If you are a federal employee and you are disabled, injured, or no longer capable of performing your job, you may be eligible for US Office of Personnel Management (OPM) disability retirement benefits.
OPM disability retirement provides valuable financial support for federal employees who can’t work due to certain debilitating medical conditions. However, as with any disability benefits program, there are specific requirements needed to qualify for OPM disability retirement.
This blog post will explain federal employee disability retirement eligibility under OPM. We’ll cover the basic OPM disability retirement requirements for federal employees.
We’ll also answer common questions, including:
- Is it hard to get federal disability retirement?
- What conditions qualify for federal disability retirement?
- Can I get OPM disability retirement for a pre-existing condition?
Our federal employment law attorneys explain what you need to know to determine if you are a federal employee with OPM disability retirement eligibility.
If you need help drafting an OPM disability retirement request, our federal OPM disability retirement attorneys are here to help you. Contact us online or call (800) 801-0598 today to schedule a consultation!
OPM Disability Retirement Qualification Requirements
OPM disability retirement is a program designed to provide financial support to federal employees who can no longer perform their essential job duties due to disability or illness.
To qualify for OPM disability retirement, federal employees must meet certain minimum eligibility standards for their medical condition and job performance.
These eligibility standards include:
- Minimum period of creditable service. Federal employees must have worked in their roles for a certain minimum period and not be considered contractors or temporary staff members to qualify for OPM disability. The minimum period of service required depends on your role and the federal retirement program under which it falls.
- Proof of long-term disability. For employees to qualify for disability retirement, their condition must be expected to last at least a year. Proving this requires detailed documentation from a qualified physician backed by medical records, lab results, and physical evaluations.
- Inability to perform useful and efficient service. Employees must also demonstrate that their illness or disability prevents them from fulfilling their professional obligations. Generally, this involves showing how their medical condition prevents them from fulfilling at least one of the essential tasks of their position.
- No options for accommodation or reassignment. Federal employers must offer accommodation and the possibility of reassignment to employees facing limiting medical conditions. To qualify for OPM disability, your agency must not be able to reasonably accommodate your disability or reassign you to perform another equivalent job at the same grade or pay level.
Beyond these basic eligibility standards, federal employees must also fulfill certain administrative requirements to qualify for OPM disability benefits. This includes applying on time and with sufficient documentary and medical evidence. Federal employees must also apply separately for Social Security Disability Insurance and submit proof of doing so in their OPM application.
FERS vs. CSRS Eligibility
Federal employees can qualify for OPM disability retirement under both the Federal Employees Retirement System (FERS) and the Civil Service Retirement Service (CSRS). Keep in mind that these are two distinct systems. So while they share some similarities, they have their unique qualification criteria.
Below are the requirements needed for both the FERS and the CSRS.
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Federal Employees Retirement System (FERS) requirements:
- 18 months of creditable civilian service,
- Must become disabled while serving in a position covered by FERS, and
- Must apply for Social Security benefits and must submit the proof in OPM application.
Civil Service Retirement Service (CSRS) requirements:
- Five years of creditable civilian service
- Must become disabled while serving in a position covered by CSRS, and
- Must apply for Social Security benefits and must submit the proof in OPM application.
These altered requirements reflect the different nature and structure of CSRS compared to FERS.
Understanding the Difference Between Occupational and Total Disability
Social security disability and most other disability programs require total disability. This means that the applicant must be totally unable to perform meaningful work.
On the other hand, OPM federal disability requires that a worker only have an occupational disability. This means that workers don’t need to be totally disabled from working to obtain OPM disability retirement.
They only need to demonstrate that they are disabled from performing at least one essential function from their position.
Is It Hard to Get Federal Disability Retirement?
Acquiring federal disability retirement (FDR) can often be challenging, but it’s not impossible. The level of difficulty often depends on the specific circumstances of the applicant and the nature of their disability.
Let’s walk through some factors that can make the process challenging for applicants.
Documentation Requirements
To receive federal disability retirement, you must provide extensive medical documentation demonstrating how your condition affects your ability to perform your job duties. It can be time-consuming to secure the detailed medical reports, test results, and physician opinions needed to show the extent of your disability. However, doing so is indispensable for a successful application. Insufficient medical evidence is one of the main reasons for disability benefits denials.
Application Complexity
The OPM application process is multifaceted and requires careful attention to detail. It’s only too easy to leave out important information or documents. However, any oversight or missing information can delay your application processing—or outright denial.
Unfortunately, agency HR departments are often not up-to-date on the specifics of OPM disability retirement requirements. This frequently leads to employees receiving incorrect or misleading guidance that can harm their chances of success.
Overlap with Other Benefits
Federal employees may be eligible for or receive other financial benefits for a disabling medical condition, such as federal workers’ compensation, Social Security Disability Insurance, and VA disability. These overlapping benefits can sometimes reduce the amount of OPM disability a federal employee can receive.
