Granted Social Security Disability but Denied FERS/CSRS Disability Retirement?

I have heard from a lot of Federal employees and postal workers that they have been approved for Social Security disability but later denied Federal Disability Retirement under FERS or CSRS by the Office of Personnel Management (OPM).  This can be very confusing to the federal employee or postal worker; after all, how can 2 Federal Agencies reach seemingly contradictory conclusions.

This article will attempt to explain how this might happen – and what the Federal employee or Postal worker can do about it.

First of all, contrary to some advice you may receive, an award of Social Security disability benefits does not require an award of Federal Disability Retirement to a federal employee or postal worker.

The biggest reason that you might receive different decisions – a grant of Social Security disability but not Federal disability retirement under FERS or CSRS (or vice versa) – is because the legal standards for the two types of disability claims are different.

Generally, a Social Security disability applicant need only prove that he or she is unable to engage in any "substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months".  That's a mouthful - boiled down, to be eligible for Social Security disability, the Federal employee or postal worker must not be able to perform any gainful work due to a medical condition that will last at least 12 months.

On the other hand, a Federal Disability Retirement applicant needs to prove that he or she is unable, because of disease or injury, to render useful and efficient service” in his current position and does not qualify for accommodation or reassignment.  This is a little easier to understand.  For FERS/CSRS disability retirement, a postal worker or Federal employee need only be unable to work in their current job because of a medical condition.

It is hard to imagine a medical condition that qualifies a federal employee or postal worker for Social Security disability benefits but does not qualify that same individual for Federal Disability Retirement under FERS or CSRS.  The Social Security definition of disability includes an inability to perform any gainful activity while the FERS and CSRS definition includes an inability to perform useful and efficient service in only your current job.

For this reason, in any federal disability retirement application or appeal, both OPM and the MSPB must consider an award of Social Security disability benefits. Where most federal employees or postal workers go wrong is when the OPM or the MSPB concludes that the evidence of a Social Security disability award is outweighed by inconsistent and inadequate medical evidence in the Federal Disability Retirement application.

In most situations where a federal employee or postal worker is awarded Social Security disability but denied Federal Disability Retirement, the issue comes down to the objective nature of the medical evidence and what it says (or, more importantly, what the medical evidence doesn’t say).

If your medical evidence does not show your doctor’s objective reasoning as to how certain aspects of a particular medical condition render you unable to perform specific work requirements, then OPM and the MSPB may be able to successfully conclude that your medical evidence is inadequate to support a grant of Federal Disability Retirement - even though you are getting Social Security Disability for the same condition(s).

Additionally, if your medical evidence shows that you did not comply with a doctor’s orders for treatment that might have controlled the medical condition and allowed you to keep working, then OPM and the MSPB could deny your federal disability retirement claim, even though Social Security has approved you for disability retirement.

What does the Federal Employee or Postal Worker do to fix this problem?

Step One: Doctor's reports and statements.

First, when you apply for Federal Disability Retirement, make sure that your doctor reviews your Federal or Postal position description and explains how the condition you have prevents you from performing the specific duties in that position description.  Make sure the doctor states in writing that he reviewed and considered that position description.  As always, an explanation, not a statement, is essential.

Step Two: Supplement the record on Reconsideration.

Second, when OPM denies your application for Federal Disability Retirement because your medical evidence doesn’t objectively reason how your condition prevents you from performing your duties, supplement the record with a reasoned explanation from your doctor at the reconsideration stage.

Step Three: Secure your doctor's testimony.

Third, when you are appealing to the MSPB, call the doctor to testify as to how your condition prevents you from performing the duties of your current federal or postal position.

Step Four: Make sure OPM and the MSPB have a copy of the letter granting you social security disability.

Fourth, always provide a copy of the Social Security decision granting you disability.  There may or may not be a need to give your entire Social Security Disability application and supporting medical documentation to the OPM or the MSPB - you should always consult with a federal disability retirement lawyer before giving too much (possibly irrelevant) medical information to OPM or the MSPB.

None of those four steps guarantees you will be granted Federal disability retirement, or perfectly protects you from an MSPB finding that while approved for Social Security Disability, you are not entitled to Federal Disability Retirement.  However, following the above steps is the best way to attack OPM's denial throughout the process.

More info: Federal Disability Retirement Lawyer