OPM Form SF 3112C and the Sufficiency of the Physician’s Statement

Confusing necessity and sufficiency is always a precarious matter. That which is necessary may not be sufficient for a given purpose, and failure in understanding such a fundamental distinction can be fatal to a Federal Disability Retirement claim.

SF 3112C requires that a physician complete and provide essential medical information in the pursuance of a Federal Disability Retirement application. The form itself — SF 3112C — is the vehicle by which the medical documentation is obtained. It is “necessary” in the sense that SF 3112C delineates a guideline of the type of information which is needed in order to become eligible for Federal Disability Retirement benefits.

The form itself — SF 3112C — however, is to a great extent irrelevant (although, the U.S. Office of Personnel Management has recently required that a signed SF 3112C be included in the final Federal Disability Retirement packet, despite SF 3112E clearly stating that an “equivalency” of the form would satisfy the lack thereof, as in the attachment of the medical documentation itself), and it is instead the medical documentation through which SF 3112C is obtained, which is what is important.

Regardless, while the OPM SF 3112C constitutes the vehicle, is necessary, but is ultimately irrelevant in and of itself, it is a necessary form to the extent that it mandates the delineation of what information is required for eligibility and entitlement to Federal Disability Retirement benefits.

Will following the guidelines in accordance with what SF 3112C states, result in a successful OPM Disability claim? That is the question of “sufficiency”, as opposed to “necessity”.

Over the years, case-law and statutory interpretation and expansion of Federal Disability Retirement laws have greatly altered the landscape of a Federal Disability Retirement claim. SF 3112C is the vehicle of necessity, although the form itself is an unnecessary one. The greater question is whether it is sufficient to meet the legal weight of preponderance of the evidence, and that question must ultimately be answered by questioning the efficacy of the form itself.

Sincerely,

Robert R. McGill, Esquire

SF 3112C

OPM Standard Form 3112C: Physician’s Statement:

Forms tend to intimidate; the more official the appearance, the greater heightening of anxiety in close encounters of this kind.  Beyond the alien look of some forms (for those who have already identified the two references to Steven Spielberg’s 1977 Science Fiction film, you have revealed what generation you are from), the size of the font, the extent of warnings issued (i.e., “Privacy Act and Public Burden Statements”, etc.), and most importantly, the cogency and clarity of understanding for a third-party being requested to provide valuable and necessary information on behalf of a patient — these are all important considerations to entertain.

In this busy world, where doctors must wear multiple hats — of administrative overloads, compliance with billing requirements in Medicare, Medicaid, and numerous other government portals, etc.; of earning sufficient income in order to pay staff, salaries and practice expenses; of ensuring privacy protections; and, finally, beyond all of the headaches associated with running a medical practice — of actually engaging in patient care becomes almost a secondary issue. Time is limited; time is a commodity of invaluable substance; time is a restrictive resource when the exhaustion of the modern world impinges upon the daily necessity of making a living.

And so the Federal or Postal Worker who is filing for Federal Disability Retirement benefits hands, sends, or faxes a government form, demanding that a doctor complete another issuance of what can only be kindly termed as a nuisance or a headache.  The normal response of the treating doctor is to procrastinate, ignore, or, worse yet, to put together a bundle of treatment records and send them off.

OPM Form 3112C, the so-called Physician’s Statement, is the crucial linchpin of a Federal Disability Retirement application; yet, the form itself is an intimidating venue which can predispose a Federal Disability Retirement application to a preview of failure. Are there alternatives? SF 3112C itself is put forth as if it is a necessary prerequisite in the entire process of filing for Federal Disability Retirement. The answer can be found in another form — SF 3112E — where it clearly states: Attach SF 3112C, Physician’s Statement (or its equivalent).

It is the equivalency which is the key to a successful Federal Disability Retirement application, for the Federal Employee on long-term sick leave (SL) or the injured Postal worker who is preparing, formulating and filing for Federal Disability Retirement benefits, whether one is under FERS or CSRS, through the U.S. Office of Personnel Management.

Equivalencies matter, and what constitutes such “equal-ness” in acceptable form, is the key to a successful Federal Disability Retirement application.

Sincerely,

Robert R. McGill, Esquire

 

Disability Retirement for Federal Workers: How and What

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, “how” one states something is often just as important as the “what” one says.

The latter is relevant for obvious reasons:  the subject of the statement is the “identifier” for purposes of directing the reader (in this case, the person who is handling your Federal Disability Retirement benefit application at the U.S. Office of Personnel Management) to focus upon a particular matter; but just as importantly, “how” it is said — i.e., the tone, tenor and context of the “what”.

