OPM Federal Disability Retirement Claims Processes

Sep 19, 2016

OPM Process

Filing for Federal Disability Retirement is often a lengthy and confusing process. Many Federal workers feel lost and don’t know where to start. This post will cover the process that The Office of Personnel Management (OPM) takes once it receives your application for disability retirement. The OPM has just 16 Legal Administrative Specialists (LAS) that review anywhere between 10,000-14,000 cases a year. That’s a lot! So generally speaking, there is usually a backlog of applications. This makes it all the more important to ensure you submit a complete and timely application for federal disability retirement.

OPM Acknowledgement Letter and Civil Service Account Number

OPM will send you an acknowledgement letter with information about your claim and your Civil Service Account (CSA) number, once they receive your application. Questions before receiving this acknowledgement should be directed to your employing agency. Contrary, questions you have after receiving this letter should be directed to the OPM. Make sure to have your CSA number available. You or your employing agency may be notified if additional information is needed.

Your case gets assigned to an LAS and that person makes a determination based on seven criteria. If your claim is found to meet all the following criteria, it is approved.

  1. You have become disabled due to a condition that resulted in a deficiency in performance, conduct, or attendance.
  2. Your medical condition is defined as a disease or injury.
  3. Your disabling medical condition must be expected to last for one year from the date you file your application for disability retirement.
  4. The relationship between your service deficiency and medical condition(s) must show that your medical condition caused your service deficiency.
  5. Your inability to render useful and efficient service began while serving under CSRS or FERS.
  6. Your employing agency was unable to make reasonable accommodation for your medical condition.
  7. You did not decline an offer of reassignment to a vacant position within your employing agency and commuting area at the same pay/grade level and tenure to which you are qualified.

*Also, remember to apply for Social Security Disability (SSD) as well. Although you do not have to be approved, this is a requirement when applying for Federal Disability Retirement. The OPM will need a copy of your receipt for your application for SSD or the decision letter.

Approval

Both you and your employing agency will be notified if your application is approved. At this point, your agency will be requested to separate you. They will need to send OPM your final retirement records and the actual date of separation.

Your file is sent to the Payment Processing Department, upon approval, where they will take your payment history in federal service to calculate your annuity benefits. They may also make the proper deductions for your insurance and spousal annuity, if necessary. Interim payments are designed to help financially until the OPM computes the exact amount of your annuity. These payments can be authorized after your application is approved, your agency has notified OPM of the date your pay stopped, and OPM has your receipt, or decision letter, from your application for SSD. Your benefits will then start accruing on the first day after your pay as an employee has stopped, and your disability and service requirements have been met.

Denial

If your claim is denied, both you and your employing agency will be notified, and OPM will provide you with information about your right to request a further consideration. If you choose to appeal the first denial (called a Reconsideration), you will have 30 days from the date of the denial letter for OPM to receive your application. Your application will be sent to a different LAS than the one who worked on your case in the initial stage. Be sure to include any new supporting documentation. If your claim is approved at this stage, it then follows the same process as if it were approved initially.

Should your claim be denied at the Reconsideration level, you will have one final chance of getting your claim approved. Again, you will have 30 days to appeal, but this time, your 30 days begins when you receive the denial letter. (Note the difference from the above paragraph) You will have to appeal to the Merit System Protection Board (MSPB). This is a more formal process and the OPM will assign an Administrative Judge to oversee the case. A house attorney will also be assigned to defend the denial decision.

*Something of note, the MSPB offers a way for you to file your appeal online. This can be very helpful when trying to meet a deadline, and they will send confirmation numbers through email. If you have access to email and are comfortable using computers, this may be a great option for you.

We, at Harris Federal Law Firm, have helped many federal workers through every step of this process. If you, or someone you know, is facing the reality of Federal Disability Retirement, feel free to give us a call at 877-226-2723 or fill out this inquiry form for a free consultation.

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