Denials and Appeals
OPM denies a significant percentage of initial disability retirement applications. Fortunately, federal employees have the option to appeal an initially denied application.
Preparing for an appeal requires additional time and effort to collect evidence and strengthen your case.
However, this is often worth the effort. Many denials are overturned on appeal, especially when backed with representation from a knowledgeable federal employment attorney.
Subjectivity
Evaluating the impact of a medical condition can be somewhat subjective, especially when it comes to mental and emotional disorders. Proving that these conditions are debilitating enough to warrant federal disability retirement can be more challenging than proving the severity of physical ailments.
Legal Hurdles
A set of complex laws and policies regulates federal employee disability retirement eligibility. For example, employees seeking federal disability retirement must show that their agency can’t fulfill certain legal duties to accommodate their medical condition.
If your employing agency can reassign you to another position at the same pay grade you are qualified for and can perform despite your medical condition, your federal disability application retirement may not prevail.
Despite these challenges, countless federal employees successfully obtain federal disability retirement every year. Proper legal guidance, thorough documentation, and perseverance are essential.
[DOWNLOAD] OPM Disability Retirement for Federal Employees
What Conditions Qualify for Federal Disability Retirement?
OPM disability retirement does not have a strict list of specific medical conditions that qualify individuals for benefits. Instead, the focus is on how a medical condition affects an individual’s ability to perform the essential duties of their federal position.
Many conditions (including physical and psychiatric) have historically been recognized as grounds for OPM disability retirement when those medical conditions significantly impair job performance.
Potentially qualifying OPM disability retirement medical conditions could include physical disorders such as:
- Musculoskeletal issues—chronic back pain, arthritis, herniated discs, carpal tunnel, or other repetitive stress disorders;
- Heart conditions—heart disease, hypertension, heart failure;
- Breathing disorders—asthma, chronic obstructive pulmonary disease (COPD), fibrosis of the lungs;
- Neurological disorders—multiple sclerosis, Parkinson’s disease, epilepsy;
- Autoimmune conditions—Lupus, Crohn’s disease, fibromyalgia; and
- Other chronic conditions and impairments—cancer or vision or hearing loss.
Some psychiatric conditions that could qualify for disability retirement include:
- Bipolar disorder;
- Major depressive disorder;
- Post-traumatic stress disorder;
- Borderline personality disorder; and
- Cognitive impairments like dementia, Alzheimer’s, or traumatic brain injuries.
It is also possible to obtain OPM disability retirement because of multiple conditions that collectively make you unable to perform your essential job duties. Ultimately, the key to a successful FDR claim is demonstrating the nexus between the medical condition and job performance.
Consequently, thorough medical documentation is crucial. This includes physician’s reports, medical test results, and detailed accounts of how the condition affects daily living and job performance.
Letters or statements from your coworkers or supervisors attesting to the changes in your performance can also be beneficial.
Federal Disability Retirement: Frequently Asked Questions
Applying for federal disability retirement is a complex process governed by multiple federal laws and policies. If you have specific questions, contacting a legal professional is best.
What Is OPM Disability Retirement?
OPM disability retirement is an employee benefit that helps those who are unable to complete a normal career due to illness or disability.
This program differs from other forms of disability compensation, such as that provided by the Social Security Administration or the Department of Veterans Affairs.
You should consider applying for disability retirement only after you have provided your federal employee with complete documentation of your medical condition and they have exhausted all reasonable accommodations available to make your work manageable.
Can a Federal Employee Have Disability Retirement Eligibility If Their Disabling Condition Was Pre-Existing?
The short answer is yes. OPM does not assess the cause of your disabling condition. Therefore, it does not matter whether the disabling condition pre-dated your federal employment.
Nor does it matter if you suffered the injury at work. The critical inquiry is whether the condition prevents you from performing your job duties.
How Long Does the Application Process Take?
Cases can vary, but preparing to apply for disability retirement can take a few weeks to several months. Typically, OPM takes several months to review and decide on an individual application.
What If I’ve Received a Separation from Federal Service?
To qualify for OPM disability, you must submit your application for disability retirement to OPM within one year after the date of your separation.
If your separation is longer than 31 days, your former federal employer may no longer have access to your personnel records and, therefore, might not be able to recover them in time to process your disability retirement application and submit it to the OPM within the year limit.
For such reason, we advise that you submit your OPM disability request directly to OPM instead of submitting it with your employer.
Seek Legal Guidance with Your OPM Case
Drafting a disability application can be complex, and a simple mistake can affect your case’s outcome. Our team at Pines Federal can work with you to gather the various components of your disability application to ensure that you meet all the requirements.
We know how to draft your request to your employer and address and objections if they claim it would cause undue hardship on the employer. We can provide you with the best possible chance of having your application approved, thus avoiding delays in compensation. We’ve been helping federal employees for over 60 years, and we are ready to help you too.
Contact our OPM disability retirement attorneys by calling (800) 801-0598 or filling out our online form today.