Monthly Archives: February 2018

You Have Appeal Rights with OPM

appealRecently, nearly 600 retired federal law enforcement officers received notification their Annuity Supplement was being reapportioned to provide a former spouse with extra income. So, why is that? Why did the Office of Personnel Management do this unexpectedly?

Let’s look and find out why.

Federal law enforcement officers have special provisions allowing them to retire earlier than other federal employees. That also allows them to receive the Annuity Supplement longer.

So, let’s say you retired as a FLEO at age 50 because you met the requirements to do so. You’ve been receiving the FERS Annuity Supplement for the last few years because you’re not eligible to receive Social Security yet.

Now, let’s say a few years before you retired, you and your spouse divorced, and you’ve been paying alimony ever since. Everything is going fine, then you receive a notification from OPM telling you they are reapportioning $10,000 from your Annuity Supplement to provide your former spouse with additional income. To make up for this, the government is reducing your monthly Annuity Supplement check by $250 for the next 40 months. This may cause you to be unable to pay bills.

This is the actual scenario for those 600 retired FLEO’s mentioned earlier. The notifications came without earning and the reductions in pay were almost immediate.

Some fought back by filing appeals with the Merit Systems Protection Board saying they didn’t think those supplements would be reapportioned to their former spouses aftertheir divorces had been finalized unless a court ordered it. After those appeals, OPM claimed they rescinded the retroactive payments, however, annuitants say their paychecks still reflect the deduction.

This highlights the importance of anyone receiving FERS benefits to speak up if you notice anything negative happening to your retirement checks. Regardless of how long you’ve been retired from federal service, you are afforded the right to appeal OPM decisions that adversely affect you and your annuity.

You should first file an appeal with OPM requesting a reconsideration of the initial decision if it states in writing there is a right to reconsideration (normally it will). Appeals to OPM for reconsideration must be made within 30 calendar days of receiving the initial decision in writing. If OPM takes up the recon, it must issue a final decision in writing to the retiree, competing claimants, and the retirees’ former agency.

In this case, OPM’s notifications were written as final decisions, meaning there no appeal right to them. When this is the case, you should appeal directly to MSPB. Appeals to MSPB are the same for retirees as active federal employees. These appeals need to be filed at the nearest regional or field MSPB office within 30 days of OPM issuing its final decision. If MSPB accepts the appeal, it will assign an administrative judge to hear the case and issue a ruling.

If either side is dissatisfied with the judge’s decision, the case can be appealed to the full MSPB Board (currently there isn’t one because of the lack of quorum) or to the U.S. Court of Appeals for the Federal Circuit.

Should the ruling be against you at the Full Board, you still have the option of filing an appeal to the U.S. Court of Appeals for the Federal Circuit.

The moral of this story is to know you have appeal rights and what they are. You don’t want to be paying into the retirement system all the years you worked just to have OPM decisions adversely affect your FERS benefits if they don’t have to.

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Who is the General Services Administration?

general

This post will look at who the General Services Administration is, what kind of work they do, and how they benefit the federal government and American citizens. The mission of the GSA is to “deliver value and savings in real estate, acquisition, technology, and other mission support services across government”. And their vision is to create an effective and efficient government for the American people.

Benefits for Federal Government

GSA provides a centralized procurement for the federal government, offering billions of dollars’ worth of products, services, and facilities that federal agencies need to serve the public. Their acquisition solutions supply federal purchases with cost-effective, high-quality products and services form commercial vendors.

They help agencies build and acquire office space, products, and workspace services, and oversee the preservation of historic federal properties. They oversee policies covering travel, property, and management practices, and promote efficient government operations.

Benefits for Citizens

The agency helps keep the nation safe by providing tools, equipment, and non-tactical vehicles to the U.S. military and providing state and local governments with law enforcement equipment and disaster recovery products and services.

They serve the public and make the government easier by offering free access to and information about government programs.

