As a federal employee, you may be eligible for disability benefits if a medical condition prevents you from performing your job. These benefits can equal millions of dollars over your lifetime, however, applying for these benefits can be a complicated process. That is why you need an experienced federal disability lawyer on your side. To learn more about how we can help you, contact The Law Office of Aaron D. Wersing.
Two systems may provide disability benefits to federal employees. The current disability program is the Federal Employees Retirement System (FERS). In 1987, it replaced the previous benefit program, the Civil Service Retirement System (CSRS). If the federal government employed you before 1987, you could still have coverage under CSRS.
To be eligible under FERS, you must have worked as a federal civilian employee or a postal worker for a minimum of 18 months. CSRS eligibility dictates that you must have been employed as a federal civilian employee or postal worker for a minimum of five years.
Qualifications for Federal Disability Benefits
Federal disability benefits are available to those federal employees who have become disabled due to injury or disease that prevents them from performing “useful and efficient service” in their current job position. That means you cannot carry out one or more essential elements of your work position. As part of your benefit application, you will need a doctor’s statement confirming, among other things, that your claimed disability will last twelve months or more starting on your application filing date.
The federal agency that employs you must confirm that it tried but cannot accommodate you in your current position with your medical condition. They also need to verify that no other positions exist nearby in the same agency at your same pay grade. There is no requirement that you show your disability resulted from a job-related injury, occupational disease, etc.
FERS/CSRS disability benefits differ from Social Security disability (SSDI), since SSDI requires you to show that you’re completely disabled and unable to work, whereas FERS/CSRS only requires that you are unable to fully perform your position of record.
How Do I Apply for Disability for FERS?
If you plan to apply for federal disability retirement benefits, you must file your application within one year after separation from your job. This means that you can submit your application while you are still working or within one year of your federal government separation date. Your separation date isn’t necessarily the same date you stopped working or became disabled, so be sure to check to confirm your date of separation before leaving your job.
To apply for FERS, you will need to complete several forms that can be obtained from the Office of Personnel Management (OPM) or through your agency’s personnel office. One form is the Applicant’s Statement of Disability, which can be obtained from either of these offices.
Social Security also covers employees eligible for FERS. You will need to apply for Social Security disability benefits simultaneously with your FERS filing, although you do not need to be approved for SSDI in order to receive disability retirement benefits from OPM. The Social Security Administration has the necessary forms and instructions to complete your application for SSDI benefits, and the application can generally be completed online.
For FERS disability retirement, you need to provide sufficient medical evidence to support your claim for disability retirement benefits. It will be necessary to contact your doctors and pay whatever fees are required to get copies of all your records. To improve your chances of approval, you will want to provide a detailed statement from your doctor, as well as provide medical evidence such as:
- Objective findings, including diagnoses, diagnostic test findings, medical opinions, etc.;
- Subjective evidence, including reports of your pain and disability; and
- Information that relates to how your disability affected your ability to perform your most recent job.
Your supervisor and Human Resources office will also supply certain forms which they have to complete. If you are still employed by your agency or within 30 days of separation, your agency will then forward your application to the Office of Personnel Management (OPM). If more than 30 days have elapsed since your separation, you will be responsible for sending your application directly to OPM.
You can still proceed with filing your application if your agency doesn’t concur with your statements of disability. It just means that you are moving forward without your agency’s support. In addition, there are several strategies which can significantly strengthen your application.
The OPM will then review your documentation, including the medical evidence that you submitted. If your application is approved and your condition is not considered permanent, you may be required to undergo periodic medical evaluations until you reach the age of 60. If your condition is permanent, no regular assessments will be required.
Appealing a Denial of Benefits
If OPM denies your application, a FERS disability lawyer can help you file an appeal. You have 30 days from the date of the denial to file for a reconsideration, and you can elect an additional 30 days to provide updated, additional information for OPM to consider. When you submit your reconsideration documents, you can then include updated or new information that could improve the chances of getting your application approved.
If your request for reconsideration is denied, your case will need to go before the Merit Systems Protection Board (MSPB). An administrative law judge will review your case and render a decision.
Deadlines throughout the claims process are stringent. If you miss one deadline, it could ruin your chance of ever getting approved. Don’t risk your benefits by attempting to handle an appeal on your own. Let our experienced federal disability lawyers help.
