Below are OPM's stated criteria for winning FERS Disability Retirement Cases. Now, what does this gobbledygook mean? There are thousands of cases defining what these criteria mean, and new cases redefine the criteria all the time. Thus, these criteria are anything but straightforward. The ultimate point here is that you need someone with a knowledge of the case law which interprets these criteria, knowledge which you likely don't have, but a good lawyer should have.

OPM's Seven Criteria:

Required Documentation

To decide if your disability claim is allowable, OPM considers the documentary evidence you, your agency, and your physician provide. Your claim can be allowed only if the evidence establishes that you meet all of the following criteria:

1. A deficiency in service with respect to performance, conduct or attendance, or, in the absence of any actual service deficiency, a showing that your medical condition is incompatible with other useful service or retention in the position.
2. A medical condition, which is defined as a health impairment resulting from a disease or injury, including a psychiatric disease.
3. A relationship between the service deficiency and the medical condition such that the medical condition has caused the service deficiency.
4. The disability must be expected to last at least one year.
5. You became disabled while serving under the Federal Employees Retirement System.
6. The inability of your employing agency to make reasonable accommodation to your medical condition.
7. The absence of another available position, within the employing agency and commuting area, at the same grade or pay level and tenure, for which you are qualified for reassignment. OPM will not pay for any medical examination or procedure needed to provide the necessary documentation.

ANSWER: Disability retirement is a right. Any employee who belongs to either the Civil Service Retirement system (CSRS) or the Federal Employees Retirement System (FERS), after meeting certain threshold requirements, can collect a portion of his or her salary if a medical condition prevents him or her from continuing work in a government job. It is not a favor, a handout, or a gift, but a right for which you have already paid through contributions to your retirement fund. Whereas regular retirement gives you the right to stop working and begin collecting if you reach a certain age, disability retirement gives you this right if you develop a disability, even if you haven't yet reached retirement age. Just as the premium payment on your fire insurance policy protects you against the loss of your house due to fire, your monthly paycheck retirement deduction protects you against loss of income due to disease or injury.

ANSWER: You do NOT have to be totally disabled to collect disability retirement. You are considered disabled if you are unable to render "useful and efficient service." If you are unable to perform satisfactorily a single (just one and any one will do) "critical element" of your current government job on account of an illness or injury, then you cannot render "useful and efficient service" and are eligible for disability retirement. It does not matter that you may be able to perform all of the other elements of that job. If you can't perform that single "critical element," then you are by definition disabled.

To some this sounds too good to be true; particularly to some physicians who are accustomed to thinking of disability in terms of wheelchairs, oxygen tents, and life support machines. They often fail to grasp the fundamental point that Congress has chosen to define disability for government employees in far more liberal terms than disability is defined in other areas of the law. As a consequence of their misunderstanding, many doctors are reluctant to go all out for their patients who do not meet the more traditional definition of disability. One result is that their patients end up being denied a benefit to which they have a legal right. One of my major tasks in representing government employees seeking disability retirement is to educate physicians and others on this critical point so that they can, in turn, really go to bat for their patients.

Example: Andy suffers from the chronic pain of a slipped disc whenever he is required to sit for even short intervals. Andy's desk job requires long stretches of sitting. Andy has no trouble playing golf or dancing till dawn, but he cannot sit without pain. Because Andy can not render "useful and efficient service," he is disabled from his government job even though he can play golf and dance. If he meets the other requirements, he is entitled to disability retirement.

ANSWER: Just as the disability need not be total, it also need not last forever. You are entitled to disability retirement if your disabling symptoms are likely to last for at least one year. While no less than one year's duration is sufficient, no more than one year's duration is required.

Example: Barbara's job description required her to travel by airplane, at least one time each month, to the agency's field office. She developed an uncontrollable phobia of flying and could no longer attend the monthly meetings. Accommodation was not possible, such as by conference telephone call, since effective meetings required her physical presence. Barbara's psychiatrist corroborated her claim with a "reasoned medical opinion," which included a prognosis that her symptoms would not abate for at least one year. Barbara is disabled because she is unable to render "useful and efficient service" for at least one year. She is entitled to disability retirement if she meets the other requirements.

ANSWER: That depends on the retirement system to which you belong. FERS employees are required to be enrolled in their retirement system for a minimum of 18 months to be eligible for disability retirement. CSRS employees must be enrolled a minimum of five years in their retirement system to be eligible.

ANSWER: No. You have a right to disability retirement even if you were sick or injured prior to your government employment, so long as you became disabled by the symptoms of your disease or injury after you were employed. In other words, a pre-existing disease or injury will not bar you from collecting, as it might with many types of disability and health insurance. A pre-existing disability, however, will bar you from collecting.

Example: Charlie entered government service with cerebral palsy, but he was able to perform his job very well for a number of years. Later, his condition worsened so that he lost the ability to perform some of the critical elements of his job. Because he is unable to perform at least one of the critical elements of his job, he is unable to render "useful and efficient service" and is legally disabled. Although he entered government service with cerebral palsy, the condition did not become disabling until later. Thus, if he meets the other requirements, he is entitled to disability retirement.

ANSWER: That depends on the nature of the medical evaluation or treatment you refuse. You cannot be denied disability retirement for refusing to undergo diagnostic procedures or treatment strategies that are relatively invasive, relatively painful, or may result in further illness. However, in one case an employee's chronic back pain was exacerbated by being overweight. She was denied disability retirement when she refused to accept medical advice to exercise and lose weight.

ANSWER: No. Disability retirement compensates you regardless of either the nature or the cause of the disability. Nor does it matter where the disability was incurred, whether at the desk or on the dance floor. Workers' compensation is a different program that compensates employees for disabilities which are exclusively job-related.