Strategic Goals

Save taxpayers money through better management of federal real estate.

Deliver cost savings and value for taxpayers through smart asset management while also providing innovative workplace solutions that help agencies fulfill their missions.

Establish GSA as the premier provider of efficient and effective acquisition solutions across the federal government.

Lead acquisition and procurement strategies that help agencies access inventive and effective commercial solutions, make it easier to do business with the government and use buying power to drive cost savings.

Improve the way federal agencies buy, build, and use technology.

Lead the change to modernize the governments’ approach to technology, products, and services. Guide agencies through innovative and efficient technology deployment to meet their missions and fulfill the needs of Americans in a quickly evolving world.

Design and deliver expanded shared services within GSA and across the federal government to improve performance and save taxpayer money.

Transform admin services in the government by leading consolidation of common mission-support processes and services across the government. Implementing this best practice will make these services better, faster, and more affordable while allowing government agencies to dedicate more resources to their mission.

History

GSA, created to streamline the administrative work of the government, was established by President Harry Truman on July 1, 1949.

They consolidated the National Archives Establishment, Federal Works Agency, and Public Buildings Administration; the Bureau of Federal Supply and the Office of Contract Settlement; and the War Assets Administration into one federal agency tasked with administering supplies and promoting workplaces for federal employees.

Their original mission was to dispose of war surplus goods, manage and store government records, handle emergency preparedness, and stockpile strategic supplies for war. They also regulated the sale of various office supplies to federal agencies and managed some unusual operations.

Today, through its 2 largest offices—Public Building Service and Federal Acquisition Service—they provide workspace to the more than one million federal civilian workforce, oversees the preservation of more than 480 historic buildings and facilitates the government’s purchase of high-quality, low-cost goods and services form commercial vendors.

1950’s-1960’s

GSA took on a critical assignment of emergency preparedness and began stockpiling strategic materials for wartime. They retained various emergency management functions until they those functions were transferred to FEMA in 1979.

In 1960, GSA created the Federal Telecommunication system, a government-wide intercity telephone system. Two years later, the Ad Hoc Committee of Federal Office Space recommended a major new building program to address obsolete office buildings in D.C.—resulting in many new offices now.

1970’s-1980’s

In 1970, the Nixon administration created the Consumer Product Information Coordinating Center, now called the Federal Citizen Information Center.

The Federal Buildings Fund, authorized in 1971, became operational in 1974 when GSA issued its first rent bills to agencies. They also became involved in administration policy issues.

In 1984, they introduced the government to charge cards. Today, the GSA SmartPay program has over 3 million cardholders.

The next year, they began providing government-wide policy oversight and guidance for federal real property management, in response to an executive order signed by President Ronald Reagan.

1990’s

In 1995, GSA created the Courthouse Management Group to manage the largest courthouse construction project in 50 years. The project led to the renovation or rebuilding of federal courthouses across the country.

2000’s

GSA embraced new technologies, launched electronic government initiatives, and helped the government do business over the internet. In 2007, they consolidated the Federal Telecommunication Service into the Federal Acquisition Service to better align the delivery of services.

In 2010, GSA became the first agency to move email to a cloud-based system, reducing inefficiencies and costs 50%. Since that time, many initiatives have been launched to better streamline government technology.

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More Training to Protect Whistleblowers

whistleblower

A new law and recent activities have prompted The Office of Special Counsel to update guidance on whistleblower activities. A series of recent memos from U.S. Special Counsel Henry Kerner reiterated a common reminder to agency leaders: watch what kind of message your organization is sending to your employees about their whistleblower rights.

OSC acknowledged that legally monitoring employee communications can serve “legitimate purposes”, but it also reminded agencies that federal employees have a legal right to disclose waste, fraud, and abuse and not fear reprisal and punishment.

“The Office of Special Counsel strongly urges executive departments and agencies to evaluate their monitoring policies and practices and take measures to ensure that these policies and practices do not interfere with or chill employees from lawfully disclosing wrongdoing,” Kerner wrote in a memo.

