Tag Archives: compiling medical evidence to support opm disability application

Federal Employee Medical Retirement: Assumptions and Presumptions

At what point does a house of cards collapse, when based upon assumptions and presumptions?  The words are used interchangeably; the slight conceptual distinctions may be of irrelevant import to justify differentiation.  One can perhaps quibble that assumptions point more toward the conclusory stage of an argument, whereas presumptions often involve the prefatory issues in a logical sequence of argumentation.

Both engage suppositions not based upon “facts”; and, of course, there is the problematic issue of what constitutes facts, as opposed to mere assertions of events and opinions derived from such facts and events; with the further compounding and confounding task of sifting through what was witnessed, what was thought to have been observed, when, who, the intersection between memory, event, and sequence of occurrences, etc.

Presumably (here we go using the very word which we are writing about, which is rather presumptuous to begin with), Bishop Berkeley would have allowed for either and both to be used in order to maneuver through the world without bumping into chairs and tables which, for him, were mere perceptual constructs in the subjective universe of “ideas” in the heads of individuals.  And Hume, for all of his logical deconstructionism concerning the lack of a “necessary connection” between cause and effect, would assume that, in the commonplace physical world we occupy, presumptions are necessary in order to begin the chain of sequential events. Waking up and walking down the stairs to get a cup of coffee, one need not wait for the necessary connection between thought and act in order to begin the day.

For Federal and Postal employees who are considering filing for Federal Disability Retirement benefits, whether one is under FERS or CSRS, proceeding through the administrative morass of one’s agency and ultimately into the U.S. Office of Personnel Management, based upon the dual deterrents of assumptions and presumptions, can be a harrowing experience.  It is not the factual basis which defeats a Federal Disability Retirement application filed with OPM; rather, it is always the baseless presumptions and assumptions which kill the successful outcome.

Medical facts must be established; narrative facts about the impact upon one’s inability to perform the essential elements of one’s job can be asserted; but it is always the connective presumptions and unintended assumptions which complicate and confuse. Always remember that a narrative based purely upon presumptions and assumptions cannot possibly exist without the concrete adhesives of some foundational facts; like a house of cards, it waits merely for the gods of chance to blow a puff of unforeseen breath to topple the structure that was built without an adequate foundation.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Medical Support, Belief, Documentation and the Diagnosis

Ultimately, in preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, one must always remind one’s self that this is a “paper presentation” (regardless of the prevailing and inevitable march towards a paperless society) to the U.S. Office of Personnel Management (OPM).  As such, there are certain inextricable components in the presentation itself, which must be reviewed, evaluated, and decided upon before proceeding.

As a “presentation” which is meant to be persuasive — i.e., proving by a preponderance of the evidence that one is entitled to the Federal Disability Retirement benefit, whether under FERS or CSRS — it must obviously have the essence of the proof itself:  Medical Support.  Without the medical support, one need not consider moving forward at all.

Once the Federal or Postal employee has ascertained that he or she has the medical support to proceed, then the question is one of obtaining the documentation which confirms such support.  For, a pat on the back and a wonderful smile from the doctor will not be persuasive to OPM; the doctor must be willing to document, in detailed format, the support which is expressed.

Next, in sequential order, the medical documentation must reveal, convey, and persuasively reflect, a level of belief which will be tested in the event that the Federal Disability Retirement application is denied at the First Stage of the Process, and further tested if it is denied at the Second, or Reconsideration Stage, of the process.  Thus, in short, the treating or supporting doctor must possess a level of belief in one’s case, and be willing to support that belief throughout the entire administrative process.

Finally, the doctor must be able to make a diagnosis, but more than that, to support the diagnosis, and be willing to make the “nexus” between the diagnosis, the patient’s physical, emotional and cognitive capabilities, and to relate them to one’s positional duties of one’s job.  It is through this process of connecting the dots, where the end-goal is achieved:  of obtaining one’s Federal Disability Retirement benefits.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: The Theoretical, Practical and Mechanical Realms

Just as Aristotle identified the conceptual distinction between two kinds of wisdom — theoretical and practical — so such a distinction, along with a third (mechanical), resulting and consequential end to the administrative process, exists in the procedures identified as “Federal Disability Retirement“.  

The theoretical parallels the “preparation” portion of the process — of coming to terms mentally and emotionally with the necessity of filing for Federal Disability Retirement benefits, as a result of accepting that a medical condition is impacting one’s ability/inability to perform one or more of the essential elements of one’s job.  Next, the Federal or Postal worker who is either under FERS or CSRS must apply that theoretical knowledge in a practical sense, by formulating the proper approach, by compiling the aggregate of medical evidence, describing a sufficient nexus between one’s medical conditions and the positional requirements of one’s job, etc.; and, finally, there is the “mechanical” portion of filing for Federal Disability Retirement benefits with the Office of Personnel Management — the actual filing of the application, as well as the completion of the necessary forms.  

Such conceptual distinctions and identification of different realms of necessary requirements which must be met, are helpful in taking a logical, sequential approach in preparing, formulating and filing for Federal Disability Retirement benefits under FERS or CSRS, if only to bifurcate in one’s own mind the realms which must be contemplated, applied and completed, before proceeding to the next step.  Above and beyond the three conceptual realms of preparing, formulating and filing for Federal Disability Retirement benefits under either FERS or CSRS, of course, is the overarching need for good counsel and effective advice.

Ultimately, practical application of a theoretical construct must begin with the wisdom to know that which is sufficient, applicable and effective; and while information is helpful, knowledge is the key to meeting the burden of proof, of showing that one’s Federal Disability Retirement application under FERS or CSRS meets the “preponderance of the evidence” standard of review.

Sincerely,

Robert R. McGill, Esquire