Medical Retirement for Federal Workers: Testing a Relationship

If the advent of a crisis is a true test of a relationship, then the satisfaction of an ongoing need in response to the crisis is the harbinger of sincerity.  Testing the relationship is often the secondary trauma one must experience in life; for, the feeling of isolation which often accompanies a crisis — that sense that no one else can fully understand the experience; that others, while empathetic words of condolences may be uttered, can always seek the refuge of their comfortable zones of privacy and go on with their lives — is further exacerbated by the island of singularity which one recognizes in the face of finding one’s self in the the human condition of crisis.

For the Federal and Postal employee who suffers from a medical condition, such that the chronicity and progressive decline of that medical condition impacts one’s ability to perform all of the essential elements of one’s job, the testing of relationships must necessarily occur.  The test of that doctor-patient relationship, to see whether and to what extent one’s longstanding treating doctor will support the need for Federal Disability Retirement; the test of the worker-to-coworker relationship; the employer-employee relationship; they all become tested, to observe their elasticity, their durability, and their sincerity.

Fortunately, it is not one’s own agency which makes a determination on a Federal Disability Retirement application, but rather, a separate, independent agency — the U.S. Office of Personnel Management.  But one’s own agency is required to complete certain portions of a Federal Disability Retirement application, and those required parts will also be a partial test.  For the Federal and Postal employee who must endure the crisis of a medical condition.

Federal Disability Retirement is a process which will test many things — not the least of which will involve who were and are one’s true friends.

Sincerely,

Robert R. McGill, Esquire

 

Medical Retirement Benefits for US Government Employees: Physicians

Physicians are peculiar animals.  They are here to help; and from their perspective, success is measured in terms of how rarely a patient returns for further care.  The ultimate sentence of failure is to conclude that nothing further can be done for an individual, and one must therefore declare that the patient is permanently disabled.

For the Federal or Postal employee contemplating filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, such a perspective on the part of the physician is important before approaching the treating doctor with a request for a medical report.  That is why the SF 3112C is such an ineffective vehicle of communication.

Consider this:  SF 3112C is a government-prepared form; it is formulated by Federal bureaucrats; the language merely proposes generic guidelines concerning what is required — without any amendments or consideration of case-law refinements which have been promulgated over the evolution of Federal Disability Retirement laws over these many years.

Perhaps more importantly, however, is the lack of bedside manners in handing to a physician a standard form.  While many physicians themselves lack adequate bedside manners, it is the epitome of bad form to thrust a pre-printed form (no pun intended) under the nose of a physician who is supposed to be treating and taking care of you, and to declaratively order, “Fill this out”.  Even an addendum of “please” will not adequately modify such an affront.

The physician-patient relationship is one based upon communication, knowledge, personal sharing, and a good bit of explaining.  Taking the time to prepare a physician is the least one should do in preparing for an effective Federal Disability Retirement application.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for US Government Employees: Succinctly Put

In a technological age where one’s attention is diverted by multiple needs, wants and necessities, the old adage that “time is money” is merely a reflection of the commodity-based approach prevalent in our society and lives at large.

One understands that in certain geographical locations, to encounter the salutation, “Hi, how are you,” is merely a formality, and is not meant to have one pause and actually provide the historical details of the past day, week or month, leaving aside any acceptable response other than a quick, “Fine, thank you,” and to walk quickly by.

In other parts of the country, foreign or domestic, such a greeting must actually be met with a personal conversation, lest one is left to be considered rude and unneighborly.  It is precisely because time is considered a valuable and threatened commodity, that one is left with attempting to devise ways in which to “maximize” the precious but ethereal substance.

In a Federal Disability Retirement application, when one approaches a medical doctor in requesting records, notes, or a rather detailed report in order to obtain support for one’s Federal Disability Retirement submission through the U.S. Office of Personnel Management, it is important to explain thoroughly; to request in detail; but at the same time, to remain succinct in order to deal with the aspect of time as a commodity.

Doctors know the value of time; they tie it to life and death decisions on a daily basis, and are keenly aware of the importance of a life’s time.  To show respect for a doctor’s time is important in the very approaching of the medical personnel.  It is simply one more thing to keep in mind in preparing, formulating and filing for Federal Disability Retirement benefits from OPM, whether under FERS or CSRS, for all Federal or Postal employees.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Delicate Balance between Persistence, Perseverance, and Pestering

Persistence, perseverance, pestering…is it all the same?  The first of the three implies an enduring deliberation of effort, and is neutral as to whom it applies to; the second is normally in reference to the individual who is engaging in the effort; and the last carries with it a negative connotation, like a gnat who is attracted to the smell of someone’s shampoo or body odor.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, it is important to distinguish the subtle differences between the three words applied.  For, in the end, it is not the words, but the actions which each describes, which is important for the entire administrative process.

