Employees who become disabled during the course of their federal career may be entitled to a disability annuity. First, under CSRS/CSRS Offset, they must have completed at least five years of federal civilian service; under FERS, only 18 months. Second, while employed in a position covered by either CSRS/CSRS Offset or FERS, they must have become disabled for “useful and efficient service” in both their current position and any other vacant position at the same grade or pay level for which qualified.
Before they can be considered eligible for a disability retirement benefit, their employing agency must determine that they are not qualified for reassignment to any other vacant position within the agency and commuting area at the same grade or pay level of the position they currently occupy. In addition, they or someone acting for them must file an application for disability retirement.
An employee is “disabled” when the information submitted indicates that there is a service deficiency caused by disease or injury, of sufficient degree to preclude useful and efficient service. “Useful and efficient service” means:
- either acceptable performance of the critical or essential elements of the position or the ability to perform at that level; and
- satisfactory conduct or attendance.
Service that is not “useful or efficient” is a level of performance or attendance which, if it were to continue, would warrant denial of a within-grade increase, demotion or other remedial action.
Refusal to accept reassignment to a position at the same grade and pay level in the same commuting area terminates the agency’s obligation to identify any other vacant position and may disqualify the employee from further consideration for disability retirement.
Filing a disability annuity claim
A claim for disability retirement must include documentation that clearly and specifically establishes:
• a deficiency in service with respect to performance, conduct or attendance, or in the absence of any actual service deficiency, a showing that the medical condition is incompatible with either useful service or retention in the position;
• a medical condition defined as a disease or injury, including psychiatric disease;
• that the medical condition caused the service deficiency;
• the duration of the medical condition, both past and expected, and a showing that the condition, in all probability, will continue for at least a year;
• the inability to provide useful and efficient service arose while serving under CSRS/CSRS Offset or FERS;
• the inability of the employing agency to make reasonable accommodation to the medical condition; and
• the absence of another position within the employing agency and commuting area at the same grade or pay level and tenure, for which the employee is qualified for reassignment.
Employing agencies will provide assistance and the necessary forms to obtain statements from supervisors and attending physicians and proof that the condition prevents the employee from performing useful and efficient service. If the employee is found to be disabled as outlined above, the disability retirement will be approved.
Up to age 60, the disability retiree will be subject to periodic medical reevaluations to determine whether the disabling condition continues to exist, and an annual review of earnings to determine whether he or she is restored to earning capacity (total income from work in a calendar year exceeds 80 percent of the current pay level for the former job).
Note: Employees who are covered by CSRS Offset and FERS also must apply for Social Security benefits. If eligible for both, certain offsets will apply.
A disability annuitant whose annuity is terminated because of an “earning capacity provision,” and whose earnings in any subsequent year fall below 80 percent of the current rate of pay for the retiree’s former position, may obtain reinstatement of benefits if the retiree has not been reemployed in a federal position and “has not recovered from the disability for which he was retired.”
Likewise, regulations at 5 CFR 831.1211(a) provide that when a disability annuity stops, “the individual must again prove that he or she meets the eligibility requirements in order to have the annuity reinstated.” In the case of a disability annuitant whose earning capacity has been restored but who thereafter loses his or her earning capacity, the regulation provides that benefits will be reinstated if the annuitant “has not recovered from the disability for which retired.”
The regulations define “disability” to mean “inability, because of disease or injury, to render useful and efficient service in the employee’s current position, or in a vacant position in the same agency at the same grade or pay level for which the individual is qualified for reassignment.”
The statutory and regulatory requirement that the employee prove that he or she “has not recovered from the disability” for which retirement was granted means that the employee must prove not only the existence of a medical condition, but also that the medical condition is disabling in nature—that it prevents the employee from rendering efficient and useful service in the employee’s position or an equivalent position.
The retiree is not entitled to resumption or retention of disability benefits simply by showing that his or her medical condition is similar, or even identical to, the condition that resulted in an initial determination of retirement eligibility. The retiree must also show that the medical condition is disabling.