With the morass of information available regarding the myriad and complex angles of the Federal Disability Retirement process, it’s easy to get overwhelmed and sidetracked from the real question: Am I Eligible?
To answer to this straightforward query, let’s explore the seven eligibility criteria to assess how likely it is that your application will get approved:
Eligibility Criterion #1: You became disabled because of a medical condition which resulted in a service deficiency in performance, conduct, or attendance.
A service deficiency means that your performance, attendance, or conduct is less than fully successful and is of sufficient degree that does not allow you to perform useful and efficient service* in (a) your current position, or (b) a vacant position in the same agency at the same grade or pay level and tenure for which you are qualified for reassignment.
- *Useful and efficient service means fully successful performance of all the critical or essential elements of the position (or the ability to perform at that level) with satisfactory conduct and attendance.
- If there is no such service deficiency, your disabling medical condition must be incompatible with either useful and efficient service or retention in your position.
While this may sound complex, it simply means that you need to do the following:
- Establish with medical evidence that you have a medical condition that is at a level to be considered disabling. In this instance, “disabling” is generally defined as a physical or mental impairment that substantially limits one or more major life activities (such as driving, sleeping, hearing, walking, standing, lifting, bending, reading, concentrating, communicating, caring for oneself, and of course working.) Note: if you’ve already been separated from federal service, you need to show that the condition became disabling before the date of your separation.
- Establish that you have a service deficiency in performance, attendance, or conduct. The ideal way to achieve this is to provide a recent unsuccessful performance appraisal to prove performance deficiency. For attendance deficiency, you can show leave reports indicating excessive leave with documented emails or memos from a supervisor that demonstrates hardship on the agency due to your leave. For conduct deficiency, you can provide any reprimands, notices of discipline or such that indicate your conduct is intolerable for your position.
- If there is no evidence of any service deficiency (perhaps you’ve been on FMLA during the time your condition progressed to a disabling level, or perhaps your supervisor is not documenting your failings, etc.) you need to prove that your disability is simply incompatible with your job. Note: Again, if you’ve already been separated from federal service, you need to show that your medical incompatibility existed prior to your separation date.
- Your SF 3112B that your supervisor is required to complete for your disability retirement application can be the best evidence for this when he/she endorses a service deficiency.
Eligibility Criterion #2: You have a medical condition that is defined as a disease or injury.
You want to show evidence that your doctor, or other medical professional, diagnosed you with a condition found in the International Statistical Classification of Diseases by the World Health Organization. In other words, your medical records should list a formal diagnosis with a corresponding ICD code.
Eligibility Criterion #3: The relationship between your service deficiency and your medical condition(s) must show that your medical condition caused your service deficiency.
Assuming that:
- you’ve established that you have a disabling medical condition, AND
- you’ve established that you have a service deficiency,
You need to show proof that your service deficiency has been directly caused by your disability. For example, if you have bipolar disorder and have been written up for consistent work errors, perhaps you can show how your FMLA paperwork and office visit records list side effects of your medication as cognitive difficulty, inability to concentrate or perform analysis, or such. Or perhaps you are experiencing pain to such a degree that it impairs your concentration, and you also experience pain-induced insomnia, which further exacerbates your inability to perform the cognitive functions of your job.
Eligibility Criterion #4: Your disabling medical condition is expected to continue for at least one year from the date you filed your application for disability retirement.
You will need to produce evidence that you have done your due diligence as far as standard treatment via medication and/or therapy, and your medical prognosis does not give hope for a sufficient recovery within 12 months of the submission of your application. If such a prognosis is not clearly gleaned from existing medical records, have your doctor write such a statement and sign it.
Eligibility Criterion #5: Your inability to render useful and efficient service began while serving under CSRS or FERS
You need to show evidence that at the time you were hired as a federal employee, you were able to perform your job, and that your medical state was compatible with your job. One way this can be accomplished is by showing successful performance appraisals from that time.
If you were diagnosed with the condition for which you are claiming disability prior to your induction to federal service, you need to show that the condition was not yet disabling at the point of hire, and only became exacerbated to a disabling level at a later point during your federal employment.
Eligibility Criterion #6: Your employing agency was unable to make reasonable accommodation.
You need to show that you either made effort to request reasonable accommodation and were denied by your agency (and you cooperated with any request from them to provide medical evidence so that they can potentially approve your accommodation request – not that you were denied due to your negligence), OR:
You made effort to request reasonable accommodation, but the accommodations you were provided with were insufficient; AND/OR:
There are no accommodations that exist that could possibly allow you to perform your job or provide sufficient service. Such a claim is best accepted when bolstered by a signed statement from your medical professional.
The certified SF 3112D that your agency is required to complete for your application can be the best evidence for this, when your agency endorses that they were unable to accommodate you due to the severity of your medical condition.
Eligibility Criterion #7: You did not decline an offer of reassignment to a vacant position within your employing agency and commuting area at the same grade or pay level and tenure for which you are qualified.
You need to ensure that if, after it became clear that you would be unable to be accommodated, you did not refuse an offer to be reassigned, and you need to ensure that you cooperate with the search for a vacancy if your agency initiates one.
Some things to keep in mind: If you have been offered a reassignment to a job that meets your medical requirements, but is either in a different agency, commuting area or will provide a lower salary, you can decline the offer and still be potentially eligible for OPM Disability Retirement.
If your agency has never approached you with an offer of reassignment, it logically follows that you never declined any offers of reassignment and would still meet this criterion. Meaning, you aren’t obligated to specifically request reassignment to remain eligible for disability retirement.
Cyril Dubin works exclusively with federal employees to prepare their FERS Disability Retirement application. With her years of experience and fine-tuned process, she aims to make the experience smooth and stress-free. Reach out to Cyril at cyril@kaldisability.com or visit the FERS Specialists website.
