Federal Worker Disability Retirement: Work as the Causal Inception

In a claim filed with the Office of Workers’ Compensation Programs (OWCP), causality and whether it is work-related, occupationally related, etc., are issues which will inevitably arise, precisely because the statutory mandates which govern OWCP rules and regulations require proof of a causal connection.

Under Federal Disability Retirement for FERS & CSRS employees, however, such work-related causality is not an issue, because it is not a requirement that a medical condition was “caused” while performing one’s Federal or Postal job, or that there be some connection to an occupational hazard or inherent workplace relationship.  That does not mean, however, that there cannot be a workplace connection; merely that, whether or not there is any such relationship between the medical condition and the work environment, it is not an issue which possesses any significant relevance to the filing of a Federal Disability Retirement application.  

These “fine distinctions” can be confusing for non-lawyers (and, indeed, even for lawyers who are supposedly trained in being able to analytically dissect multiple compounding concepts within statutory language).  

“Causality” to the workplace can, however, be discussed and even referred to in a medical report, or in the Applicant’s Statement of Disability (Standard Form 3112A), as a provision for historical and background context, but it is not an essential element to prove in a Federal Disability Retirement application under FERS or CSRS.  Too much emphasis on the historical context, however, can lead to the unforeseen and dangerous consequence of having one’s case characterized as a “situational disability“, and one must always be cognizant of such a danger.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Discretionary Determinations

Reviewing medical documentation often involves a discretionary determination in preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS.  Relevant documentation should be filed as an attachment in support of a Federal Disability Retirement application; sometimes, medical reports, notes and records which are from specialists or referral doctors, contain information which is helpful, irrelevant, or detrimental to an application, and determinations as to whether to file it or not is a matter of discretion.  

It is the responsibility of the Federal or Postal employee to prove, by a preponderance of the evidence, that one is entitled and eligible for Federal Disability Retirement benefits under FERS or CSRS.  Meeting the criteria of eligibility is a matter of some latitude; determining what evidence to include involves a certain amount of discretion; in either case, one must affirmatively prove one’s case.  

Thus, FMLA paperwork previously completed by the doctor may have addressed a particular issue for a specific timeframe; OWCP forms previously filled out by the doctor may pertain more to a particular time-period or for the issue of causation, etc.  In the totality of the picture of one’s history of medical conditions, one must utilize a discretionary sense of wisdom in determining which medical evidence will be helpful, and which may potentially hinder.  It is never an exact science; but then, science itself is no longer an exacting endeavor.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Office Notes

The Office of Personnel Management, in reviewing a Federal Disability Retirement application under either FERS or CSRS, will often request to see the doctor’s office/progress notes, detailing the history of treatment for the previous 18 months.

Such scrutiny of clinical notations made by the treating doctor is meant to verify and validate the statements made by the doctor in his or her medical narrative report, to see if there are internal contradictions between the clinical notes and the narrative report prepared for purposes of obtaining Federal Disability Retirement benefits.  Such a review of clinical notes can be an unfair process, precisely because they are being reviewed with a paradigmatic purpose in mind:  to “find” any inherently contradictory remarks or evidence which conflicts with statements made in the primary medical report.  

Thus, reviewing the medical notes in a vacuum, outside of the context of the entirety of treatment, and with the intention and motive of seeking out any “discrepancies”, will sometimes result in a denial based upon selective interpretation of the office/progress notes.  Statements such as, “medications are helping”, “patient notes feeling better”, “Is sleeping much better”, can provide a false picture of the actual progress of the Federal Disability Retirement applicant.  Indeed, such a skewed picture will often come up in the denial letter issued by the Office of Personnel Management, where the denial letter will selectively quote from the progress notes.

This reminds one of a particular case where the Office of Personnel Management quoted from clinical notes, statements made by the applicant:  “Feeling much better”; “Making great progress”; “overall doing very well.”  The problem, however, is that the applicant was permanently in a wheelchair, and the job was that of a Law Enforcement Officer.  It was denied at the Initial Stage; at Reconsideration, when the pertinent facts were pointed out to OPM, it was quickly approved.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: Too Much Information

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, brevity and succinctness should be the guiding rule.  Often, over-explaining and overstating a particular issue, while intending to be helpful and fully descriptive, can result in greater confusion and muddling of the issues.  

This is found not only in the Applicant’s Statement of Disability, but also in an Agency’s responsive completion of forms — both the Supervisor’s Statement as well as the Agency’s efforts for Reassignment and Accommodation.  Previously, much has been written concerning (for example) the Agency’s attempt to explain how the Federal or Postal employee was “accommodated” in various ways.  