OSC specifically reminded agency leaders that employees have the right to disclose information to Congress. “Monitoring an employee’s communication, including emails, computer files or conversations, simply because the employee made or may make a protected disclosure has a chilling effect on these lawful activities,” Kerner wrote.

In a recent memo to Justice Department leaders, Attorney General Jeff Sessions told employees that “attorneys, officers, boards, divisions, and components” shouldn’t communicate with members of Congress, committees, or their staff without advance coordination with the agency’s Office of Legislative Affairs. He said the goal of the congressional communication policy is to ensure department and executive branch interests are fully protected.

Senate Judiciary Committee Chairman Chuck Grassley asked Sessions to review the new policy and take corrective action. “Without directly addressing the rights of federal employees to communicate with Congress, the memorandum could leave the impression that the department is attempting to prevent lawful disclosures and discourage employees from exercising their statutory and constitutional rights to directly communicate with Congress.”

The Make It Safe Coalition, which includes the Government Accountability Project, Project on Government Insight, Public Citizen and Union of Concerned Scientists, all called out Session’s new policy. “When an agency unlawfully gags its employees, it threatens Congress’ ability to engage in oversight and hampers citizens’ rights to know about waste, fraud, abuse, and threats to the public’s health, safety, and liberty,” the coalition wrote to Kerner.

More Training

The Dr. Chris Kirkpatrick Whistleblower Protection Act is prompting new agency standards on training. Under this law, agencies have new requirements for training their employees and supervisors on how to deal with whistleblower complaints.

Most agencies (90%) are currently certified or registered in OSC’s previous certification program. Much of this program still applies; but agencies have a few extra steps to take to remain in compliance with OSC’s program and keep their certifications.

Agency heads must make sure new employees are trained on their whistleblower “rights and remedies” within their first 180 days on the job. They must also train their supervisors annually on how to respond to whistleblower complaints. Further, agencies should work with the Office of Personnel Management to develop supervisory performance standards for protecting whistleblower disclosures, including “the degree to which supervisory employees respond constructively when employees make protected disclosures, how supervisors take responsible actions to resolve these disclosures, and ways in which the supervisors foster an environment in which employees of the agency feel comfortable making such disclosures,” OSC said.

Agencies can suspend or remove supervisors who fail to act on a whistleblower disclosure, if the manager has committed similar offenses in the past, OSC said.

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Should You Elect a FERS Survivor Benefit?

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A survivor benefit is designed to help a surviving spouse in the event you (the federal employee) passes away in retirement. The survivor benefits you elect determine how much your spouse will receive from your FERS pension if you pass away first in retirement. If you’re married when you complete your FERS retirement application, you’ll need to elect a survivor benefit. However, deciding which benefit to elect can be tough as there are pros and cons to each.

Maximum Survivor Benefit

Your spouse receives 50% of your unreduced pension if you pass away first in retirement. Your monthly pension is reduced by 10%.

Partial Survivor Benefit

Your spouse receives 25% of your unreduced FERS pension if you pass away first in retirement. Your monthly pension is reduced by 5%*.

No Survivor Benefit

Your spouse will receive no survivor benefit if you pass away first in retirement. All FERS pension payments will stop at your death and eligibility for federal health insurance will end. Your monthly pension isn’t reduced*.

*Your spouse is automatically entitled to the Maximum Survivor Benefit UNLESS he/she consents to a Partial Survivor benefit or waives it entirely. If that’s the case, your spouse must complete Form 3107-2, Spouse’s Consent to Survivor Election.

Example: Max Survivor Benefit

Say you have an unreduced FERS pension of $1,000 a month and you elect the Max Survivor Benefit for your spouse. This reduces your pension by 10% to $900 a month. If you pass away first, your spouse will now receive 50% of the unreduced pension equal to $500 a month.

