minimum of 18 months of Federal Service and the existence of a medical condition that prevents the Postal employee from performing one or more of the essential elements of one’s Postal position.  As with all endeavors and administrative engagements, however, there is the initial, somewhat-superficial rules that apply; then, there are more “secondary” and detailed issues to identify and ascertain in gaining further knowledge of the process —  questions about accommodations and reassignment; of resignation as opposed to separation and termination; and whether you can work during the process, to what extent and for how long; and many further questions besides.  Basic familiarity is a given; detailed analysis is a must; complete understanding is recommended in preparing, formulating and filing an effective Postal Disability Retirement application.
  2. Do use the available law to your advantage.  The law can be used both as a sword as well as a shield.  If the former, it is utilized to advance your cause; if the latter, as a defensive mechanism to counter the aggressive parry of one’s opponent.  Preemptively use the law in guiding the U.S. Office of Personnel Management into approvbility Retirement application.  Anticipate the arguments that may arise; if the Postal Service is about to separate you from Federal Service for excessive use of SL or because you have been on extended LWOP, negotiate the terms of the termination in order to have the right to assert the Bruner Presumption.
  3. Do not necessarily believe what the Postal Service tells you.  In the previous formulation of the 10 Dos and Don’ts, the admonition was, “Do not believe everything the Postal Service tells you”.  Here, the slight twist is:  Do not necessarily believe what your agency tells you.  It may well be that the U.S. Postal Service is honest and forthright; that your Human Resource Office will provide you with the correct information, and even that they will “work” with you during this difficult time in your life.  However — and this is the caveat and the care that needs to be taken when relying upon an Agency’s direction and advice — when the Postal Facility begins to suspect that you will no longer remain as part of the “team” in pursuance of the Postal Service’s “mission”, your status as an outcast will be reflected in the selective information given and revealed.  As human nature is inherently one of a herd-mentality, it is best to take the approach of a well-known figure when considering information from a source that may no longer be looking out for your best interests:  trust, but verify.
  4. Do not wait until the last moment.  Again, this is a slight variation from the previous recommendation, which stated simply:  “Do not wait.”  Procrastination makes for unnecessary emergencies, and while medical conditions tend to take up all of the focus and energies needed just to get through a given day, the most effectively formulated Postal Disability Retirement applications are the ones that have been prepared with foresight, care and deliberative intent.  However, as life often interrupts the best-laid plans, so medical conditions have the tendency and effect of delaying the completion of multiple other facets of daily living activities, and so the following admonition is applied:  If you do not file on time, you will be precluded from making any arguments at all; if, on the other hand, you at least file before the deadline, you can always supplement later.
  5. Do be careful in completing the Applicant’s Statement of Disability.  Standard Form 3112A is the core and essence of a Federal Disability Retirement application.  The questions on SF 3112A appear to be simple enough, but the question that most people fail to ask and have answered is:  Are there legal consequences if certain questions fail to be answered in a particular manner?  The simple answer to such a query is:  Yes.  Many people believe that if you just list the major diagnosed medical conditions, gather up a few medical records that show that you have been medically identified to suffer from such conditions, package it all together and ship them over to the U.S. Office of Personnel Management, that somehow the bureaucratic process will recognize the seriousness of it all and grant you your Postal Disability Retirement benefits.  Good luck with that approach.
  6. Do be the gatekeeper of the information conveyed.  It is never a good idea to rely upon the good intentions of others, if only because one’s definition of “good” and that which constitutes “good intentions” can never be presumed.  As the burden of producing evidence sufficient to meet the legal criteria of “preponderance of the evidence” is placed upon the Postal Disability Retirement applicant, so the responsibility of that which is submitted can be determined by the Applicant him/herself, or his/her attorney.  Always review everything before it reaches its final “destination point” — the U.S. Office of Personnel Management.
  7. Do prepare each stage of the process as if it will require the next.  While it is true that each Stage of the Administrative Process called “Federal Disability Retirement” is unique, important and self-sufficient in and of themselves — and while we all hope that there will be no need to go to the “next” stage — nevertheless, a little bit of preemptive foresight is always a good idea.  The First Two Stages of the bureaucratic process (i.e., the Initial Stage of the application and the “Reconsideration” Stage of the process are both before the U.S. Office of Personnel Management, while the “Third Stage” of the process is an administrative appeal before a Judge at the U.S. Merit Systems Protection Board) may not require preemptively extensive legal argumentation, inasmuch as OPM’s “medical specialists” are not lawyers and care little about the governing law.  Nevertheless, making sound legal arguments is often a necessary pre-condition in preparing for the Third Stage of the Administrative process — before an Administrative Judge at the U.S. Merit Systems Protection Board — and it is a good idea to “prepare the groundwork” for that possible eventuality by arguing the major legal precedents during the first two stages of the process in anticipation of the possibility for appearing before the U.S.Merit Systems Protection Board.
  8. Do not unduly focus upon the details of a denial. Each Stage of the Postal Disability Retirement process is independent of the other, to a great extent.  The added “qualifier” — “to a great extent” — is meant to apprise all Postal Disability Retirement applicants, potential or otherwise, as to the practical impact of receiving a denial at the First, Initial Stage of the Process, or at the Second, Reconsideration Stage of the process.  Each stage is viewed de novo — as new, starting over again, etc.  Thus, to try and rebut point-by-point the rationale or reasoning of the First Stage OPM’s “Administrative Specialist” is somewhat of a waste of time, as the person who will be reviewing any newly-submitted evidence at the Second, Reconsideration Stage will not be relying upon the reasons for the denial propounded at the First Stage.  This is not to say that the Applicant shouldn’t consider the general reasons and specific rationales given as to “why” one’s Federal Disability Retirement application was denied at the First Stage — only that a “point-by-point” refutation is often an act of futility.  The same general rule applies to a Second, Reconsideration Denial — for, at that point, it becomes a “game-changer” in that the de novo process will be taken up in a completely different forum:  Before an Administrative Judge at the U.S. Merit Systems Protection Board.
  9. Do calculate time-frames on the “conservative” side.  Yes, yes, it does “say so” — that you have thirty (30) days from the date of the letter in which to respond to an Initial Denial, and 30 days from the date of a Reconsideration Denial to file an appeal with the U.S. Merit Systems Protection Board — or from the date you received the denial.  However, it is always a good idea to take the date of the letter and respond in a timely fashion using that date, instead of the more “flexible” date of when you received the Letter of Denial.  Perhaps it will seem “unfair” that there was such a lengthy delay between the date of the letter and the date you received the letter; however, as life is often full of unfair events, so this one should be viewed with a similarly dispassionate perspective.  As a general rule, that which can be ascertained as an indisputable fact (like the stated date on the denial letter) has the greater basis of reliance than one which can be later disputed (like the date one “received” the denial letter).
  10. Do not turn your responses into a personal vendetta.   Be professional about it.  It is sometimes difficult to provide a Reader’s Digest version of the history of the medical condition and be your own harshest editor, but understand that the central focus of the reviewing “specialist” at the U.S. Office of Personnel Management who will make the decision upon your Postal Disability Retirement application does not have the time, inclination or desire to sift through tangential and irrelevant meanderings in your Applicant’s Statement of Disability as reflected on SF 3112A.  Going on a tirade about how the Postal Service failed to accommodate you is not the issue; what attempted accommodations were provided and how they failed, might be — but only if stated in an objective, dispassionate manner.

