Have you recently applied for Federal Disability Retirement, only to receive a denial? The Office of Personnel Management (OPM) is denying more initial applications than ever. However, it’s important to understand that a denial does not mean the end of the road for your disability retirement claim; you have appeal options.
In this article, we’ll delve into some common reasons why Federal Disability Retirement applications are denied by the OPM, so you can better understand how to avoid these pitfalls and increase your chances of a successful claim.
1. An unclear prognosis:
When filling out the necessary forms, your doctor must have clearly stated that your condition is expected to last at least 12 months. Having a condition listed as “severe” or “long-term” does not clearly show the OPM that you will be disabled for the next 12 months. This may seem like a nitpicky reason for denial, as it should be clear that these words mean a person is unable to work, but the OPM wants everything to be as straightforward as possible.
Federal Disability Retirement is seen as a long-term benefit since it will last until you reach age 62, so the OPM wants to ensure your medical condition will last.
2. No doctor restrictions:
Medical restrictions are a crucial part of your application for disability retirement. Your doctor should clearly state any medical restrictions you have that will prevent you from performing your job duties. This will help prove that you have a service deficiency, which is a necessary requirement for Federal Disability Retirement. A service deficiency is any degradation in performance, attendance, or conduct at work. Having a service deficiency helps prove that your medical condition is negatively affecting your ability to perform your job. With this service deficiency, you must also prove that your medical condition is causing the deficiency. If your service deficiency is unrelated to your disability, that could have caused a denial.
3. Agency forms were filled out incorrectly:
Your agency must have filled out sections B, D, and E of the 3112 form. The OPM could have denied your application due to information that’s blank, incorrect, or contradictory to any other evidence included.
Section B of the 3112 is called the “supervisor’s statement,” which provides the agency’s perspective on your condition. This statement should accurately represent your condition and your restrictions, which means you need to have communicated with your supervisor about your medical condition before you apply for disability retirement. We often see supervisor statements that don’t talk about the full struggles of an employee, which can lead to a denial.
4. A lack of supporting documentation:
One reason your Federal Disability application was denied could be a lack of supporting documentation. Supporting medical documentation is one of the most important parts of your application. It’s crucial to include the right documentation that fully explains your medical condition and why you need your restrictions; provider statements, restrictions assessments, and functional capacity evaluations can all do this. Even if you include all the required documents and forms, it may not be enough.
5. Small application errors:
To be approved for Federal Disability Retirement, your application needs to be filled out completely and accurately. Small mistakes, like misspellings or wrong dates, can lead to a denial. Understanding and correctly filling out all the forms and documents can be stressful and confusing, especially when the weight of your financial future is weighing on your mind. This is why it’s recommended to have legal representation. Our team is here to do the legwork and take the burden of the application off your shoulders.
6. Failure to meet eligibility and qualification requirements:
Because there are a lot of eligibility and qualification requirements for Federal Disability Retirement, it’s easy to misunderstand them. To be eligible, you must be a FERS federal employee, you must have 18 months of creditable services, and you must have a medical condition that prevents you from performing at least one essential function of your job. In addition to these three prerequisites, there are 7 qualification requirements that you must meet as well. Falling short on any of these may result in a denial from the OPM.
These are just some of the many reasons why your Federal Disability Retirement application may have been denied. Knowing why you were denied – and exactly how to address the issue – can significantly strengthen your appeal. Letting an experienced legal team take the burden of your denial off your shoulders will give you the confidence you need to move forward.
Whether you’ve already been denied or are worried about receiving a denial, partnering with a firm that specializes in Federal Disability Retirement will help you confidently take the next step toward fully securing your benefits.
Give our office a call at 877-226-2723 to schedule a free consultation. Our consultants are here to evaluate your case – no matter what stage you’re in – and guide you toward a more secure future. We look forward to hearing from you!
