It's incredibly disheartening and stressful when you've applied for disability retirement benefits through the Federal Employees Retirement System (FERS) only to have your application denied. This can feel especially frustrating and unfair if you're dealing with a debilitating condition that prevents you from working.
However, denial is not necessarily the end of the road. First, it can be helpful to understand some common reasons why FERS applications might be denied. With the help of an experienced federal employment lawyer, it's possible to navigate the appeal process effectively.
Here are five of the most common reasons your FERS application might have been denied.
#1. You Did Not Submit a Fully Completed Application
FERS applications are rife with bureaucratic red tape and require abundant detailed information. A missed field, incomplete form, or lack of proper documentation can mark your application as incomplete, leading to a denial. This could occur due to a simple oversight or an inability to secure necessary documentation from physicians or other sources.
To prevent this from happening:
- Carefully read through the entire application before starting to fill it out.
- Seek advice or assistance if you need clarification on any part of the application.
- Keep organized records of all your medical documents, employment history, and other relevant information.
- Make copies of every document you send, and consider sending your application via certified mail to confirm it was received.
Ensuring your application is fully completed before submission increases the chances of your FERS application approval. However, keep in mind that even a fully completed application does not guarantee a positive outcome; other factors may influence the decision.
#2. Your Disability Is Not Severe Enough or Your Prognosis Is Unclear
It's important to understand that to qualify for FERS disability retirement, one's medical condition must be severe enough to prevent them from performing useful and efficient service in their current position. An application might be denied if your medical documentation does not demonstrate that you cannot work due to your disability. If it is not apparent that your disability is expected to last for at least one year, your application may be rejected.
To ensure that your disability is properly conveyed:
- Work closely with your physician to document your medical condition, symptoms, and prognosis thoroughly.
- Provide evidence of consistent treatment and follow-ups.
- Include records of hospitalizations or surgical procedures, if applicable.
- Describe in detail how your disability impacts your ability to perform your job.
#3. You Didn't Provide Adequate Medical Evidence
The FERS disability retirement application process requires robust medical evidence to support your claim of disability. Simply stating that you cannot work due to health issues is insufficient. The application must include comprehensive medical documentation confirming your condition's severity and longevity. Applicants often need to provide more substantial evidence, which can lead to an application denial.
To avoid this issue:
- Regularly consult with your doctors and ensure they understand the importance of their role in your application.
- Obtain and submit detailed medical reports and test results.
- Include letters from medical professionals who are familiar with your condition and have treated you.
- If possible, incorporate supporting documentation related to mental health issues, as they are often overlooked.
- Don’t forget to update your application if your condition changes or worsens.
Proper substantiation of your health condition will help to establish the credibility of your claim. Despite this, remember that FERS might still consider other factors when reviewing your application.
Moreover, the quality of your medical evidence matters as well. It's not just about the quantity; the medical documents you provide should be able to convincingly demonstrate how your disability hampers your job performance. Your physicians should provide a clear link between your medical condition and your inability to fulfill your job duties.
#4. You Have Not Complied with Your Treatment Plan
FERS requires you to adhere strictly to the treatment prescribed by your physician to remain eligible for disability retirement benefits. Failing to comply with your treatment plan might lead to the conclusion that you are not doing everything in your power to improve your condition and return to work, resulting in the denial of your application.
To avoid complications, ensure that you:
- Follow your doctor's treatment recommendations diligently.
- Keep records of all your treatment, medication receipts, and visitation dates to the doctor.
- If you experience severe side effects or the recommended treatment doesn't work for you, discuss adjusting the treatment plan with your doctor rather than abandoning it altogether.
#5. You Could Be Granted a Reasonable Accommodation Instead
FERS might deny your application if they determine that your agency could grant reasonable accommodation for your disability, enabling you to continue performing your job duties. Reasonable accommodation could include modification of work hours, restructuring job tasks, or providing assistive technology or tools. If such accommodation would allow you to perform the essential functions of your position, your application for disability retirement might be denied.
To address this:
- Consult with your physician to assess whether a proposed accommodation would be genuinely feasible given your health condition.
- If reasonable accommodation is offered and it does not, in reality, enable you to perform your duties effectively, document these issues in detail.
- Consider seeking legal advice to understand your rights and navigate the complex process of responding to proposed accommodations.
Despite these potential roadblocks, it's important to remember that a denial isn't the end of the road. Understanding these common reasons for denial can help you to prepare a robust application. If you've already been denied, consider seeking the help of an experienced federal employment lawyer to navigate the appeal process.
How The Law Firm of John P. Mahoney, Esq., Attorney at Law, PLLC Can Help
At The Law Firm of John P. Mahoney, Esq., Attorney at Law, PLLC, we understand the complexities and frustrations that can accompany the FERS disability retirement application process. From helping you to understand the requirements and intricacies of the FERS application process to assisting with an appeal in case of an initial denial, we stand ready to provide the legal support you need.
We aim to eliminate the stress and uncertainty associated with the application process. We do this by ensuring all forms are accurately completed, medical documentation is thorough and compelling, and all necessary measures are taken to build a strong case on your behalf. Our attorneys are experienced in handling cases involving various medical conditions and understand how to present evidence effectively to demonstrate the severity and permanence of your disability.
Even if your application has been denied, we can help you understand why your application was rejected and how to navigate the appeals process. For more information, please read our article about Appealing a FERS Denial.
We understand the emotional and financial toll filing for FERS disability benefits can take on an individual or family, and we want to help get you the peace of mind and security you deserve. Our team will work tirelessly to ensure the best possible outcome for your case.
If you are dealing with a denied FERS application, don’t hesitate to contact us at (202) 350-3881 or fill out our online form to schedule a consultation.