Lists which purport to identify X-number of this or that rarely comprise an exhaustive compendium of the things that need to be done, and this list by no means accounts for all of the intricacies involved in preparing, formulating and filing an effective Federal Disability Retirement application, to be submitted ultimately to the U.S. Office of Personnel Management.  Indeed, here’s another “Commandment” that should be followed:  Do not try to be your own lawyer.  Law is a peculiar animal; its technical nature and complexities often challenge the best of us, but more importantly, legal principles tend to have tentacles that reach beyond a simple understanding gleaned from a synopsis discovered on the Internet, whose source has not been ascertained and where validity is questionable.

Postal Disability Retirement is a specialized area of law that cannot easily be condensed into an abbreviated list of 10 dos and don’ts, but these Ten Principles listed herein, in addition to the previous ones discussed in a prior article, may provide some useful “tips” in preparing, formulating and filing an effective Postal Disability Retirement application with the U.S. Office of Personnel Management.  The operative concept here, of course, is encapsulated by the word “effective” — for, why else would you expend your time, effort and resources in applying for a benefit which must be proven by a preponderance of the evidence, unless it has become a necessary contingency leaving little choice in the matter?  Effectiveness is gained not by chance or unplanned circumstances, but by taking a deliberative approach in preparing, formulating and filing based upon knowledge and gained wisdom, and the principles underlying any efficacy of endeavors must always begin by knowledge gleaned from past experiences, or from a lawyer who is experienced in such matters.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement for U.S. Postal Service Employees – The Needed Proof

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Postal Service employees often feel that they are second-class citizens – both in terms of their status and stature as a “Federal employee” who is under either the Federal Employees Retirement System (FERS) or (for those lucky ones who are quickly diminishing in numbers but who were able to enter the Federal workforce prior to the 1986 transition) under the Civil Service Retirement System (CSRS); and in terms of pay scales and discussions in Congress related to bloated budgets, inability to become profitable, etc.

