| |
The U.S. Office of Personnel Management (OPM), the Social Security Administration (SSA) and several other Federal agencies are working together on a test project to provide better customer service for Federal employees applying for both FERS and SSA disability benefits. This test project is called "FEDMER"-- Federal Medical Evidence of Record.
As with most other public and private disability programs, FERS disability applicants must also file for Social Security Disability Insurance (SSDI) Benefits since the law requires that FERS disability benefits be reduced if SSA benefits are awarded. While the rules for qualifying for FERS and SSDI differ, both programs require that decisions be based on medical evidence of record - or MER - provided by the employee's medical provider.
Although Federal agency human resource staffs work closely with applicants to make sure OPM has all the medical evidence of record and other information it needs for a FERS decision, there is no current process for OPM to share this information with SSA staff. SSA, therefore, routinely asks applicants and medical providers for the same medical evidence of record that OPM already has. This has confused and frustrated everyone involved -- applicants, medical evidence providers and agency staffs.
In the FEDMER test project, agencies will send MER and other claims-related documents provided by the applicant and medical provider directly to OPM, which will forward them to SSA. This will ease the burden on the applicant and the medical provider and improve the SSA process as well. The end result will be that applicants are likely to receive an SSA decision sooner and be more satisfied with the process.
HOW DOES FEDMER WORK?
- It's simple. You receive a FEDMER packet which includes the FERS Application package and an SSA-Preclaim's Package, which contains information and forms needed for your Social Security disability application. Your agency benefits specialist will go through the packet with you.
- You sign the attached Statement of Participation that informs SSA that you intend to file for Social Security disability benefits. You don't have to call or go to a Social Security Office directly.
- You contact your medical providers (e.g., any health professional who has records and other information about your disability) and get them to complete certain FERS forms and to provide you and your agency with medical records about your disability.
- You return your completed FERS application and SSA forms to your agency. You may also provide your agency with your birth
certificate and proof of military service (if this documentation is not provided, your claim will not be delayed; however, SSA will
request it later in the process). Upon receipt of this documentaion, your agency benefits specialist will review them, copy and certify documents (such as a birth certificate and DD214 -- proof of military service) and send the information to OPM for a decision. If you've stopped working, your agency will alert SSA to set up a claims interview (preferably by phone) to complete your SSA application.
- OPM will make its decision right away if it has all the information it needs. If it is clear that certain documentation is
missing, OPM will work with you, your agency, and your medical providers to get it and make a decision as quickly as possible. You and your medical provider will not be asked to provide the same medical information to SSA. OPM will forward it all to SSA for you.
- SSA likely can make a decision sooner because it will know you've stopped working and will have the MER you've provided already on hand. SSA may, however, need additional MER for its decision. If so, SSA will schedule and pay for any special medical tests.
- When SSA makes its decision, it will send OPM a copy of your decision letter. If you qualify for SSA disability benefits, OPM will be able to adjust your FERS benefit faster so that you receive the right amount sooner.
WHY SHOULD YOU PARTICIPATE?
The FEDMER advantages are:
- You get both the FERS and SSA forms you need right away.
- Both OPM and SSA will use the evidence you collect.
- You and your medical provider won't need to provide the same information twice.
- Evidence will reach SSA faster, allowing SSA to make a decision more quickly.
- Your agency can certify certain documents SSA requires, such as your birth certificate, rather than sending the originals to SSA.
- You don't waive any of your rights under either program and can withdraw at any time.
WHAT IF I DECIDE NOT TO PARTICIPATE?
You will not be disadvantaged in either claims process. You must provide OPM and your agency with proof that you have filed for SSA benefits. You and your medical provider must provide MER and other information separately to each agency.
|
|