CalPERS Disability Retirement Attorneys

Appealing Denied CalPERS Disability Retirement: Pitfalls & How to Avoid Them

Receiving a denial letter from CalPERS after applying for disability retirement can be devastating, particularly for public employees whose medical conditions prevent them from continuing their careers. However, many denied applicants make critical mistakes during the appeal process that doom their cases before they reach a hearing. The experienced attorneys at the Los Angeles area law firm of Cantrell Green help denied applicants identify what went wrong in their initial applications and develop appeal strategies that address CalPERS’s specific concerns.

Understanding why applications fail and how to fix those problems during the appeal process significantly improves outcomes. Moving beyond simply refiling the same information toward strategically addressing deficiencies transforms weak applications into successful appeals.

Why CalPERS Disability Applications Get Denied

CalPERS denies disability retirement applications for several recurring reasons that applicants must understand before mounting effective appeals. Insufficient medical documentation ranks among the most common grounds for denial. CalPERS requires objective medical evidence demonstrating that the applicant cannot perform essential job functions, and opinions from treating physicians alone often don’t meet this standard. Without comprehensive documentation linking specific medical conditions to specific job limitations, applications fail.

Failure to establish permanence dooms many applications. CalPERS disability retirement requires conditions that are permanent and stationary, meaning they’ve reached maximum medical improvement and won’t significantly change with additional treatment. Applications submitted too early, before conditions stabilize, or without clear medical opinions regarding permanence, face denial for this reason.

Inconsistencies between claimed limitations and other evidence also trigger denials. CalPERS reviews social media, surveillance footage, and other evidence that may contradict claimed disabilities. Applicants whose activities appear inconsistent with their alleged limitations face credibility challenges that undermine their entire applications.

The CalPERS attorneys at Cantrell Green in the Los Angeles area analyze denial letters to identify the specific deficiencies that caused initial applications to fail and develop targeted strategies to address these issues on appeal.

Procedural Mistakes in CalPERS Appeals

The CalPERS appeal process involves strict procedural requirements, and missing deadlines or failing to follow proper procedures can forfeit appeal rights entirely. Applicants have limited time to request administrative hearings after receiving denial notices, and this deadline is not flexible. Many denied applicants, still processing the disappointment of denial, miss this critical window and lose their opportunity to contest the decision.

Failure to request all relevant documents from CalPERS before the hearing leaves appellants unable to challenge the evidence used against them. CalPERS maintains files containing medical reviews, investigative reports, and other materials that inform their decisions. Without reviewing this evidence, appellants cannot effectively rebut negative findings or identify errors in CalPERS’s analysis.

Inadequate hearing preparation frequently distinguishes successful appeals from unsuccessful ones. Administrative hearings before the Office of Administrative Hearings follow formal procedures including evidence rules, witness examination, and legal argument. Applicants unfamiliar with these procedures often fail to present their strongest evidence effectively or to challenge CalPERS’s evidence appropriately.

The experienced attorneys at the Los Angeles area law firm of Cantrell Green ensure clients meet all procedural requirements and prepare thoroughly for CalPERS administrative hearings that determine their retirement futures.

Fixing Documentation Deficiencies in CalPERS Appeals

Medical documentation deficiencies represent the most fixable problems in denied CalPERS applications. If initial applications relied primarily on brief physician statements or check-box forms, appeals should include comprehensive narrative reports addressing job-specific functional limitations. Physicians must explain not just what conditions exist but specifically how those conditions prevent performance of essential job functions.

Independent medical evaluations from specialists in the relevant medical field often prove more persuasive than treating physician opinions. CalPERS and administrative law judges may view treating physicians as advocates rather than objective evaluators. Independent specialists who review all medical records and conduct thorough examinations provide the objective evidence CalPERS requires.

Vocational evidence linking medical limitations to job requirements strengthens documentation packages. Vocational experts can analyze job descriptions, identify essential functions, and explain why specific medical limitations prevent performance of those functions. This expert testimony connects medical evidence to the legal standard for disability retirement.

The CalPERS attorneys at Cantrell Green in the Los Angeles area work with medical specialists and vocational experts to develop documentation that addresses the deficiencies identified in denial letters.

Addressing Credibility Concerns in CalPERS Cases

When CalPERS denials suggest credibility concerns based on surveillance, social media, or inconsistent statements, appeals must directly address these issues rather than ignore them. Explaining apparent inconsistencies often proves more effective than hoping administrative law judges won’t notice them. Activities that seem inconsistent with disability claims may have reasonable explanations that, when properly presented, resolve credibility questions.

Medical evidence explaining why certain activities remain possible while job functions remain impossible helps reconcile apparent inconsistencies. Many conditions produce variable symptoms, allowing good days and bad days. Others limit specific movements or sustained activities while permitting brief tasks. Expert testimony explaining these distinctions addresses credibility concerns arising from misunderstood medical realities.

Witness testimony from coworkers, supervisors, family members, and friends who have observed the applicant’s limitations provides corroboration that counters CalPERS’s credibility attacks. When multiple witnesses consistently describe limitations the applicant claims, isolated surveillance footage showing a few minutes of activity becomes less persuasive.

The experienced attorneys at the Los Angeles area law firm of Cantrell Green develop strategies to address credibility concerns head-on in CalPERS appeals, turning potential weaknesses into opportunities to demonstrate the genuine nature of clients’ disabilities.

Building a Winning CalPERS Appeal Strategy

Successful CalPERS disability appeals require comprehensive strategies that address every deficiency identified in denial letters while anticipating CalPERS’s likely arguments at hearing. This begins with thorough analysis of the denial letter to understand exactly why the application failed. Generic appeals that don’t target specific deficiencies waste the opportunity to fix identified problems.

Gathering additional evidence before hearings strengthens appeal cases. Updated medical records documenting ongoing treatment and continued limitations show that conditions persist. New diagnostic testing may reveal objective findings that weren’t available during the initial application. Employment records documenting job requirements provide the foundation for proving inability to perform essential functions.

Preparing witnesses and organizing evidence for effective presentation at hearing maximizes the impact of strong appeal cases. Administrative law judges evaluate credibility based on witness demeanor as well as substance, making preparation for testimony important. Evidence must be organized logically and presented persuasively to tell a coherent story of disability that meets CalPERS requirements.

The CalPERS attorneys at Cantrell Green in the Los Angeles area build comprehensive appeal strategies designed to overcome the specific obstacles that caused initial denials and position clients for successful hearings.

Los Angeles Area CalPERS Attorneys

CalPERS disability retirement denials don’t have to be the final word. Understanding why applications fail, avoiding procedural mistakes during appeal, fixing documentation deficiencies, and addressing credibility concerns strategically transforms denied applications into successful appeals. The appeal process offers opportunities to correct problems and present stronger cases than initial applications allowed.

The experienced attorneys at the Los Angeles area law firm of Cantrell Green help denied CalPERS applicants navigate the complex appeal process and develop winning strategies for administrative hearings. If your disability retirement application has been denied, schedule a consultation to discuss what went wrong and how to build a successful appeal.

Free Consultation with Los Angeles CalPERs Attorney: 562-622-4800

This article applies to members of  California Public Employees’ Retirement System (CalPERS); and does not reflect the rules, laws or regulations governing how other public retirement systems are administered. If you have question about another public employee retirement system, find your system, below – or call our attorneys at: 562-622-4800