Persistence may be appropriate for the relationship between the patient and one’s doctor, in pursuing medical treatment, and support for one’s Federal Disability Retirement application. Perseverance may be seen as a valiant character issue, for a multitude of things, including undergoing medical procedures, trying to continue to work despite medical obstacles, exhausting all avenues with an agency, etc.  Pestering, if seen from a doctor’s viewpoint, reflects an attitude which may betray a desire to support one’s Federal Disability Retirement application.

There is often a delicate balance between the three, and one must be sensitive to such a balance in preparing, formulating and filing for Federal Disability Retirement benefits from OPM.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement for Federal Workers: Responsibility of the Applicant

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, the importance of adequately conveying persuasive information to the Claims Representative at the Office of Personnel Management must be a primary goal of the Federal or Postal employee.  

Rarely does a doctor, without guidance and some “prodding”, execute an administrative duty such as preparing a medical narrative report for a patient, in a sufficiently excellent manner.  The work product of a doctor is normally defined by patient care, clinical examination, and prescribing an effective course of treatment.  It is up to the patient or his/her Federal Disability Attorney to remind the doctor as to “why” it is important to provide a medical narrative report in a Federal Disability Retirement application.  

Often, it is merely that the doctor does not understand the necessity of preparing a narrative report; or, as confusing as the entire administrative process of preparing a Federal Disability Retirement application is to the Federal or Postal employee, it is exponentially more confusing to the doctor, who is normally not part of the Federal workforce (unless he or she happens to be a doctor for the Department of Veterans Affairs, or is part of the Veterans Health Care System).  

It is ultimately the responsibility of the Federal or Postal employee to convey persuasive evidence and argumentation to the Office of Personnel Management, in order to meet that burden of proof, of showing that by a preponderance of the evidence the Federal or Postal employee has proven that he or she is eligible for Federal Disability Retirement benefits. While medical records, treatment notes, office notes, etc., can often be persuasive on their own, the applicant must be able to formulate a statement and refer to “the law” in order to convince the OPM Representative that his or her case meets that burden of proof.

Sincerely, Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Is the Doctor in, Please?

In preparing, formulating and filing an OPM Disability Retirement application under Federal employee retirement system (FERS), the support of one’s treating doctor is essential in putting together an effective presentation to the Office of Personnel Management.  Sometimes, even doctors have to be reminded of his or her “obligation” to a patient.  When, how, and in what manner of approaching the doctor, is a discretionary element of the process best left up to the patient.  

The reason why the “treating doctor”, as delineated by cases and opinions rendered by Administrative Judges at the Merit Systems Protection Board and by Judges at the U.S. Court of Appeals for the Federal Circuit, is the best one to provide a clinical assessment and evaluation of one’s ability or inability, and the extent thereof, of performing one or more of the essential elements of one’s job, is that the long-term relationship that has been (or should have been) established over these many years of treatment, is a foundational basis of being able to ascertain the abilities, capabilities, and limitations of the patient’s physical, emotional and mental condition. 

If a treating doctor hides behind the excuse of saying that he or she is not “equipped” to make a disability determination, or that there are doctors “out there” who specialize in disability determinations, and he/she is not one of them, an explanatory discussion should be engaged in with the doctor, which should include at least the following three (3) elements:  (1)  A reminder of the history of the doctor-patient relationship, (2) that your particular doctor is the one who knows the intimate details of your medical conditions and the history of treatment engaged in, and (3) that such administrative headaches resulting in obtaining Federal Disability Retirement benefits from the Office of Personnel Management is a vital part of the long and recuperative process that the doctor has been trying to attain.  

Ultimately, it is the treating doctor who is the best one to render an opinion as to whether a Federal or Postal employee whom the doctor is treating, can continue to perform all of the essential elements of one’s particular job.  The question then is, Is the doctor in?  Meaning:  Is the doctor still going to “be there” when it really counts?

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: The Reluctant Doctor II

Dealing with the Reluctant Doctor — one who presumably has been treating the potential applicant for Federal Disability Retirement benefits for at least several months, but often for several years — is a rather “touchy” subject.  

On the one hand, the build-up of confidence, confidentiality, and security developed over many years of having a doctor-patient relationship is at stake; on the other hand, the Federal or Postal employee has come to a critical point in his or her future, career and professional life, where the support of the treating doctor in the preparation, formulation and filing of a Federal Disability Retirement application has become necessary.  

