Federal Worker Disability Retirement: Is the Concept of “Preexisting Condition” Ever an Issue?

Sometimes, the Office of Personnel Management will refer to a medical condition which “preexisted” — and it is often confusing as to what they are referring to.  The term “preexisting medical condition” must necessarily imply the question, “Preexisting to what”?  

For health insurance coverage, the issue is obviously one of a medical condition which existed prior to the start of medical coverage, and thus the question becomes whether or not the insurance company has an obligation to pay for medical bills incurred for treatment which existed and began prior to the terms of the policy.  

For purposes of Federal Disability Retirement, however, the question of a preexisting medical condition often encapsulates an admixture of multiple issues, based upon confusing a variety of concepts.  In a denial issued by the Office of Personnel Management, some cases will be denied based upon the assertion that a particular medical condition upon which a Federal Disability Retirement application is based, preexisted the time of Federal Service, and the Federal or Postal employee — despite the existence of the medical condition — was able to perform the essential elements of the duties of the Federal or Postal position.

Thus, a person with a confirmed Veteran’s Administration rating enters into the Federal government and is able to perform the job duties as required (for example).  Such an argument (or lack thereof) by the Office of Personnel Management is thus mixing a couple of issues, and conceptually identifying it as “preexisting condition”:  that the Federal or Postal employee has a medical condition which was identified prior to entering the Federal Service; that he or she was able to successfully perform the essential elements of the job; that the same medical condition is now the basis (or at least one of them) for a Federal Disability Retirement application.  But the issue is not really one of “preexisting condition” — for, whether the medical condition existed prior to or during one’s Federal Service is really an irrelevant issue — but rather, whether or not the medical condition as such became worse such that it now prevents a Federal or Postal employee to perform one or more of the essential elements of one’s job.  

Sometimes, people get the notion that by utilizing certain language, shouting certain sophisticated-sounding catch-phrases, or referring to concepts which seem intelligible, that it actually “means” something.  The concept of “preexisting conditions” is without meaning in a Federal Disability Retirement application, precisely because the law is neutral concerning that issue.  It may sound serious, but this is not OWCP or some other legal forum which applies a criteria regarding “preexisting conditions”.

Sincerely,

Robert R. McGill, Esquire