How a medical report is stated will often determine the success of a Federal Disability Retirement application, more than what is expected to be said.  For, from the perspective of the Office of Personnel Management, the generic “what” (the subject matter of the application) will almost always contain the obvious:  that there is a medical condition; that the medical condition prevents one from performing one or more of the essential elements of one’s job; that the Federal or Postal worker will make statements and claims of an inability to perform certain key elements of one’s job because of one’s medical conditions, etc.

On the other hand, how it is stated:  Is it persuasive?  Does the doctor follow from a reasonable explanation to an unequivocal conclusion?  Is the doctor convincing?  While the “what” of a Federal Disability Retirement application, whether under FERS or CSRS, may be a necessary condition of a Federal Disability Retirement application, it may not be sufficient; sufficiency may be determined by how a Federal Disability Retirement application is prepared, formulated, and ultimately filed.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: The Doctor

Out of all of the elements comprising a Federal Disability Retirement application — the various aspects, including medical, personal, impact-statement, statement of disability, Supervisor’s Statement, etc. —  the essence of it all must be coordinated around the core of the case:  the medical narrative report

That alone has multiple, inherently complicating factors:  Why won’t the surgeon write the report?  Why is it that the Pain Management doctor, or the Internal Medicine doctor, or the Family Physician is the one often most cooperative and willingIs the Chiropractor’s opinion sufficient?  Is it helpful?  How detailed must the report be?  How long must you be a patient in order to establish the threshold of having a “longstanding doctor-patient relationship“?  Are medical records in and of themselves sometimes sufficient to obtain Federal Disability Retirement benefitsIs it sufficient to get a Therapist to do the report, without the Psychiatrist?  Can a therapist alone win a case? Must I undergo a Functional Capacity Evaluation?  Can I use reports from an OWCP Second Opinion doctor?  If my Psychiatrist only sees me for five minutes each time and prescribes the medication, is it necessary for him/her to write a report?  How detailed must the report be?  Is the doctor going to understand, let alone actually read, the SF 3112C?  These are just some of the questions which one is immediately confronted with, in beginning the process of putting together a Federal Disability Retirement application under FERS or CSRS.  It is a complex, overwhelming process.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: The Family Doctor and the Surgeon

I am often asked whether or not a medical report from the “specialist” will have a greater impact than a family doctor.  Implied in such a question, of course, is a perspective which tends to see the family doctor as somehow “less qualified”, sort of like comparing the technical deficiencies of a “country doctor” as opposed to a “real doctor” — one who works in an emergency room in a large metropolitan hospital.  Perspectives and prejudices have a way of defining judgments, and assumptions, presumptions and long-held beliefs, whether valid or not, often rule our lives. 

How can I answer such questions?  In the course of a Hearing before an Administrative Judge at the Merit Systems Protection Board, I have had family doctors testify who were unbeatable, and certainly overwhelming in his or her expertise and medical knowledge.  The years of experience in having to deal with thousands of patients, and confronting and treating medical conditions of every imaginable sort — and making decisions (including referring patients to “specialists” for concurring or confirming diagnoses and opinions) involving the “whole” patient’s medical condition and treatment — came through with such persuasive force and overwhelming confidence, that it was indeed the “family doctor” or the “country doctor” who ruled the day. 

Similarly, I have had the “specialist” testify in cases, who barely were able to coherently describe the connection between the medical condition and the essential elements of the job.  And, of course, sometimes the opposite is true — good surgeon, mediocre family doctor; mediocre specialist, great country doctor.  As in all things, in Federal Disability Retirement applications under FERS or CSRS, it is not so much that the credentials matter, as the character, experience, and “heart” of the doctor who treats the patient.

Sincerely,

Robert R. McGill, Esquire

OPM SF 3112 Schedule C Form: The Doctor’s Statements

The lack of cooperation from a treating doctor, who is asked to provide a medical narrative report for a Federal Disability Retirement application under FERS or CSRS, may be based upon one of several factors:  It may be that the doctor merely refuses to engage in any type of administrative support for his patients; it may be that the doctor has private suspicions that, to openly admit that his/her patient must file for Federal Disability Retirement means that his/her treatments have failed, and thus, the patient/disability retirement applicant is considering filing a malpractice action, and asking him/her to write a supportive medical narrative is merely a ploy to set the groundwork for a later malpractice action; it may just be bad bedside manners; or it may be that the doctor does not understand the Federal Disability Retirement process, and how it differs for Social Security Disability, or Worker’s Comp.

If it is the latter reason, then it is the job of the attorney to make sure and explain, delineate, and inform the doctor of the nature, extent, and context of Federal Disability Retirement — and to show how an approval for disability retirement benefits will be the best thing for his/her patient.  This is where an attorney representing an applicant for Federal Disability Retirement benefits under FERS or CSRS becomes a crucial component in the preparation of such an application.

Sincerely,

Robert R. McGill, Esquire