The Physicians and the Substance of a Federal Disability Retirement Case

Ultimately, the essence of any claim, endeavor, vocation or activity possesses a characteristic “essence” of a matter — that which defines itself, reveals its core value, and manifests the substantive content of what X “is” as opposed to the accidental and peripheral appearances which can throw one off from the central enigma of that which we seek to unravel.

That is the defining history of Western Philosophy; it is what Plato began in inquiring about the differences between Forms and appearances; what Aristotle did in rolling his sleeves up and getting down to the serious work of scientifically approaching the world through observation and keen perspective; and in more modern times, it is encapsulated by the work of Heidegger, who viewed every being as an encounter to unmask in the experiential sequel learned from his master, Edmund Husserl and the school of phenomenology.

The History of Philosophy has since been one of loss of stature, as all of the subsciences have taken on their prominent roles and fractured apart from the umbrella of philosophy.  Psychology, Anthropology, Physics, Theology — they have all found and formed their own mouthpieces.

Medicine and the physicians who represent the discipline of the medical community have a unique and enduring perspective; it has now become defined by an approach of pharmacology and surgery, prompting alternative movements of holistic endeavors. But until a time in a distant future which accepts “other” approaches, it is the physician with an “M.D.”, “D.O.”, or other such designation, which will be necessary in the acceptable community of opinions and judgments. Yes, Chiropractic care, Physical Therapists, Nurse Practitioners, Psychologists and LCSWs can help to prove a case; but the central focus of authoritative acceptance still comes primarily from that guy or girl who went to “medical school”.

For the Federal and Postal employee who seeks to obtain Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, the core of one’s case must be based upon a view towards the examiner, reviewer, or “Administrative Specialist” as designated by OPM, and what that individual will accept as the authoritative basis of a viable Federal Disability Retirement case.  This is a world where the word of the physician is paramount; and those in the communities of subsets can certainly lend authoritative support; but it is always a mistake to confuse the outpost for the headquarters.

In a viable OPM Disability Retirement application, it is important to obtain the opinion and support of that which will provide the essence of authoritative support, to the greatest extent possible. What opinion to seek; how the narrative opinion is characterized; who provides it; and what the substantive content will state — all will make a difference in preparing and formulating a Federal Disability Retirement application, and its proper presentation to the authorities at the U.S. Office of Personnel Management.

While the “enemy” may attack and destroy the perimeters and outposts, until the neurological center of an organism is defeated, all such efforts are destined to fail.

Sincerely,

Robert R. McGill, Esquire

 

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

CSRS & FERS Medical Disability Retirement: The Treating Doctor

There is efficacy and motivational bias.  Sometimes, unintended consequences result in the coalescence of both, but where the result is unaffected by the underlying reason for acting upon an event.

In OWCP cases, the motivational bias almost always includes the intent of the Department of Labor to try and save money, and to steer the injured worker to undergo treatment (if one can call it that) and oversight with one of “the company” doctors who can quickly declare a person to be healed and ready for return to full-time duty, despite protestations of pain, discomfort and limitation of movement, all to the contrary.

It is no accident that the ever-present Worker’s Comp Nurse who infringes upon the patient-doctor relationship by imposing her presence upon each visit, agrees whole-heartedly with any such assessment of full recovery, and ignores the pleas of the patient/OWCP benefit-recipient.

By contrast, those who are filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, are encouraged to speak with their longstanding treating doctors, as opposed to merely going to a doctor whose motivational bias may stem from the source of one’s payment.

Treating doctors who have a long tenure of doctor-patient relationships have little underlying motivation to do anything but look out for the best interests of the patient.  If Disability Retirement is the best course, then that will be what the treating doctor will support.  It is ultimately the relationship that has been established over the many years, which makes for all the difference.  And that difference is worth its incalculable weight in gold.

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 (for US Federal Employees): Administering Treatment versus Administrative Functions

Doctors rarely have any problems with administering treatment based upon clinical encounters and subjective narratives from their patients; yet, when it comes to providing a medical report and performing similar administrative functions, the sudden pause, hesitation, and sometimes outright refusal, is rather puzzling, if not disconcerting.

Such trepidation from the doctor can obviously result in a difficult wall for purposes of preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS.

For, much of medical evaluation, diagnosis, prognosis and prescribing of treatment encompasses receipt of subjective responses from the patient:  where the pain is present; the nature and extent of the pain; the history and chronicity of manifested symptoms; even functional capacity evaluations must necessarily be an observation of the subjective actions & reactions of the participant.  Of course, there are often distinguishable “objective” factors — swelling; carcinogenic versus benign tumors; broken bones, etc.

On the other hand, even MRIs and other diagnostic tools reveal only that X exists — not that X results in symptom Y.  An example would be a bulging disc — while the abnormality itself may show up on an MRI, whether the individual experiences any pain from the abnormality may differ from subject to subject.

This is why, despite the willingness of a doctor to treat based upon most factors being “subjective” in nature, it becomes a puzzle why the same doctor shows an unwillingness to write a report stating that, because of the medical conditions for which patient M is being treated, one must necessarily conclude that he or she cannot perform essential elements X, Y and Z of his or her job.

It is the jump from treatment-to-disability-determination which is often problematic for the treating doctor.  All of a sudden, the excuses flow:  “I am not trained to make such determinations”; “There is no objective basis for your pain” (then why have you been treating me for over a decade and prescribing high levels of narcotic pain medications?); “I can’t say whether you can or cannot do your job”; and many other excuses.

