Medical Retirement Benefits for US Government Employees: Insufficiency Test

The validity of an allegation that there is an insufficiency of X is partly determined by an objective standard, and partly (if not mostly) derived from a judgment as to the nexus between X and the standard to be applied.  

In Federal Disability Retirement cases, whether under FERS or CSRS, the basis of most Federal Disability Retirement denials is that there is an insufficiency of proof, whether as to issues of accommodation, medical opinion, medical documentation; questions about deficiency of service; and multiple other specified areas — but all will ultimately be determined to have a “lack” of something such that it fails to meet a “sufficiency” test.  But sufficiency can only be determined by comparing what exists (i.e., what has been previously submitted to the U.S. Office of Personnel Management) to what the legal standard of proof requires.  

Further, since the overriding legal standard is based upon a “preponderance of the evidence“, which requires that something be ‘more likely than not’, the narrow gap between human involvement in the judgement of sufficiency, and a truly objective basis for such insufficiency, is susceptible to human error.  Because of this, appearance of quantity in addition to quality is often what is required.  

As decisions by OPM are rendered by a wide range of people whose judgment, competence and approach in evaluating a case differ greatly, it is unfortunately necessary to take into consideration the foibles of human error.  Until a precise algorithm is invented which applies fairly and accurately in all cases across the board, we must continue to deal with human beings, the their errors of judgment.

Sincerely,

Robert R. McGill, Esquire

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