The Partial Survivor Benefit is the same concept except your monthly pension is reduced by 5% and your spouse would receive 25% of your unreduced pension.

This benefit becomes especially important when it comes to health insurance. Continuation in FEHB coverage is only available to a spouse who is eligible to receive a survivor pension. If you pass away first in retirement and your spouse wants to continue FEHB coverage, your spouse MUST:

  • Be entitled to receive a FERS survivor benefit (max or partial), AND
  • Have been enrolled in FEHB prior to your death

If your spouse elects to waive the survivor benefit, their FEHB terminated after your death.

Exception: If your spouse is an active FERS/CSRS employee or retiree and elected no survivor benefit, upon your death, they can elect their own FEHB coverage.

The survivor pension is a lifetime benefit for your surviving spouse. Your spouse receives monthly payments until they die UNLESS they remarry before the age of 55. If your spouse does remarry before age 55, the FERS survivor pension and any FEHB coverage terminate.

FLTCIP

If you pass away first in retirement and your spouse wants to apply for the Federal Long Term Care Insurance Program, they can only do so if he/she is entitled to a FERS survivor pension. If your spouse has waived the survivor benefit, they cannot apply for FLTCIP after your death. However, if your spouse already has a FLTCIP policy, their coverage continues for as long as they pay their premiums, regardless of the FERS survivor pension option you selected.

What Happens if My Spouse Passes Away First?

If you’ve elected a survivor benefit and your spouse passes away first, you’ll need to contact the Office of Personnel Management as soon as possible to report their death and complete the forms so OPM will stop reducing your FERS pension. There will be no refund of the money deducted during retirement, however.

It’s a tough decision you must balance between living with a reduced retirement income and providing for your spouse in the future. It’s a permanent decision so weigh the option carefully.

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Is a Bailout Needed for the USPS?

bailoutThe President’s 2019 budget proposal addresses the failing finances of the United States Postal Service. The proposal says reforms are needed to allow it to “meet it’s financial and service obligations with business revenue, as intended, rather than a taxpayer-financed bailout”.

Postal Service Financial Problems

The USPS continues to report big losses when the agency announces its financials at the end of each quarter. It reported a $540 million net loss for the 1st fiscal quarter this year and for 2017, it reported a $2.7 billion net loss. This makes 11 straight years of financial loss.

First class mail is declining with more internet use. USPS noted mail volumes declined by approximately 20 billion pieces.

Benefits Costs

One of the biggest contributing factors if the cost of providing health and retirement benefits to employees. The White House’s 2019 budget proposal notes, “Since 2012, USPS has prioritized payments to employees and vendors, while defaulting on required payments of more than $5 billion each year to the Office of Personnel Management for current and former employee benefits costs.”

It goes on to say that the Postal Service must be “given the ability to address their expenses—including the cost of personnel—and take appropriate actions to balance service levels with revenue. USPS must also have the flexibility to raise the revenue necessary to support their operations.”

The budget document is vague on how USPS should address their issues. It does reference a report from the Government Accountability Office, where GAO thinks it would be a good idea to take the Postal Services’ finances into consideration when negotiating employee pay and benefits rather than just giving the union what it wants.

Postal Reforms

GAO and the White House budget proposal both agree that reforms are needed.

In this excerpt, the budget proposal states:

“The Budget proposes a combination of operational reforms and retiree health and pension changes to restore solvency to USPS and ensure that it funds existing commitments to current and former employees form business revenues rather than taxpayer funds. Operational reforms include changes to how rates are set, modification of USPS’s delivery schedule, and the use of more efficient delivery methods. In addition to government-wide changes to health and pension programs that will reduce USPS operating costs, postal reforms to modify USPS’s contributions for life and health insurance for employees to be more consistent with government-wide standards.”

The “government-wide changes” referenced aren’t new. They include proposed cuts to retirement benefits such as the elimination of the COLA for FERS employees and of the FERS Special Retirement Supplement and changing annuity calculations to use a high-5.

