Introduction
Applying for federal disability retirement can be a complex and often stressful process. Facing a denial can be disheartening, but it’s crucial to remember that it’s not the end of the road. This article provides a comprehensive overview of the appeals process, outlining the steps involved and offering guidance to help you navigate this challenging time.
Understanding the Federal Disability Retirement Application Process
The federal disability retirement application process typically involves three stages:
1. Initial OPM Review
The first step involves submitting your application to the Office of Personnel Management (OPM). Current federal employees’ applications are first processed by their employing agency, while those separated for 31 days or more go directly to OPM. This initial review can take approximately 8-12 months. Approval at this stage is ideal, but if denied, you have the right to appeal.
2. Reconsideration
If your initial application is denied, you can file for reconsideration with OPM’s Boyers Disability Section. This request must be submitted within 30 days of receiving your denial letter. During reconsideration, you have three options: request a re-review of existing evidence, submit new evidence within 30 days, or request a 30-day extension to submit new evidence. It’s highly recommended to strengthen your case with additional documentation. A new medical specialist at the Boyers Disability Office will review your case, taking about 4-6 months.
3. Merit Systems Protection Board (MSPB) Appeal
If your reconsideration request is denied, you have 30 days from the denial date to appeal to the MSPB, an independent agency outside of OPM. The MSPB appeal process is quasi-judicial, meaning it operates like a court. You’ll be assigned a judge, and if your case proceeds to a hearing, it’s typically conducted telephonically or via video conference. You have the right to decide whether or not to have a hearing. The entire MSPB process, from filing to a judge’s decision, can take 6-8 months.
Understanding Interim Payments, Back Pay, and Insurance
Interim Payments
If your application is approved at any stage, you’ll start receiving interim payments while you await the finalization of your application. These payments are generally around 80% of your estimated monthly annuity and do not include deductions for health or life insurance.
Back Pay
Once your application is finalized, you’ll receive back pay for any annuity owed to you from the date you were eligible, typically your last day in pay status or separation date. Back pay usually arrives as a lump sum or in installments.
Insurance Reinstatement
If you were eligible and elected to continue your federal health insurance into retirement, your coverage will be reinstated retroactively with your finalized payments. This reinstatement allows you to recoup eligible out-of-pocket medical costs incurred during the period you were without coverage. However, keep in mind that premiums paid for private insurance plans obtained through the marketplace are typically not covered for reimbursement.
Seeking Legal Assistance
Navigating the federal disability retirement appeals process can be overwhelming. Seeking legal assistance from experienced attorneys specializing in federal disability retirement can significantly ease the burden and increase your chances of success. They can guide you through each stage, ensuring deadlines are met, applications are correctly filled out, and strong arguments are presented on your behalf. Most attorneys offer free consultations to discuss your case and determine the best course of action.
Conclusion
While a denial of your federal disability retirement application can be disheartening, remember that you have options. Understanding the appeals process and seeking expert guidance can significantly improve your chances of securing the benefits you deserve. Persistence and a thorough understanding of the process are key. Remember, you’re not alone in this journey, and resources are available to help you through every step of the way.