Will my medical condition be accepted for the OPM disability pension?


OPM disability retirement requirements can be confusing. You may have read everything you can find about this benefit and still wonder, “Will my medical condition be accepted by the OPM?” »

OPM Disability Retirement gives you the opportunity to retire early, while receiving a secure monthly pension, health and life insurance, creditable years of service, and the ability to work outside the federal sector. This is a life changing benefit and it is important to know whether or not you will be able to receive it depending on your condition.

The good news is that OPM does not have a fixed list of disabilities eligible for OPM Disability Retirement. If your condition affects your ability to do your particular federal job, and you have enough medical evidence to prove it, you could potentially qualify for this benefit.

Defining disability

The OPM’s definition of disability differs from the definition of disability under other laws like the ADA and Social Security disability.

According to the OPM, disability is any medical condition that prevents an employee from continuing to complete at least one of the main functions of their running position.

OPM Disability Retirement is only looking for occupational disability and not total disability. So all you have to do is prove that you can no longer work in your current federal job, not just any job. Keep in mind that your disability does not have to be work-related, but must last for at least one year.

For example, a USPS mailman tears a rotator cuff while playing football with his child. Their doctor says their injury should last at least a year. As a USPS factor, they are expected to lift at least 70 pounds. Since they tore a rotator cuff, if they are now unable to lift that amount, which could qualify them for OPM disability pension.

Types of disabilities

There are many different types of disabilities, but they are generally divided into mental and physical disorders. These disabling conditions may be pre-existing, but to be approved for OPM Disability Retirement you must show that they worsened while you were in your FERS position after a period of useful and effective service.

When determining whether an employee seeking disability retirement is capable of performing useful and efficient service, the MSPB will consider whether the employee is a danger to themselves or others. See Thorne v. Office of Personnel Management, 107 LRP 15380, 105 MSPR 171 (MSPB 2007).

Your incapacity must result in a professional incapacity, which is important to distinguish from a situational incapacity. A situational disability is only a problem because of your current situation and if resolved, you would be able to perform the essential functions of your job.

For example, you have a colleague who is causing you extreme anxiety and it is affecting your ability to work. If that co-worker is fired or you are transferred to another location and you are now able to complete your work without a problem, this is considered a situational disability.

It is often more difficult to prove that your mental condition is an occupational disability as opposed to a situational disability, so it is important to know the difference and know how to support your case.

Physical conditions

Physical conditions affect your body and your physical ability to do your job. Physical disabilities can be temporary or permanent, but even temporary physical disabilities often have lasting effects.

Physical disabilities usually manifest in two ways, either through traumatic injuries or repetitive motion injuries.

  • Traumatic injuries are sudden injuries that are disabling – it could be a stroke, heart attack or even a car accident.
  • Repetitive motion injuries are conditions caused by repetitive motion over a period of time – this could be carpal tunnel syndrome or degenerative disc disease.

Service gaps for physical conditions

For the OPM disability pension, you must prove that your medical condition caused a service deficiency in attendance, performance or conduct. These service gaps often show up differently for physical and mental conditions, but looking at physical conditions–

presence

A lack of attendance can be caused by doctor’s appointments, physical therapy, a doctor limiting your work, or an extended sick leave.

performance

A performance deficit for a physical condition is the inability to perform certain physical elements of your position, such as the inability to lift 70 pounds for a USPS factor.

Conduct

It is very difficult to link a driving impairment to a physical condition because driving requires a certain level of behavior and physical conditions are unlikely to have an impact on this.

Mental disorders

Mental disorders affect your brain and mental health. Mental disorders can be difficult to prove because there aren’t many diagnostic tests for mental disorders, so it’s important to have supporting documentation and medical professionals on your side.

Your mental condition can be affected by your physical condition, and OPM disability annuitants are often approved for several types of medical conditions.

Some common mental conditions that are accepted for OPM disability pension are; major depressive disorder, bipolar disorder and post-traumatic stress disorder.

Service gaps for mental disorders

As with physical conditions, you must prove that your mental condition is the cause of a service impairment to be eligible for OPM Disability Pension. Since mental conditions are harder to prove, service gaps can vary significantly depending on your situation.

presence

Lack of attendance could again be caused by doctor appointments, therapy, or a doctor limiting your work. Mental disorders could also lead to excessive use of CNP or AWOL statuses.

performance

Performance impairments for mental disorders are often attributed to an inability to concentrate or an inability to perform complex tasks.

Conduct

Driving impairments are generally more attributable to a mental condition than to a physical condition. Although this may still be difficult to prove, the support of a doctor to link the condition to a driving impairment would often be sufficient.

*Important Note

In the absence of an actual deficiency in performance, conduct or attendance, an employee may be able to demonstrate that their deficiency is incompatible with useful or efficient service or retention in their position. When a claim for disability retirement is based on the justified restriction of an employee from performing critical or essential job duties, there is often no evidence of a decline in actual performance. See Thieman v. Office of Personnel Management, 98 FMSR 5118, 78 MSPR 113 (MSPB 1998); Gometz v. Office of Personnel Management, 95 FMSR 5449, 69 MSPR 115 (MSPB 1995).

Overall, having supportive medical professionals and the right documentation can significantly strengthen your OPM disability retirement case, regardless of your condition. It’s also important to have an experienced legal team on your side who knows how to compile the best claim possible for your specific condition.

Leah Bachmeyer-Killie is an associate attorney at the federal law firm Harris. She graduated from the University of Kentucky Law School in 2013 and has since worked full-time at Harris Federal. She is passionate about improving the lives of federal employees. Contact Léa at (877) 226-2723.

© 2022 Leah Bachmeyer-Kille. All rights reserved. This article may not be reproduced without the express written consent of Leah Bachmeyer-Kille.

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