OPM Disability Retirement: The Qualifying Medical Condition

The question is often asked, “Does my medical condition qualify for Federal Disability Retirement?”, or some variation of that question.  

Such a question, of course, in order to “make sense” in the context of a Federal Disability Retirement application under FERS or CSRS, must be reformulated, precisely because the manner in which it is posed produces multiple sub-questions.  For, ultimately, the laws and regulations governing Federal Disability Retirement do not provide for a calculus of a mathematical correspondence, where medical condition X is considered a “qualifying” one, whereas medical condition Y fails to meet such a qualification criteria.  

The sub-questions which are immediately necessitated by the originating question, involve multiple factors:  Does the medical condition you suffer from impact your ability to perform one or more of the essential elements of your job?  In what way?  Can you describe how the medical condition impacts your ability to perform your job?  Are you being medically treated for your medical condition?  Will the doctor support you in your quest and application for Federal Disability Retirement benefits?

Take, for instance, the following “extreme” hypothetical, used for purposes of expanding upon the previous conceptual paradigm:  Question:  Does my aching right thumb qualify for Federal Disability Retirement benefits?  Answer:  Normally not.  Sub-question:  If my job requires the constant and repetitive use of my right thumb, and such use is an essential element of my job, can my aching right thumb qualify me for Federal Disability Retirement benefits under FERS or CSRS?  Answer:  In all likelihood, yes.  

Often, it is the right question asked, and not the answer to the original question, which is the important starting point of the process in preparing, formulating and filing for Federal Disability Retirement benefits, whether under FERS or CSRS, from the Office of Personnel Management.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: A Real-life Hypothetical

Assume the following hypothetical:  A Federal or Postal employee who is 48 years old, with 25 years of Federal Service, engages in a type of work which is repetitive, day in and day out (yes, even this sentence is repetitive and redundant), full time, over the course of those 25 years.  

One day, while moving a piece of furniture at the direction of his spouse, he feels a sudden and sharp pain in his back.  He has to sit down and rest for a while.  The “for a while” turns into a visit to the emergency room, then to his family doctor.  The MRI shows a disc bulge at L5-S1, with multi-level disc degeneration, spinal stenosis, and other degenerative changes.  Despite multiple modalities of treatments, including epidural steroidal shots, physical therapy, variances of medication regimens, etc. (and you can even add a surgical intervention), the pain continues to worsen and deteriorate his medical condition.  The chronic pain prevents him from performing his job.  Whether sedentary or physical, the high distractability of the pain results in his poor performance.  

Can he/she file an OWCP claim?  Such a claim is submitted and rejected, because the issue of causality cannot be established.  An appeal is filed, and it is again denied.  The treating Neurologist and Orthopaedic Specialist are unwilling to establish a direct causal link.  But one argues:  Do those 25 years of repetitive work account for nothing?  Can it all have occurred because of the singular occurrence?  Does my medical condition reflect that of a person twice my age merely because of a single incident?  

It is precisely because causality is the crux of OWCP, that Federal Disability Retirement under FERS or CSRS is an important benefit for all Federal and Postal employees. OWCP/FECA is a benefit which is great for the limited role it plays; Federal Disability Retirement is a benefit with wider applicability, and the chance for the Federal or Postal employee to enter into another phase of life.

Sincerely,

Robert R. McGill, Esquire