For Postal employees who are considering filing for Postal Medical Retirement under FERS or CSRS, the question is often queried as to whether the U.S. Office of Personnel Management treats Postal employees differently than non-Postal, Federal employees.   Whether there is any empirical evidence of discriminatory intent on the part of OPM against Postal employees who file for Federal Disability Retirement benefits, is essentially a non-starter.  For, in the end, each case must be decided on the unique quality and extent of the medical documentation compiled.   Further, one cannot compare and contrast differentiated groups lumped by “Postal” as opposed to “non-Postal”, precisely because the uniqueness of each Federal Disability Retirement case is characterized by the medical condition itself; the type of job and positional duties undertaken by individual X who suffers from the medical condition; and the extent, severity and chronicity of the medical conditions in relation to the duties.

With literally hundreds of Federal agencies, and thousands and tens of thousands of differing types of jobs, one cannot aggregate a generic “Postal Worker” and compare it to a compounded composite of “other Federal workers”.  Thus, it is a wrong question to ask.  Instead, the proper question to ask would be:  Given a Postal Worker who is in craft-X, who suffers from medical condition-Y, is there a greater incidence of denials from the U.S. Office of Personnel Management of Postal Workers who file for Federal Disability Retirement benefits, and if there is a greater proportional aggregate of denials as compared to the total number of denials, is there a valid reason for such disproportionate treatment?

In other words, it would be – on its face – incomparably unfair to compare an IT Specialist with the Department of the Navy, who suffers from severe Major Depression and anxiety, to a City Letter Carrier who suffers from status-post cervical discectomy and fusion, precisely because of the type of medical condition involved, and the positional requirements of both.  Further, are there inherent factors within the U.S. Postal Service which can account for any disparate treatment (if we proceed on the assumption that there even exists such differentiation of reviewing and deciding Federal Disability Retirement applications filed by Postal Workers, as opposed to non-Postal, Federal employees)?   The answer is, Yes.

The Postal Service has for years been identified with the notoriety of refusing to accommodate their workers.  Whether in association with OWCP and the Department of Labor, where workers are sent to “second opinion” doctors and “referee” medical facilities in an effort to get people off of the rolls of OWCP and back to full duty; or in conjunction with the National Reassessment Program where an across-the-board infrastructural policy was implemented stating that no accommodations were available for those craft employees who could no longer perform all of the essential functions of one’s job, and that no medical restrictions or limitations would be henceforth honored – a maneuver meant to get rid of all Postal employees who were not fully functional in their jobs – the approach of the U.S. Postal Service in attempting to regain a competitive edge was to try and get rid of anyone and everyone who suffered from a medical condition such that the medical condition prevented the employee from performing all of the essential elements of one’s job.  One might think, upon first considering that approach, that such a maneuver by the U.S. Postal Service would increase the chances for getting a Federal Disability Retirement application approved – for, by conceding that the injured craft employee cannot perform any jobs at the U.S. Postal Service, the assumption would be that such a concession would be evidence for the U.S. Office of Personnel Management, as well as the Federal Disability Retirement applicant, that one is qualified because of the self-admission by the Postal Service, for Federal Disability Retirement benefits.

The problem is twofold:  First, the U.S. Office of Personnel Management is a separate agency from the U.S. Postal Service, and applies a legal criteria which gives scant attention to what the Postal Service thinks, does, or acts upon; and Second, evidence of what the U.S. Postal Service decides – while of somewhat dubious impact and persuasive authority – is ultimately not what makes a Postal Disability Retirement applicant eligible for Postal Disability Retirement benefits.

Indeed, look, for example, beginning with some older precedential cases such as Wilkey-Marzin v. OPM, 82 M.S.P.R. 200 (1999) – where  the Merit Systems Protection Board found that in order to determine a disability retirement in favor of an appellant,  there must be a showing beyond uncorroborated subjective evidence, and provide a “reasoned explanation” of the origins of the disabilities, and how it is disabling with respect to one’s specific duties.  In providing some guiding principles, the Board noted that the Judge should consider the following evidence: (1) objective clinical findings; (2) diagnoses and medical opinions; (3) subjective evidence of pain and disability; (4) evidence relating to the effect of the applicant’s condition on his ability to perform in the grade or class of position last occupied (see also Dunn v. Office of Personnel Management, 60 M.S.P.R. 426, 432 (1994) ).  Note that nowhere in the four (4) guiding principles is there an indication that what the agency does or doesn’t do, should be of primary consideration.  This is not to say that the issue of accommodations will not be relevant; and, certainly, one can argue that an NRP-based decision of refusing any work, or the dreaded “DRAC” (the so-called District Reasonable Accommodation Committee) determination of “no work available”, cannot be effectively used; but the primary focus in a Federal Disability Retirement case, from the viewpoint of the U.S. Postal Worker, should be to prove one’s case based upon the medical documentation, and not rely upon anything which the Postal Services does or doesn’t do.