Doctors, by nature dislike the administrative aspects of preparing lengthy medical narrative reports.  Yet, most doctors recognize the necessity of that aspect of their practice, and are willing to perform the service as part of their duty to their patients.  A diplomatic, sensitive balance must be struck, but one that is honest and placed within the appropriate context of one’s health and future well-being.  

In essence, the doctor must be asked about his or her support in preparing a Federal Disability Retirement application under FERS or CSRS, but in the context of a larger discussion concerning one’s health, treatment modalities, permanency and chronicity of disabling medical conditions, and future treatment.  In essence, the “reluctant doctor” must be persuaded to disrobe his or her reluctance, for the sake of the patient’s health.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Government Employees: Confirming the Relationship

After undergoing all of the those diagnostic tests; after allowing the doctor to clinically examine, prescribe multiple medications based merely upon the say-so of the doctor; after allowing for invasive surgery; sending you to physical therapy; if the time then comes to prepare and file a Federal Disability Retirement application under FERS or CSRS, it is important to confirm the real strength of that “patient-doctor” relationship that has apparently been ongoing and fostered for those many months, years, and sometimes, decades.

It is not enough to get a nebulous “pat-on-the-back-sure-I’ll-support-you” sort of response, and with that, you receive a thick packet from the medical office, you open it, and inside is merely a copy of your medical records.  No — “support” must be concrete and definitive. It must mean, specifically, that the doctor is willing to write an excellent medical report outlining his or her opinion in connecting your medical condition with you inability to perform one or more of the essential elements of your job.  If it is time to file for Federal Disability Retirement benefits, it is time to have a heart-to-heart talk with the treating doctor, and see how committed he or she really was and is to this “patient-doctor” relationship.

Sincerely, Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Patient-Doctor Relationship

In filing a Federal Disability Retirement application with the Office of Personnel Management, it is always preferable (though not an absolute mandate) to have medical reports and records from a “treating” doctor of some tenure.  What constitutes a “treating doctor” is fairly uncontroversial — it means that the report rendering an opinion concerning one’s physical or mental ability to perform all of the essential elements of your job should be prepared by a doctor who has provided medical treatment, and generally has a patient-doctor relationship.  The duration of the tenure which then creates such a “patient-doctor” relationship does not necessarily put a specific time frame upon a doctor.  It can mean anywhere from a month to a decade, in my view.

From the applicant’s perspective, it is important to understand that the person who is considering filing for Federal Disability Retirement benefits has been establishing and fostering that relationship, and this is important to see.  Those many years of going to the doctor, speaking to him or her about the most personal of problems — one’s medical conditions — is part of what creates that special bond identified as a “patient doctor relationship”.  It is a relationship which has been created and fostered through interactive needs, and that relationship should be strong enough to ask the doctor, when the time and need comes to fruition, for a medical report in support of one’s Federal Disability Retirement application.  So, at this point in the issue, as one is contemplating Federal Disability Retirement, does your interaction with your treating doctor constitute a “relationship”, or is it merely an economic exchange of goods and services?

Sincerely,

Robert R. McGill, Esquire

Go to:  Patient-Doctor Relationship (Part II)

FERS & CSRS Disability Retirement for Federal and USPS Workers: Tendencies

There are certain tendencies which seem to exhibit themselves on a spectrum of behaviors, and the pattern is fairly common.  As such, it is important to be aware of the natural tendencies of all parties involved when filing for Federal Disability Retirement benefits under FERS or CSRS.  For instance, it is a common tendency for the doctor — Family Doctor, Orthopaedic Surgeon, Neurologist, Psychiatrist, etc. — to avoid having to write a medical narrative report for a Federal Disability Retirement application.

What to do about it?  To try and place the doctor at ease by explaining the process in as direct, simple and concise manner as possible; then to tie the importance of the request for a Medical Narrative Report to the overall treatment plan for the patient — you.  To have an attorney involved can further ease the natural anxiety of a doctor — but it helps to have the client/patient forewarn the doctor as to the role and involvement of the attorney.

Attorneys and doctors are “natural enemies” (i.e., attorneys sue doctors; doctors hate to be sued; ergo, doctors have a natural tendency to dislike lawyers).  If the patient/client, however, approaches the doctor and explains that the lawyer who is representing him or her is there to explain the process, to guide the doctor in the preparation of the entire packet, including giving guidance to the doctor in formulating a medical narrative report, then the tendency towards anxiety and reluctance to assist in a Federal Disability Retirement application can be lessened and overcome.  Tendencies are there to be recognized, then to be adjusted in order to achieve a positive outcome.

Sincerely,

Robert R. McGill, Esquire