What Reforms May Happen?

Many changes are proposed under the Postal Service Reform Act of 2017. The bill would have Medicare eligible Postal Service retirees and family members automatically enrolled in Medicare Parts A and B, and the Postal Service would cover a decreasing portion of Medicare Part B premiums for current retirees transitioned into Medicare.

USPS has been stating it needs action from Congress to help its situation.

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Potential Impact to Retirement Benefits

impact

Every year when the President releases his budget proposal, FERS employees and retirees wonder what kind of impact there may be regarding their benefits.

Let’s look at each proposed change and its potential impact on retirement.

Pay Freeze

Impact: Moderate

If an extended pay freeze is enacted, it may cause your earnings potential to be permanently lowered. It’s very hard to make up the difference from your stagnant earnings during a pay freeze.

You may also receive less TSP FERS match over your career.

Also, if your career earnings are lowered, your High-3 may be lower, therefore, causing your monthly FERS pension payments to be less. Ultimately, this could cause more withdrawals from your TSP to make up the difference.

High-3 to High-5

Impact: Low

Currently, the FERS pension calculation is based on your High-3 average, which is your highest average basic pay you earned during ANY 36 consecutive months in your career under FERS. These are often your final 3 years of service but can be an earlier period.

A change to a High-5 would likely mean the calculation would extend to a 60 month, or 5-year average. This could reduce your FERS pension by a small amount. Again, this could cause you to withdraw more from your TSP to make up the difference.

Paying More into FERS

Impact: None to Low

FERS employees automatically contribute a percentage of basic pay into FERS each pay period. This provides a monthly FERS pension in retirement.

The amount you contribute is based on which FERS system you’re in. In the past 10 years, there were 2 more retirement systems added to FERS:

  • FERS Contribution: .8% (FERS employees hired between 1/1/84-12/31/12)
  • RAE (FERS) Contribution: 3.1% (RAE=Revised Annuity Employee), (FERS RAE employees hired between 1/1/13-12/31/13)
  • FRAE (FERS) Contribution: 4.4% (FRAE=Further Revised Annuity Employee), (FERS FRAE employees hired on or after 1/1/14)

The proposed increase for FERS contributions could cause FERS employees to contribute substantially more. FERS RAE and FRAE employees may have to contribute more as well.

Thrift Savings Plan

Impact: Unknown

These changes could mean less take-home pay which could force you to reduce TSP contributions to make up the difference. Lower contributions can cause you to lose some FERS TSP match.

Eliminating FERS COLA

Impact: Severe

The FERS COLA is calculated by the U.S. Department of Labor and is based on the change in the Consumer Price Index (CPI) for Urban Wage Earners and Clerical Workers from the 3rd quarter average of the precious year to the 3rd quarter average of the for the current year.

The current FERS COLA is applied as follows:

  • If the CPI increases by less than 2%, the FERS pension is increased by the actual CPI
  • A CPI increase of 2%-3% means the FERS pension increase is capped at 2%
  • If the CPI increases by more than 3%, the FERS pension is increased by the actual CPI minus 1%

The current calculation may cause you to withdraw more from your TSP to cover expenses because the FERS COLA may not actually keep up with rising costs.

A COLA elimination would have a severe impact on retirement because the FERS pension payment would be frozen from the start of retirement. Again, drawing more from your TSP is a concern. You may risk running out of savings during your lifetime.

Eliminating FERS Supplement

Impact: Severe for those retiring under age 62

This Supplement, also known as the Special Retirement Supplement, provides an additional monthly pension to retirees who meet specific criteria:

  • Minimum Retirement Age with 30 years creditable service, OR
  • Age 60 with 20 years of creditable service, OR
  • FERS special provisions

This supplement helps “bridge the gap” between early retirement and Social Security eligibility at age 62. The calculation is based on the number of years of service and is a percentage of your Social Security benefit estimate at 62. The Supplement ends when you reach 62.