In the end, if there has been an increase in the number of Federal or Postal Service Disability Retirement applications, in proportional numbers as compared between “Postal Workers” and any other single Federal Agency of the U.S. Government, it may be because of such unreasonable and uncompromising positions taken under the NRP, the DRAC decisions or in conjunction with OWCP claims.  For, when a determination is made that an agency (in this case, the U.S. Postal Service) will refuse to in good faith attempt to accommodate injured employees, such an intransigent policy will quite obviously increase the numbers of applications to obtain Federal Disability Retirement benefits.  But reliance upon what the agency does, without solid medical evidence to prove, by a preponderance of the evidence, that the Postal Worker is eligible and entitled to Federal Disability Retirement benefits, is to run a fool’s errand.  Postal Service employees have had to face multiple obstacles over the years, both in economic downsizing and frozen pay structures; and the decision to shed its workers from within because of medical conditions is merely an indication of the heart and soul of the Postal Service – not necessarily any evidence which would qualify the Postal Worker for Federal Disability Retirement benefits.  For that, one must affirmatively go out and compile one’s case, and use such evidence of the NRP as merely a secondary, peripheral evidence.

Sincerely,

Robert R. McGill, Esquire

 

Federal Disability Retirement benefits for Postal Employees: The OWCP Option versus OPM

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The National Reassessment Program’s (NRP) primary option for Postal employees who are not “fully productive” (interpretation:  anyone who cannot perform the full panoply of all of the essential elements of one’s job) is for the Postal employee to file for OWCP benefits.  A letter from the NRP will allegedly state that they have searched for all available work and have concluded that the Postal Service is unable to accommodate the Postal employee based upon the medical conditions identified.  The option:  file for benefits from the Department of Labor, Officer of Workers’ Compensation Programs.

Complacency allows for a period of peacefulness and peace of mind.  The operative concept (and critical juncture of concern) is that such peace of mind exists “for a period” of time.  OWCP compensation – designed as a mechanism to allow for a Postal employee to recuperate from an injury or a medical condition incurred while “on the job” or during the course of performing his or her occupational duties – is primarily meant for a temporary period of time.  Thus, TTD (temporary total disability) payments are made to Postal employees during the time of medical treatment and temporary disability, with the goal being that the Postal employee will return to work.  Further, compensation for the permanent disability suffered (identified as a “scheduled award”) is determined once a Postal employee has reached “Maximum Medical Improvement”, and when a percentage disability rating can be ascribed to an individual.  The paradigm of OWCP is therefore based upon the projected conceptual framework that it is temporary, compensatory for a set period of time, in order to allow for the eventual return of a Postal worker to his or her craft duties.

The reality of the situation, of course, is that many Postal workers in every craft imaginable – Letter Carriers (Rural or City), Mail Handlers, Mail Processing Clerks, Maintenance Workers, Sales, Service & Distribution Clerks, etc. – can be placed (and have been placed) on OWCP rolls and often “forgotten” for years, and sometimes decades (note the plural).  Such long-term payments, generous by some standards (75% of the gross salary for those with dependents; 66 2/3% for those without), can lead to a sense of complacency and comfort.

The problem with complacency and comfort, however, is that a Postal Worker can remain on the rolls of OWCP, receive the “temporary total disability” payments for years and years, and suddenly be informed that he or she is no longer disabled, has recovered, and therefore is no longer entitled to OWCP compensation. Perhaps the Postal Worker is directed to undergo an “Independent Medical Examination” – identified, compensated by, and directed to, by the Department of Labor, Office of Workers’ Compensation Programs – to determine the feasibility of going back to work, and to establish the extent of the disability (if any).  Suddenly, the Postal worker who has enjoyed the complacency of being on the OWCP rolls for these many years sees a sudden termination of benefits.  Yes, there are appeal procedures.  Yes, there are recourses and the right to have a “referee doctor” make a further determination.  But after months of such appeals (during which time the former Postal Worker has received no compensation), while reinstatement of TTD benefits may become a reality, one often realizes that OWCP is not a permanent solution – precisely because it was never designed or meant to be such.

