APPLYING FOR OPM DISABILITY RETIREMENT
A federal employee seeking medical retirement under the Federal Employees Retirement System (“FERS”) or Civil Service Retirement System (“CSRS”) has the burden of establishing the essential elements of his or her claim. Before the Office of Personnel Management will approve an application for medical retirement, five criteria must be met:
1. The individual must have completed sufficient creditable service under FERS or CSRS.
2. The individual must, while employed in a position subject to FERS or CSRS, have become disabled because of a medical condition, resulting in a service deficiency in performance, conduct, or attendance, or if there is no actual service deficiency, the disabling medical condition must be incompatible with either useful and efficient service or retention in the position. Useful and efficient service means (i) acceptable performance of the critical or essential elements of the position; and (ii) satisfactory conduct and attendance.
3. The disabling medical condition must be expected to continue for at least 1 year from the date the application for disability retirement is filed.
4. The employing agency must be unable to accommodate the disabling medical condition in the position held or in an existing vacant position.
5. An application for disability retirement must be filed with the Office of Personnel Management (OPM) before the employee separates from service, or within 1 year thereafter.
FERS Eligibility Requirements
- You must have completed at least 18 months of Federal civilian service which is creditable under the Federal Employees Retirement System (FERS).
- You must, while employed in a position subject to the retirement system, have become disabled, because of disease or injury, for useful and efficient service in your current position.
- The disability must be expected to last at least one year.
- Your agency must certify that it is unable to accommodate your disabling medical condition in your present position and that it has considered you for any vacant position in the same agency at the same grade or pay level, within the same commuting area, for which you are qualified for reassignment.
- You, or your guardian or other interested person, must apply before your separation from service or within one year thereafter. The application must be received by either OPM or your former employing agency within one year of the date of your separation. This time limit can be waived only if you were mentally incompetent on the date of separation or within one year of this date.
- You must apply for social security disability benefits. Application for disability retirement under FERS requires an application for social security benefits. If the application for social security disability benefits is withdrawn for any reason, OPM will dismiss the FERS disability retirement application upon notification by the Social Security Administration.
CSRS Eligibility Requirements for CSRS Disability
- You must have completed at least five years of creditable Federal civilian service.
- You must, while employed in a position subject to CSRS, have become disabled, because of disease or injury, for useful and efficient service in your current position. (Useful and efficient service means fully successful performance of the critical or essential elements of the position-or the ability to perform at that level-and satisfactory conduct and attendance.)
- The disability must be expected to last at least one year.
- Your agency must certify that it is unable to accommodate your disabling medical condition in your present position and that it has considered you for any vacant position in the same agency, at the same grade or pay level, and within the same commuting area, for which you are qualified for reassignment.
- You, or your guardian or other interested person, must apply before your separation from service or within one year of your separation. The application must be received by OPM within one year from the date of your separation. This time limit can be waived only in instances involving incompetency.
Common Deficiencies in OPM Disability Retirement Applications
- Incomplete medical documentation; e.g., (copies of diagnostic tests and/or reports are not submitted).
- Medical documentation is limited and does not contain specific information to show why the applicant is not able to perform his/her duties nor how long restrictions will last.
- Medical opinions are conclusory rather than giving specific rationale that explains how the medical condition impairs the applicant.
- Medical reports reference enclosures that are missing.
- Medical reports are not signed, dated, and/or on physician’s letterhead.
- Agency physician recommendations (when made) regarding disability are not well documented, e.g., summary statement made with no documented basis for the recommendation.
- Agency certification of reassignment and accommodation efforts is incomplete (e.g., reassignment or accommodation efforts are completed but not both; attempts to assist the applicant with his/her medical/psychological problems are not documented). Also there is no explanation of why reassignment and/or accommodation is not possible or cannot continue.
- Information on the supervisory statement is in conflict with information on agency accommodation/reassignment form.
- Supervisor’s statement is incorrectly filled out (blocks are left blank, e.g., hours of leave used, and/or information regarding proposed personnel actions are not submitted).
- Supervisor’s statement paraphrases medical report rather than saying what effect the medical condition has had on the applicant that has been observed by the supervisor and/or co-workers.
- Copy of the position description is not included in package.
If you’re considering OPM disability retirement, you should contact OPM Disability Retirement Attorney Gregory A. Hall for legal assistance. If you retain Mr. Hall to assist with your application for benefits, he can help you avoid many of the pitfalls that cause applications for medical retirement to be denied by OPM.