The elimination of this would have a severe impact on an early FERS retiree because it could cause you to withdraw more from your TSP during the years before Social Security eligibility.

Reducing G Fund Interest Rate in TSP

Impact: Moderate

The risk of this could vary. If your TSP portfolio is high-risk and much of your TSP is allocated to the G Fund, this could cause a lower performance and a reduced TSP balance at retirement. Other TSP investors may choose to invest more in the F, C, S, and/or I Funds. Depending on market volatility this may or may not work out well.

FEHB Share of Cost

Impact: None to Moderate

The government pays a large portion of the cost of FEHB and the employee/retiree pays a smaller share. The share of the cost of some FEHB plans could be increased for plans that don’t meet certain criteria performance metrics. This could cause the retiree to pay more for FEHB coverage or change to a different plan.

Annual/Sick Leave Changes

Impact: Mild

Currently, unused sick leave is added to creditable service and could increase your monthly FERS pension payment. Annual leave is paid out in a lump sum payment at retirement.

If both were combined, employees may have less paid time off and may no longer receive credit towards FERS pension calculation and/or may no longer receive a lump sum annual leave payment at retirement.

This may create a mild impact on FERS retirement but may necessitate more savings for the first few months of retirement while OPM is finalizing your FERS retirement application because annual leave payout may be lower or no longer offered.

Understanding how all, or any one of, these proposed changes could impact your retirement is important, so you can make sure you are prepared. The last thing you want to have happened is deplete your savings well before you were planning.

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New Workforce Priorities Report from OPM

priorities

Last April, the Office of Management and Budget released a report titled Comprehensive Plan for Reforming the Federal Government and Reducing the Federal Civilian Workforce. It instructed agencies to “achieve near-term workforce reductions and cost savings”.

This new 2018 Federal Workforce Priorities Report by the Office of Personnel Management says the priorities it identifies “align with and support the Administration’s initiatives to reshape the workforce and maximize employee performance as outlined in the OMB memo.”

The following 6 priorities in the areas of reshaping the federal workforce and maximizing employee performance are outlined in OPM’s report.

Workforce Reshaping

Priority 1: Succession Planning and Knowledge Transfer

Conduct succession planning activities to retain and transfer institutional knowledge, as workforce reshaping efforts are undertaken.

Priority 2: Deploying Communication Tools

Adopt tools that allow employees to easily connect, communicate, and collaborate with one another regardless of geographic location.

Priority 3: Securing Technological Solutions for Human Capital Analysis

OPM will seek to acquire or develop enterprise technological solutions to assist the federal human capital community with human capital analysis.

Maximizing Employee Performance

Priority 4: Expanding Employee Development Opportunities

Provide employees with many opportunities for continuous professional growth and skill development.

Priority 5: Bolstering Employee Recognition Programs

Administer robust programs to appropriately recognize and reward employees who demonstrate high levels of performance and significantly contribute to achieving organizational goals.

Priority 6: Enhancing Productivity through a Focus on Employee Health

Encourage employees to engage in physical fitness activities during time spent commuting and being at work.

Promoting Physical Activity at Work

With respect to Priority 6 above, this report outlines the benefits of a healthy workforce. OPM offers ideas for ways agencies can foster efforts to have healthier employees. The report didn’t say these things were mandatory or would be coming to agencies soon, rather it outlined the benefits of a healthy workforce and cited research supporting each suggestion.

Standing Desks—the report said, “stand-capable desks allow employees to quickly adjust their desk stations between sitting and standing positions. There are relatively inexpensive and readily available to agencies through the General Services Administration Global Supply.”

Exercise During Breaks—this report notes that in 2016, employers were offering onsite fitness centers and classes and even reimbursements for offsite fitness center memberships. The report also cites research that found employees who exercised regularly onsite at organizations, usually 45 minutes or less, showed improved mood and performance on those exercise days.

