By Peter Casciano, Esq.
As we wind down to the close of another successful year at Andalman & Flynn, it’s natural for me to think generally about the cases we work on and any patterns that have developed. In the area of disability retirement benefits for federal employees (FERS and CSRS), I attempt to highlight here some key areas where I have noted claimants need to be careful:
Relying on your HR Department
While folks in federal human resources are largely trying to help their agency’s employees, the bottom line is that they simply don’t know much about how to win a disability retirement case. If you file your disability application while still employed, your application must be filed with your agency’s HR department. This is unavoidable. However, one should never rely solely on the advice received from their HR department regarding the sufficiency of medical evidence or how to fill out the medical portion of the application. That is beyond the HR department’s area of expertise and should be handled by you, your doctor and your lawyer.
Trusting OPM to make a Timely Decision
I have never worked on more Merit System Protection Board appeals regarding timeliness than I have this year. A common mistake claimants make is that they file the application, confirm OPM has it, and then do nothing. While it is true that OPM takes time to issue a decision and it is not advisable to harass them, regular follow-ups are always recommended. Too many times I seen where a claimant just sat and waited, the decision was issued but lost in the mail, and then OPM alleged that the claimant couldn’t appeal the decision because they waited too long. Regular follow-ups help to prevent these issues because if you can reach an OPM employee by phone, they can sometimes provide helpful information you need to know.
Don’t Assume Your Doctor Understands Federal Disability Retirement
There are many kinds of disability retirement, with Social Security Disability being the most common. Federal Employees have a special plan with specific rules. Please don’t meet with your physician and ask, “Am I disabled?” The doctor may not know the definition of disability applicable to you. Best practice is to consult with an attorney familiar with the written (and unwritten) rules applicable to federal disability retirement so that you can be prepared to discuss your situation with your doctor.
Try to Find Your Agency Documents
As part of every federal disability retirement application, your agency must fill out five documents regarding you and send them to OPM as part of your application. Your agency will rarely send these documents to you without your asking. They are critical to your case and how they are completed can make or break a claim. Try your best to track them down, review them, and correct them if need be.
Continue to Treat
This is easier said than done, especially with OPM’s long wait time. Many folks file their application and fail to continue to follow up with their physicians. This can be completely understandable for those who lose their health insurance coverage while their application is pending at OPM (a common and frightening occurrence). However, claimants must continue to follow up with their doctors diligently while their application is pending at OPM. The doctors must have a consistent treatment history with you so that they can help support the claimant through supplemental information or especially on appeal if the initial decision is a denial.
I hope this blog helps some claimants and would be happy to discuss in more detail if you contact me.
You may also be interested in:
- Federal Disability Retirement Applications for Deceased Claimants
- The Importance of Pre-Disability Earnings
- Social Security Administration Adopts New Rules to Make It Easier to Deny Applications for Disability Benefits