Such explanations, while legally untenable precisely because the efforts engaged in did not in fact constitute an accommodation as the term is defined in Federal Disability Retirement laws, nevertheless confuse the issue with the Office of Personnel Management because (A) they often provide an appearance of having accommodated the Federal or Postal employee and (B) the Claims Representative at the Office of Personnel Management himself/herself neither understands the laws governing accommodation, nor applies it properly.  

The same is often true in a long narrative of the Applicant’s Statement of Disability — where causation, harassment, the history of the medical condition, the problems at the agency, the history of how one’s work could not be performed, collateral legal forums filed with, etc. are all extensively discussed.

Remember that an answer to a question should always be guided by the question itself.  Don’t create your own question and answer the question you composed. Rather, re-read the question, and answer only the question asked.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Simplicity of the Process

In becoming deeply involved in the morass of the bureaucratic process of preparing, formulating and filing a Federal Disability Retirement application under FERS and CSRS, it is often easy to become frustrated with the inherent complexity of the process.  

Because of the multi-faceted complexities of the administrative process (e.g., obtaining the proper format and language in a medical narrative report in order to meet the legal criteria for eligibility; creating and nexus between the essential elements of one’s position in the Federal Service with the symptomatologies of the interaction between the medical conditions and the essential elements; understanding and applying the various statutory authorities and legal precedents which have evolved over many years; of preempting — if necessary — statements by the Agency or the Supervisor; and multiple other issues to be addressed concurrently), it can be frustrating for an injured or disabled Federal or Postal employee to attempt to pull all of the intricate strings together into a singular yarn of coherency and succinct presentation of a narrative form.  

Such is the time to remind one’s self of the simplicity of the process — of the 3-part essence of a Federal Disability Retirement application which will ultimately be a paper-presentation to the Office of Personnel Management.  First, the medical narrative must be simple but concise, and must provide a proper bridge between the medical condition and why a Federal or Postal employee is unable to perform one or more of the essential elements of one’s job.  Second, one’s Applicant’s Statement of Disability must be consistent with the medical narrative reports — neither understated nor exaggerated, and guided by truth. And third, it is important to understand and apply the legal precedents, and use the law as what it is intended for — a tool for both a shield and a sword.  In life’s complexities, it is important to maintain a paradigm of simplicity.  Unfortunately, it is often the simplest forms which constitute the height of complexity.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement for Federal Workers: Moving Beyond

Once a decision has been made to begin preparing, formulating and filing for Federal Disability Retirement benefits under FERS & CSRS, then the mechanical aspects of gathering and compiling the evidence to make one’s paper presentation to the Office of Personnel Management must begin.

It can be a daunting process.  However, it is overcoming the initial timidity which is the first step.  The compilation of the proper medical narrative reports with the effective wording and nexus between the medical condition and essential elements of one’s job; the creation of a narrative word picture of one’s Applicant’s Statement of Disability; any legal arguments to be presented and cited; the remainder of the Standard Forms to be completed by the Agency; the insurance forms — one can easily get lost in the morass of such paperwork.  

Then, there is the “waiting period” — that long and anxiety-stricken time of waiting for the Office of Personnel Management to makes its decision at the Initial Stage, and if denied, at the Reconsideration Stage of the process; and, if denied a second time, an appeal to the Merit Systems Protection Board.  

It is during the “waiting period” that one must begin to think about the period “beyond” — that time when one becomes a Federal Disability Retiree, where one finally has the proper time to attend to one’s medical conditions, then to rethink in terms of another job, another career, another phase of life.  It is the time to think about “moving beyond” one’s self-perception and paradigm of self-conception of being a “Federal employee”, and instead to think of the re-created self in new and fresh terms.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Government Employees: Making Explicit the Implicit

Sometimes, it is implicitly clear in the formulation of the Federal Disability Retirement application that the applicant is unable to coherently present one’s case in a Federal Disability Retirement application under FERS or CSRS.  

Whether because of the physical limitations or the cognitive dysfunctions, the brevity of the statement on the Applicant’s Statement of Disability, or the illegible handwriting, etc., may well provide an indication of one’s medical conditions and their impact upon one’s Federal or Postal duties in a particular position.  But to rely upon an implicit revelation, or to expect that a Claims Representative at the Office of Personnel Management may infer the intractable pain which the potential applicant may be experiencing, is to expect that which will likely not happen.  

The paper presentation offered to the Office of Personnel Management must be explicitly stated at every juncture, at every opportunity, at every potentially coordinating point — with succinctness and clarity of delineation, utilizing the language available, inserting the most effective, descriptive adjectives to create a compelling word picture, governed by truth and justified by the medical documentation within the parameters of the law, in order to express that which has previously remained implicit.

To make explicit that which is implicit is the key; to expect the implicit to be recognized by the reviewing individual at the Office of Personnel Management is to expect the impossible.

Sincerely,

Robert R. McGill, Esquire