The complete report goes into detail about the future challenges and opportunities for the federal workforce, such as shifting demographics in the workplace and succession planning.

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Stick to Your TSP Saving Strategy

strategy

Saving for retirement is long-term. It’s an investment. It takes time. First, you need to establish your retirement goals and a strategy that helps you reach those goals. It’s much easier to stick to your plan once you have made goals and develop and a strategy.

Avoid Chasing Returns

Distractions happen. Don’t let short-term market movements lead you astray. Avoid merely chasing returns. Trying to “time the market” means you must be consistently correct twice—knowing exactly when to get out of a particular asset class and exactly when to get back in. This may work at times, but its’ highly unlikely to be successful over long periods.

Your investment performance is determined, in large part, by your asset allocation, not by guessing which market is going to be in favor at a certain time. Significant changes can occur quickly in stock markets. By the time you react, the market may already be moving in the opposite direction. This could cost you a lot of money over time.

Saving Consistency

It’s easy to be consistent about saving for retirement since you make contributions to your TSP through payroll deduction. Further, if you’re investing 5% of your salary, your agency matches that to help you even more.

Revisit Your Plan

Just as it’s important to stick to your plan and be consistent about saving, it’s equally as important to periodically review your strategy to make sure it’s in line with your needs, goals, timeline, and risk tolerance.

There are reasons to adjust your TSP allocation, such as approaching your retirement date. This should also signal a need for adjustment to your timeline and a consideration for a more conservative asset allocation.

Other events that might require modification include marriage, divorce, job change, military service, or economic hardship.

Remember, saving for retirement is long-term. Be patient. Trust the process. Be proactive, not reactive. Doing these should help you reach your retirement goals.

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OPM Gets it Wrong Sometimes

wrong

There are three chances to get an application approved for federal disability retirement. If it is denied at the initial stage at OPM, it moves to the Reconsideration stage at OPM, where you are assigned a different legal administrative assistant than before. Lastly, if your application is denied twice, the process moves to the Merit Systems Protection Board. This series of posts is going to focus on the initial and Reconsideration stages at OPM.

Harris Federal Law Firm has helped thousands of federal workers successfully obtain federal disability retirement benefits. And we’ve helped at all three stages of the process, if necessary. While most of our clients receive an approval at the initial stage, there are those that should’ve been approved but instead are denied.

Some of these denials, quite frankly, are ones that should’ve been approved in the initial stage. This series will detail some cases we’ve seen this.

Eligibility

The requirements for federal disability retirement are as follows:

  • You must have completed 18 months of federal civilian service creditable under FERS.
  • While employed in a position subject to the retirement system, you must have become disabled, because of disease or injury, for useful and efficient service in your current position.
  • Your disability is expected to last at least 1 year.
  • Your agency must certify its unable to accommodate your disabling medical condition in your current position and it has considered you for any vacant position in the same agency at the same grade or pay level, within the same commuting area, for which you are qualified for reassignment.
  • You must apply before your separation from service or with 1 year. Your application must be received by OPM or your former employing agency within 1 year of the date of separation. The time limit can only be waived if you were mentally incompetent on the date of separation, or within one year of this date.
  • You must apply for Social Security Disability. You don’t have to be approved, but an application for FERS disability retirement requires an application for SSD.

All of these must be met to receive federal disability retirement benefits.

The Case

A recent client of ours seemed to meet all these requirements. His employing agency noted a deficiency in service. Further, his treating physicians submitted medical evidence that his conditions were directly correlated with his inability to perform his duties as a Senior Officer Specialist for the Federal Bureau of Prisons.

Doctors diagnosed medical conditions such as PTSD, Seizure Disorder, Panic Attack Disorder, and Sleep Apnea. Doctors said his related symptoms of nausea, anger, nightmares, migraines, dizziness, confusion, and lack of concentration affected his ability to render useful and efficient service. They went as far to say, “the patient was not able to go back to work after his second hospitalization…[he] is not able to work, or work in any correctional facility.”