The further option that every Postal Worker must consider, of course, is to prepare, formulate, and file for Post Office Disability Retirement benefits under either FERS or CSRS, from the Office of Personnel Management.  This can be done concurrently with receiving and being on the rolls of OWCP – by filing for Federal Disability Retirement benefits, then opting to stay on OWCP and placing the approved Federal Disability Retirement annuity into an “inactive” status – as a back-up system in the event of termination of OWCP benefits.

The problem of complacency in receiving OWCP benefits is that there are too many Postal Workers who are unaware of the distinction between OWCP and OPM Disability Retirement.  The mere fact that OPM Disability Retirement pays less than OWCP benefits is not a reason not to file – if not to replace OWCP benefits, then to at least obtain them as a back-up to OWCP.  Failing to file for the benefits in a timely manner results in foregoing – forever -the right to file for such benefits.  At some point, Postal Workers on the rolls of OWCP become “separated from Federal Service” – meaning thereby that the Postal Service takes the Postal Worker off from the rolls, stops sending the “0-balance” paystubs, and issues a PS Form 50 of generating an administrative personnel action separating the Postal employee from the U.S. Postal Service and the Federal Service.  At that point of separation, the Postal Worker has 1-year to file for Federal Disability Retirement benefits under either FERS or CSRS, from the Office of Personnel Management.  Failure to file within that 1-year timeframe results in abdicating a right to ever file.  Then, many years later, when that letter arrives from the Department of Labor directing the Postal Worker to undergo an “Independent Medical Examination” by a doctor who seemingly is a Fellow and Member of every qualifying medical association, and is compensated by OWCP for his time and energy – the Postal Worker’s concerns about possible termination of benefits will not only become a reality, but a potential financial crisis.

Further, if a Postal Worker wants to work at another job, one who is on OWCP is unable to do so.  On the other hand, those who receive a Federal Disability Retirement annuity from the Office of Personnel Management are, under the law, allowed to go out and make up to 80% of what one’s former Postal job currently pays – on top of the Federal Disability Retirement annuity one receives.  Thus, while OWCP payments often engender complacency, there is a built-in incentive to the Postal Worker to prepare, formulate, and file for Federal Disability Retirement benefits from the Office of Personnel Management – and then to start a second career, while having the time on disability retirement count towards the total number of years of Federal Service, so that when the disability annuity is recalculated at age 62 and converted to regular retirement, the time on disability retirement is counted.

These are all factors which must be thoughtfully considered.  Whatever the decision made, a Postal employee who fails to understand the distinctions between OWCP and OPM Disability Retirement may rue the day sometime in the future – far or near, one never knows based upon the capricious whim of the Department of Labor, Office of Workers’ Compensation Programs – when that termination letter arrives in the mailbox.  All options should be considered, and preparing, formulating and filing for OPM Disability Retirement benefits is an option which should not only be “considered”, but concretely filed for.

 

OWCP, the Postal Service and the National Reassessment Program

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For many years, being on Worker’s Comp when injured while working for the Postal Service, worked fairly well. The Postal Service, in conjunction with, and in coordination, would offer an acceptable “light duty position”, delineating the physical restrictions and medical limitations based upon the treating doctor’s clinical assessment, or in accordance with the OWCP-appointed doctor. The Postal employee would then work in that “modified position”, and so long as the Postal Supervisor or Postmaster was reasonable (which was not and is not always the case), the coordinated efforts between OWCP, the U.S. Postal Service and the Postal employee would result in years of “quiet truce”, with the tug and pull occurring in some of the details of what “intermittent” means, or whether “2 hours of standing” meant two hours continuously, or something else – and multiple other issues to be fought for, against, and somehow resolved.

The rules of the game, however, have radically changed with the aggressive National Reassessment Program, instituted in the last few years in incremental stages, nationwide. Now, people are summarily sent home and told that “no work is available”. Postal Workers are systematically told that the previously-designated modified positions are no longer available — that a worker must be fully able to perform all of the essential elements of his or her job. This last point, of course, is what I have been arguing for many, many years — that the so-called “modified job” was and is not a permanent position, and is therefore not a legal accommodation under the laws governing Federal Disability Retirement for FERS & CSRS employees.  After so many years of having the Post Office and the Office of Personnel Management argue that such a “modified job” is an accommodation, it is good to see that the truth has finally come out.

Sincerely,

Robert R. McGill, Esquire