The switch from administering treatment, to treating administrative matters, is one fraught with potential obstacles.  How one approaches the treating doctor will often determine whether such obstacles can be overcome — and whether one’s Federal Disability Retirement application can be successfully formulated.

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

Federal Disability Retirement: Doctors and the Peculiarities of Treatment

Efficacy of treatment is the goal for a doctor; and upon information that such efficacy has failed to render improvement or incremental signs of progress, many doctors lose interest, or become suspicious.

Social Security Disability, of course, requires a higher standard of proof — one of essentially “total disability”, where one is no longer able to engage in “substantially gainful activity” — and, as such, is an implicit admission of medical failure.

FERS & CSRS Disability Retirement, however, is merely an acknowledgement that there are certain medical conditions which, limited in their scope and impact, prevent a person from performing one or more of the essential elements of a particular kind of job.  Such a person who goes out on Federal Disability Retirement benefits can still remain productive in the work-world, by pursuing another, different kind of vocation.

As such, from a medical point of view, conveying the distinction between the two is like the difference between identifying a hill as opposed to a mountain:  both may have some elevation, but the extent and scope between the two goes well beyond a linguistic peculiarity.

Sincerely,

Robert R. McGill, Esquire

Postal and Federal Disability Retirement: The Positive/Negative Approaches

The inverse of a thing can often be just as effective as the original matter; the ultimate endpoint may be the same, but stated in a different way.  

Thus, in preparing, formulating, and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, the preferred approach is the “positive” one, where one’s treating medical doctor will affirmatively connect the dots, create the nexus between one’s medical conditions and the positional duties of one’s Federal or Postal job, and thereby providing the foundational basis of a Federal Disability Retirement application.  

However, there are instances where the “inverse” approach, or the Negative entrance into the bureaucratic nightmare called Federal Disability Retirement, might have to be entertained.  Such an approach is a more complex process, within the context of an unwilling doctor.  It takes a thorough review of the doctor’s statements which should include, “Patient X is unable to do X, Y and Z” or “Patient A has limitations in the following areas…”  

Thereafter, of course, it is the Applicant for the Federal Disability Retirement who must (or his or her attorney, obviously) take the position description and argue the 1-to-1 correspondence between the medical condition, the limitations expressed by the treating doctor, and the positional elements which are applicable.  

In the end, if the doorway to success is achieved through either means, the efficacy of the effort is what matters, and not the pathway in getting there.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: The Supportive Physician

Physicians comprise a peculiar and unique breed of people; highly trained, the best physicians must be more than a technician, however, in order to effectively treat their patients.  The uniqueness of the profession itself requires a full panoply of skills, including intelligence of application; an acuity of judgment; analytical abilities in evaluating, assessing, diagnosing, and ultimately treating; a bedside manner which conveys confidence and compassion at the same time; and not least — an ability to listen and communicate.

For the Federal or Postal worker who is contemplating preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, a physician who is supportive of the potential applicant’s endeavor is crucial to the successful outcome of the entire administrative process.  By “support” cannot merely be characterized by a smile and a pat on the back; it requires that the physician be willing to make the connection between one’s medical conditions (which the treating doctor should have a thorough knowledge and understanding of) and the essential elements of one’s job (of which the Federal or Postal employee should have a deep and detailed awareness).

Thus, as the partnership for healing comes together in the creation and fostering of a doctor-patient relationship, so the fruition of a successful Federal Disability Retirement application begins with the coalescent cooperation between the medical professional and the Federal or Postal employee who is preparing, formulating, and filing for Federal Disability Retirement benefits.  How that cooperation comes together, of course, makes all the difference, and the tell-tale sign is the willingness to provide a detailed narrative medical report.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Workers: From the Doctor’s Perspective

In attempting to understand others, it is important to gain a perspective from which the third party views the world.  Understanding the third party perspective is a way to formulating an effective way of persuading a change in that person, if that is the goal. Or, perhaps understanding X merely in order to accept the behavior or actions of the individual, is enough of a reason.

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 often important to understand the perspective of one’s treating doctor in order to obtain the necessary support and administrative initiation of the medical provider.

From the doctor’s viewpoint, it is normally counter-productive in terms of treatment and therapy to declare, ascertain and deem that the patient is “totally disabled“.  Work is therapeutic; it allows for a teleological motivation which compels continuation in recuperative and rehabilitative terms.

Further, when this “fact” is combined with the general exposure of most doctors to other forms of disability benefits — state or federal OWCP benefits; Social Security Disability benefits; private disability insurance benefits — and rarely an encounter with FERS or CSRS disability retirement issues, it becomes apparent why doctors often become reluctant and resistant to getting involved with the administrative process.  OWCP benefits require an assertion of causality-to-employment; SSDI necessitates a declaration of “total disability”; private disability policies can often lead to depositions and legal responses.

Thus, everything that is counterintuitive to a doctor’s perspective of what is therapeutically beneficial to the patient, is potentially there when presented with a request for support in a disability retirement case.

Explanation is the key to understanding; effective explanation should persuade and alter a perspective founded upon a misinformed foundation.  It is often necessary to explain the differences between FERS & CSRS disability retirement benefits and the “others” which have previously polluted the waters of a pristine stream of thought.

Sincerely,

Robert R. McGill, Esquire