It was even made clear that the diagnosed conditions would continue for at least one year.

The FBOP was unable to make a reasonable accommodation and made no offer of reassignment.

Despite all the supporting medical evidence submitted, OPM found the claimant unqualified for federal disability retirement benefits due to:

  • His application failed to show his service deficiency was caused by his medical conditions.
  • The evidence didn’t show that his condition was disabling for at least one year.
  • There were no objective psychiatric testing or clinical findings to support his medical condition was severe enough for him to be considered disabled for useful and efficient service.

However, when his application was re-submitted in the Reconsideration stage, we were able to successfully show he did, in fact, meet all the eligibility criteria for federal disability retirement and he received an approval. The documentation submitted the first time should’ve been enough for an approval, but sometimes OPM, gets it wrong.

If you receive a denial letter in the initial stage, don’t give up.

If you need assistance with your federal disability retirement application, give us a call at 877-226-2723 or fill out this INQUIRY form. The consultation is always FREE.

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OPM Wants to Cut FEHB Costs

fehb

The Office of Personnel Management issued its annual call letter for benefit/rate proposals for Federal Employee Health Benefits programs. This annual letter outlines policy goals and initiatives for FEHBP for 2019. The letter provides an idea for FEHB participants to changes that may begin in 2019.

One emphasis in the coming year is quality and affordable health insurance coverage for federal employees. The call letter states:

“OPM has developed an agency strategic objective to improve the quality of healthcare received by enrollees in FEHB plans, increase the affordability of FEHB plans, and enhance the portfolio of available FEHB plans to increase the proportion that offer high quality at an affordable cost. In alignment with this strategy, this year’s call letter focuses on topics that we believe will keep the FEHBP on a path of innovation, quality, and affordability well into the next decade.”

To meet their objective, OPM is suggesting health insurance companies in FEHB consider the following:

  • Changing cost sharing for high value and low-value benefits to help ensure members are getting the most value for their healthcare dollar.
  • Implementing high-performance tiered provider networks that offer reduced cost-sharing for members who choose a provider from such a network.
  • Reducing cost sharing when members act to manage chronic conditions or obtain higher quality or more efficient care through provider partnerships.
  • Improving enrollee engagement and decision support through online portals.
  • Exploring innovative models that include other cost management techniques.

Prescription Drugs

OPM noted that “In 2016, 26.2% of total FEHB expenditures were on prescription medications”. While that’s a major expense, this call letter states, “studies have shown that approximately 50% of medications for chronic disease aren’t taken as prescribed”.

OPM is asking health companies in FEHB to find ways to make better use of prescribed drugs including making sure people are adhering to how the medicine is supposed to be used to be effective.

The agency is also asking carriers to “review their contracts and require that members are charged the lesser of the prescription price or applicable copayment amount for prescription medicines.”

The intended result is to provide quicker turnaround time and to reduce the number of prescription abandonment rates.

OPM also thinks better technology, like electronic prior authorizations, may also help by cutting down the time providers spend to exchange clinical information with their patients.

Opioid Use

The call letter says there are many items that must be included in the 2019 health plans for FEHB on the opioid epidemic. Items include ways to reduce the number of prescriptions for opioids when other alternatives may be available.

More emphasis on rehabilitation programs will also be available. A new system is now in place for tracking opioid use from multiple providers as well as data on prescriptions and addiction to these medications.

Genetic Testing

Genetic testing has become more relevant lately, so FEHB participants may start seeing significant changes in this area in 2019. OPM avoided saying what FEHB plans should include regarding genetic testing. Instead, they wrote:

“We strongly encourage FEHB carriers to review their current benefits and propose any needed revisions for 2019. All proposals should include a description of the carriers’ genetic testing strategy, the scope of included testing, and any applicable vendor partnerships.”

This letter provides some useful information on FEHB plans in 2019. Be sure to take the time to review it.

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