USPS and Federal Disability Claims: Medical Conditions which Predate Federal or Postal Employment

Often, there is a concern about medical conditions which one suffers from, which “predate” employment in the Federal Sector, or with the U.S. Postal Service.  Such conditions are often identified as “preexisting medical conditions” — meaning, thereby, that they exist prior to an event.

In the context of OWCP (Federal Worker’s Compensation), under the aegis of the Department of Labor, such an issue normally involves the assertion and allegation (by the Department of Labor, Office of Worker’s Compensation Programs) that a Medical Condition-X already existed prior to Event-Y — the latter normally constituting the “on-the-job” accident or occurrence, or an occupational disease, etc.  Because causation — the “what caused the injury” issue — is important in OWCP/DOL cases, the concern of preexisting conditions is normally a point of contention between the Federal worker and the Federal Government/Department of Labor.

However, in OPM Disability Retirement cases, because causation is not an “issue” of concern (the “how” or “where” it happened is not a relevant legal criteria of proof), it rarely becomes a point of conflict between the Office of Personnel Management and the Federal or Postal employee.

It can become of interest, however, for the Office of Personnel Management, in a Federal Disability Retirement application, if a Federal or Postal worker has been hired and working in a particular job, with a specific medical condition for many years, successfully, but then files for Federal Disability Retirement benefits.  The reason it may become of some interest, however, is not as to the “causation” issue (of the “how” or “where” it happened), but rather, to the question:  Why is it that the Federal or Postal employee who has had a Medical Condition-X all of these years can now claim not to be able to perform Essential Elements Y & Z now?

That is the point where a medical condition existing prior to one’s Federal or Postal employment may be of some interest to the U.S. Office of Personnel Management.  It is, however, easily addressed; it just needs to be discussed in the right way.

Sincerely,

Robert R. McGill, Esquire

Postal and Federal Disability Retirement: The Inherent Complexities

It is often asked why filing for Federal Disability Retirement under FERS or CSRS is more complex, and therefor often more difficult to obtain, than (for example) Social Security Disability, or even Federal Worker’s Comp.  The simple answer is that one cannot compare apples and oranges (to quote an oft-used metaphor), but the greater inherent complexity of answering such a question involves more space than can be allotted here.

Social Security Disability, of course, has a higher standard of eligibility.  In abbreviated explanation, this means that one must essentially be “totally disabled” in order to qualify for Social Security Disability, as opposed to the “lower” legal standard of being “unable to perform one or more of the essential elements of one’s job”.  Thus, Social Security Disability cuts a wider swathe, and is generally considered to require a more onerous standard, and the resulting benefit reflects that — by allowing for restrictive ability to earn outside income, etc.  

 Worker’s Comp (OWCP, FECA/Department of Labor) is also complex in its own way, precisely because it requires a showing of occupational connection, or that the injury or medical condition was “on the job” or somehow caused by the job, the workplace, etc.  Then, its reliance upon percentage of disability, and the fact that it is not a retirement system, but a temporary mode of compensation in attempting to return the Federal or Postal Worker back to work, further contains multiple complex issues.  

Often, when a law attempts to particularize a benefit — as in Federal Disability Retirement — by focusing narrowly upon an issue (e.g., being unable to perform one or more of the essential elements of one’s particular kind of job, or any similar job), such a narrow focus creates an inherent complexity all on its own. Complexity of an issue requires a careful and studied approach; to conquer an issue, it is important to expend a great amount of time reflecting upon and scrutinizing the issue. It is only upon understanding an issue thoroughly that the complexity begins to unravel; and only then can one begin to proceed to prepare, formulate and file for Federal Disability Retirement benefits under FERS or CSRS.

Sincerely, Robert R. McGill, Esquire

Federal and Postal Disability Retirement: OWCP Intersections

To the question relevant to filing for Federal Disability Retirement benefits under FERS or CSRS, as in, “What are your medical conditions?”  — the potential applicant will often state the following:  “Well, it is an OWCP-accepted case…”  Such an answer may or may not be relevant.

OWCP under FECA (“Worker’s Comp”) is on a different benefit track from Federal Disability Retirement benefits under FERS or CSRS, as approved or denied by the Office of Personnel Management.  In many ways, the different processes are completely separate and apart.  One cannot receive both benefits concurrently. One must choose between one or the other.  Theoretically, one can switch from one to the other, then back again, but in practical terms, it is difficult because of the headaches involved in stopping one and starting the other.  One can, however, pursue both tracks of benefits concurrently; it is just that one must choose between the two if both are accepted.  

Now, this doesn’t mean, however, that one cannot “use” certain medical documentation to the advantage of the other process.  Thus, for instance, I have often used OWCP “Second Opinion” or “Independent Medical Examination” reports in helping to obtain Federal Disability Retirement benefits under FERS or CSRS.  What an irony — because we all know how “independent” second-opinion doctors are; yet, when such an “independent” doctor provides an opinion in the client’s favor, there is nothing wrong with using it to the client’s advantage when filing for Federal Disability Retirement benefits under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: OPM over OWCP

I still get many emails and phone calls about the onerous, “over-the-top” behavior, and the bullying tactics of OWCP/DOL temporary total disability payments & requirements — everything from constant, incessant and unending, harassing letters, to requiring further evaluations from second and third opinion doctors (or so-called doctors), to constantly requiring one’s treating doctor to justify the continuing disability status, thereby endangering the continuation of the doctor-patient relationship.  And who can criticize or blame the doctor for wanting to drop a patient for the amount of hours he/she has to put into, for “non-medical” issues, and for the time expended which the doctor will never be paid for? 

Yes, Worker’s Comp pays more.  Yes, it is non-taxable.  Yes, there are monetary reasons for staying on OWCP.  But the truth is, money doesn’t buy peace of mind or a life of lesser stress.  OWCP is meant to be a temporary means of providing income — it is not designed for the long term, and indeed, the Office of Worker’s Compensation makes that abundantly clear by their actions.  OPM Disability retirement under FERS or CSRS pays much less, but it allows for independence and a semblence of freedom, not even to mention a life of some dignity.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: The (non) Problem of Causality & Causation

In a Worker’s Comp (DOL/OWCP/FECA) case, causation and causality often loom as significant issues, and doctors often have to walk a difficult line in making unequivocal statements, or somewhat equivocating statements, as to the “cause” of a medical condition or injury.

Such statements can sometimes be the singular focus as to the success or failure of an OWCP case.  Why?  Because OWCP compensable injuries and medical conditions must be related to the job — either as something caused by an accident while on the job, or in some way occupationally related.

In Federal Disability Retirement cases under FERS or CSRS, one can be on a skiing vacation and incur a medical condition or disability, and so long as that person is unable to, because of the medical condition, perform one or more of the essential elements of one’s job, one is thereby eligible for Federal Disability Retirement benefits under FERS & CSRS.

Sometimes, however, the issue of causation comes into the picture, but can work in a detrimental way, but need not.  Let me clarify:  In a chemical sensitivity case, or a psychiatric condition which finds its originating “causation” from the workplace, the doctor may want to relate the “cause” of the medical condition directly to the workplace.

This is fine, so far as it goes — and, ironically, most doctors (because they have no idea about FERS or CSRS Disability Retirement) think they are doing their patients a favor by relating it as “causally related” to the workplace.  More often than not, however, it can open up a “can of worms” — of being characterized by the Office of Personnel Management as a “situational disability”, which must be avoided like the plague.

Sincerely,

Robert R. McGill, Esquire