Any disability claim relies on a comprehensive medical chart review that can establish the disability and ensure the benefits are paid to a deserving candidate. Given the complexity of the review process, attorneys handling such cases find medical review services very helpful. Whether you are applying for social security disability or federal disability retirement, supporting medical documentation is essential. In this blog we will look at the federal disability retirement program and its important features.
Federal disability retirement is supervised by the U.S. Office of Personnel Management (OPM), a federal agency; it is a benefit provided to all federal and postal employees under the Civil Service Retirement System (CSRS) and Federal Employees Retirement System (FERS). To qualify, CSRS employees must have a minimum of 5 years of service and FERS employees must have a minimum of 18 months of service. This program is different from social security disability in that to obtain social security disability the criteria is “total disability” whereas for this program a person need only be disabled from performing one or more of the essential elements of his/her particular kind of job.
- The condition must be expected to continue for at least one year from the date of application
- The employer must be unable to accommodate the disability in the particular position held or in an existing vacancy at the same grade/pay level and tenure in the same commuting area
- The applicant must not have declined an offer/reassignment to such a position.
It is important that the Federal Disability Retirement Application is submitted with careful preparation.
An important thing to note is that to obtain disability retirement benefits, your injury doesn’t have to be a job-related one – in this way it differs from workers’ compensation benefits wherein the injury must be job related.
What documentation does the OPM want to determine eligibility? The agency will focus on documentation of the following.
- The medical condition, disease or injury
- Deficiency in conduct or attendance and performance
- A relationship between the condition and the inability to perform the job
- The duration of the medical condition both past and present
- Proof that the applicant cannot perform useful and efficient service in that job position
- The lack of another position within the employing office and commuting area at the same pay level/grade and tenure for which the employee is qualified for reassignment.
Diverse conditions, injuries, and diseases require different documentation. The documentation must enable the OPM to determine that the condition exists. This is where a detailed medical chart review and medical report becomes essential.
When to file the disability retirement application? Ideally, the employee must file as soon as he/she knows that the disability will last for at least one year. An employee terminated or separated from federal service has only up to one year to file for disability retirement, failing which they will forego their right to disability retirement forever.
Applicants who receive an approval from the OPM can collect disability retirement and also work at a different job and earn up to 80% of what his or her former position pays at present.
Sometimes the OPM may deny the disability application, in which case, the applicant can request reconsideration. Instructions regarding how to make the request will be provided by the OPM. After reviewing the request, the OPM will notify the applicant and his/her employing office regarding the final decision. If the OPM’s final decision is also to deny the claim, the applicant can file an appeal with the Merit Systems Protection Board.
A common doubt many people have is whether they need to file for social security if they apply for disability retirement. Employees under FERS are required to file for social security disability during the application process whereas CSRS employees need not file for social security. Social security may be filed after a person’s disability retirement application has been approved and the person has been separated from service.
Just as for social security disability, an experienced lawyer can provide the right guidance for applicants. A good lawyer would review the medical evidence, typically using quality medical review solutions, to determine its legal sufficiency in support of the applicant’s disability retirement application. Lawyers will help to compile all required documentation, and also assist with request reconsideration in case the OPM denies the application. They will also help the applicant appeal to the U.S. Merit System Protection Board (MSPB) if the OPM’s final decision is also an unfavorable one.