How Long is FERS Disability?
The benefits you receive will depend on your age and how long you worked for the federal government. The duration of your disability depends on your medical condition and how long you have been or will be disabled. In all cases however, your disability retirement annuity will end at age 62, at which time OPM will convert your retirement to a regular retirement, using the standard retirement annuity calculation based on years of credible service and your most recent position of record.
There is often some confusion around FERS benefits and whether you can also receive SSDI benefits. FERS requires that you apply for SSDI benefits if you’re under 62, like many other long-term disability policies. If Social Security approves your application, your SSDI benefits will be deducted from your FERS benefits as described below. It is often easier to receive approval for FERS benefits than SSDI, so it’s not uncommon for people to be approved for FERS but receive a denial for SSDI.
Once approved, you may be periodically asked to provide the Office of Personnel Management with updated medical evidence that shows you are still eligible for these benefits. You could have your benefits terminated if your disability sufficiently improves or if you earn above the threshold earnings cap.
If your benefits are terminated, you may seek to have your benefits reinstated if you are under 62 years old. OPM’s standards are slightly different when you are seeking a reinstatement of benefits. The procedures will vary depending on whether your benefits’ termination was due to your restoration to your previous earning capacity or to your recovery.
Calculating FERS Disability Benefits Amounts
Calculating benefits can be complicated, and annuity calculations vary depending on the length of your service and whether you are under 62 years of age. Benefits will be calculated using a “high-3” average salary, which is the highest average basic pay you earned during any three consecutive years of service.
The calculations typically use your last three years of service; however, it could be an earlier period if your pay was higher at that time. Suppose you did not work for a federal employer longer than three years. In that case, your average salary calculation will use an average of your basic pay during all periods that qualify as creditable federal service.
For those under 62, your first 12 months of FERS disability benefits will be paid at 60% of your high-3 average salary, minus 100% of any SSDI benefits for each month in which you are entitled to both FERS and SSDI benefits. After the first year of receiving FERS benefits, you will be eligible for 40% of your high-3 average salary, minus 60% of any SSDI benefits for any month in which you are entitled to both FERS and SSDI benefits.
Applicants under 62 can opt to take their “earned” annuity if that amount is more considerable than the FERS disability calculations. Once you reach 62, your annuity is recalculated. The recalculation uses a new total to represent the annuity amount you would’ve received under FERS had you continued to work until retiring from your job.
If you are at least 62 at retirement, your benefits will vary depending on your service length. You may receive about 1% of your high-3 average salary for every year of service. For example, if you worked for the federal government for 18 years, you will receive 18% of your high-3 salary. If your calculated service time is over 20 years, you will receive 1.1% of your high-3 average salary for every year of federal employment. Some positions grant a special 1.7% factor when determining your retirement annuity, which would lead to a larger annuity.
Other benefits include the option to continue to receive federal employees health benefits (FEHB) at the reduced employee rate, Federal Employees’ Group Life Insurance (FEGLI), maintain your TSP, and continue to receive years of creditable service towards full retirement at 62.
Who Pays for a FERS Disability Lawyer?
If you choose to retain a federal disability lawyer, you will generally be responsible for the legal fees, although these fees are recoverable from the federal government in certain situations. When meeting with attorneys, it’s essential to ask the right questions. One of these questions should address the attorney’s fee structure.
Each firm sets its own fee schedule, so you should ask for information regarding an attorney’s fee schedule up front. Some attorneys bill by the hour while others charge monthly flat fees or charge by the task. If you need assistance with your initial application, the attorney fees may be lower than if you need to proceed with an appeal.
Some attorneys may be able to work out alternate payment arrangements as well, which is another reason it’s crucial to be honest during your initial consultations.
Consult a Federal Disability Lawyer Today
Pursuing federal disability benefits can sound daunting, but it doesn’t have to be. When you retain our federal disability lawyers, we will be there every step of the way. We will help file your application, gather the necessary medical evidence, draft documents, strategize ways to improve your chances of quick approval, and more.
If the OPM denies your application, we will pursue an appeal on your behalf. Let us do the work so that you can concentrate on your health and work toward recovery.