Ri38-047_March2004_High-Light

United States
Office of Personnel Management
Retirement Services Program

Form Approved:
OMB No. 3206-0237

Information and Instructions on Your Reconsideration Rights
I. Information

II. Procedures

Reconsideration is OPM’s review of its initial decision in
order to verify that all applicable laws and regulations
were properly applied.

The procedures for requesting reconsideration — as
established by Federal regulation — are as follows:

This notice gives specific instructions on how you may
request reconsideration of an initial decision made by
OPM’s Center for Retirement and Insurance Services
in any case where the decision:

·

Affects your rights or interests under the Civil Service
Retirement System or under the Federal Employees’
Retirement System, except in matters pertaining to
disability retirement and annuity overpayments.
Different instructions apply to these exceptions; see
below for more information. (5 C.F.R., Part 831 and
841)

·

Denies you basic or optional life insurance coverage
under the Federal Employees’ Group Life Insurance
Program or denies you the right to change your
post-retirement basic life insurance coverage after
retirement. (5 C.F.R., Parts 870, 871, 872, and 873)

·

·

Denies your request to enroll or change enrollment in
the Federal or Retired Federal Employees Health
Benefits Program. (5 C.F.R., Parts 890 and 891)
Denies your request to permit coverage of someone as
a family member under the Federal or Retired Federal
Employees Health Benefits Program.
(5 C.F.R., Parts 890 and 891)

These instructions do not apply to:

·

Decisions concerning a disability retirement eligibility.

·

Initial decisions under 5 U.S.C. 8336(c) regarding law
enforcement or firefighter eligibility.

·

·

A. Make your request in writing and state that you are
requesting reconsideration; if possible, include a copy
of the initial decision on which your request is based.
Include your name, address, date of birth, claim
number (if applicable), name of the health insurance
plan (if applicable), and your reason(s) for the request.
B. Your written request for reconsideration must be
received by OPM within 30 calendar days from the
date of OPM’s initial decision. (OPM can extend the
time limit if you can show that you (1) were not
notified of the time limit and were not otherwise aware
of it or (2) were prevented from responding by a cause
beyond your control.)
C. Send your request for reconsideration to:
Office of Personnel Management
Retirement Operations Center
P.O. Box 45
Boyers, PA 16017-0045
If you plan to submit additional evidence to support your
claim and that evidence is not immediately available, you
must:

·

Submit a written request for reconsideration within the
30-day time limit; and

·

Include in your request for reconsideration a statement
that you will be submitting additional evidence, a brief
description of the evidence you will submit, your
estimate of the date the evidence will be available, and
a brief explanation for the delay.

Decisions to collect an annuity overpayment.

We will acknowledge receipt of your statement and let you
know the date after which additional submissions will not
be accepted.

Where applicable, OPM will give you separate specific
instructions and information in the above instances.

III. Final Decision

Requests for reconsideration of claims denied by your
health insurance carrier should be sent to the address
shown in the brochure of your plan.

After reviewing our initial decision and any new evidence
that has been submitted, OPM will send you a final
decision in writing. We will send copies of that decision to
any competing claimants or to your employing office, if
applicable.

If you want general information about benefits or a written
decision on another matter, you should write to:
Office of Personnel Management
Retirement Operations Center
P.O. Box 45
Boyers, PA 16017-0045

Previous edition is usable

Public Burden Statement
We think this form takes an average 45 minutes per
response to complete, including the time for reviewing
instructions, getting the needed data, and writing the
request for reconsideration. Send comments regarding our
estimate or any other aspect of this form, including
suggestions for reducing response time, to the Office of
Personnel Management (OPM), OPM Forms Officer
(3206-0237), Washington, DC 20415-7900. The OMB
Number, 3206-0237, is currently valid. OPM may not
collect this information, and you are not required to
respond, unless this number is displayed.

RI 38-47
Revised March 2004