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

 

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

OPM Disability Retirement: Pre-Conditional Preparatory Steps

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether a Federal or Postal employee is under FERS or CSRS, there are steps to be taken — not only at each “stage” of the administrative process, but moreover, in the weeks and months prior to the actual formulation, compilation and submission of the Standard Forms, documentary support, writing of the Applicant’s Statement, etc.

As a “process”, one may bifurcate the necessary steps into the following:  the pre-conditional stage; the preparatory stage; the time of formulation & actualization; finally, the submission of the disability retirement packet.

In the “pre-conditional” time period, one should focus upon the single most important aspect of a Federal Disability Retirement case — that of garnering, concretizing and establishing the necessary physician-patient relationship, such that there is a clear understanding of what is required of the physician; what the physician expects of the patient; and, wherever and whenever possible, a continuing mutual respect and understanding between the doctor and the patient-applicant.

This is why the Merit Systems Protection Board has explicitly, through case after case, opined upon the preference for “treating” doctors of longstanding tenure.  For, in such a relationship of long-term doctor-patient relationships, a greater ability to assess and evaluate the capabilities and limitations of the patient’s physical, emotional and psychological capacities can best be achieved.

In every “rule”, of course, there are exceptions, and sometimes more “distant” methods of evaluations can be obtained — through OWCP doctors, referee opinions, independent examinations (indeed, one can make the argument that because it is “independent”, therefore it carries greater weight), functional capacity evaluations, etc.

For the most part, however, the cultivation of an excellent physician-patient relationship will be the key to a successful Federal Disability Retirement claim, and as such, the pre-conditional stage to the entire process should be focused upon establishing that solid 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

Federal Employee Medical Retirement: Blunt Clarifications

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 a good idea to distinguish between the entities and issues which will respond favorably or not; the extent of the response; whether straightforward or not.  

Blunt clarifications will provide an effective road map — however, remember that a question asked can provide the wrong type of information to the recipient of the question, and so one must always be careful.  

Where possible, however, it is a good idea to be clear on a road map.  Thus, by way of example, take the following:  The doctors who will be asked to provide medical narrative reports — will they be supportive?  To what extent will they be supportive?  The agency which will be receiving the Federal Disability Retirement application (assuming that the Federal or Postal employee has not been separated from Federal Service for more than 31 days) —  how will they react if they are informed now, as opposed to when the application is submitted?  Will they respond in a negative, reactionary manner, or will the supervisors and chain of command show some empathy and be supportive during the process?  

It is best to be able to gauge the level of support, be able to determine the people who will be favorable, etc.  In the end, of course, it is the medical condition which will determine the plan and course of one’s actions, because the impact of one’s medical conditions upon the ability/inability to perform the essential elements of one’s job may compel the Federal or Postal worker to file for Federal Disability Retirement benefits.  But it is a good thing to know the “road map” and the people along the way, whether supportive, neutral, or negative, in the preparation, formulating and filing of a Federal Disability Retirement application.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Appearance versus Substance

In preparing, formulating and filing for Federal Disability Retirement benefits under either FERS or CSRS, from the Office of Personnel Management, one often overlooks the basic, foundational questions needed to have answered in the preliminary stages of a Federal Disability Retirement case.

The fact that one has a medical condition which impacts one’s ability to perform all of the essential elements of one’s Federal or Postal job is a “given” — i.e., a fact that then prompts or initiates the entire procedure of even contemplating filing for Federal Disability Retirement benefits.

To proceed from that “given”, however, requires further insight and questioning — more of a practical nature, as in:  What are the essential elements of my job?  Do I have doctors who view my medical condition in the same way as I do?  More importantly, will my doctors support me in my quest to obtain Federal Disability Retirement benefits under FERS or CSRS?  How will I explain to them the very processes and procedures, of the legal and medical requirements which must be met in preparing a medical report, such that the medical narrative report will meet those legal requirements?  Do I have the resources ready in order to sustain a protracted administrative battle with the Office of Personnel Management?  Will my agency allow me to continue to work while I engage in this application for Federal Disability Retirement benefits?

These are all serious and substantive questions — ones which go beyond the mere appearance of thinking that preparing, formulating and filing for Federal Disability Retirement benefits from the Office of Personnel Management, is merely a matter of “filling out forms“.

It never is, and just as “substance” differs from “appearance” (which is the entire philosophical basis of the Socratic and dialectical tradition of Western Philosophy), so the questions one asks at the outset of the process is important in determining the substantive nature of one’s quest.

Sincerely, Robert R. McGill, Esquire

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

OPM Disability Retirement: Obtaining the Doctor’s Support

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, it is important to garner the support of the treating doctor. 

Such needed support is obvious; it is, after all, a paper presentation to the Office of Personnel Management (despite the move to a “paperless” society, the conceptual application is still relevant; for, whether paperless or not, some mode of presentation must still be forwarded to the Office of Personnel Management).  As such, one should be prepared to discuss with one’s treating doctor the “medical” benefits of filing for Federal Disability Retirement — and not just focus upon the administrative and legal efforts which must be engaged. 

Thus, for example, one should inform the doctor that obtaining Federal Disability Retirement benefits under FERS or CSRS does not prevent one from seeking other, alternate employment — one which will not medically exacerbate the conditions which one is suffering from.  As such, going out on Federal Disability Retirement has a therapeutic impact, inasmuch as it (1) allows one to recover by ceasing the type of current work and (2) as work is often considered good therapy, it allows for productivity in another, separate area.  

Remember that a treating doctor’s concern is focused upon the medical health of the patient; persuading a doctor to support one’s Federal Disability Retirement application should thus focus upon the concerns of the doctor.  Persuasion must always take into account the “other’s” concerns.  That is the key to effective persuasion.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Workers: The “Nice” Doctor

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, it is first and foremost important to have the support of one’s treating doctor.  By “support” is meant that the treating doctor must be willing to spend the time and effort needed to prepare and present a medical narrative which will not only narrate and delineate the diagnoses and symptoms — but beyond that, to take the time to explain the “why” of the nexus between the patient’s medical conditions and the essential elements of one’s job.  

To this extent, of course, the Federal or Postal Worker’s attorney should be of the utmost assistance — to guide the doctor in order to meet the legal criteria for qualifying for Federal Disability Retirement benefits under FERS or CSRS.  It is never an issue of telling the doctor “what to say” — the integrity of the medical opinion of the doctor should never be violated.  Rather, it is an issue of explaining the elements and legal criteria which need to be addressed.  

In ascertaining the level of support which a doctor is willing to provide, it is simply not enough to establish the factual foundation that the doctor is very “nice”.  Nice doctors aside — whether in conversation, table manners or a general sense that he or she is genuinely an all-around nice person — the question is, Will the doctor spend the time and effort (and yes, it is proper for the doctor to be reasonably compensated for his time and effort) in preparing a narrative report which addresses the legal elements in order to present a case of medical disability to the Office of Personnel Management?  

It is nice to have a nice doctor; it is even nicer to have a nice doctor who will support one’s Federal Disability Retirement application under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: Preparation in Anticipation of the Process

Preparation in anticipation of a process, as opposed to filing the proper paperwork to receive an entitlement, constitutes a different mindset and approach.

In preparing, formulating and filing a Federal Disability Retirement application under CSRS or FERS, where the Federal or Postal employee may be subject to undergoing the process of the initial stage of the application, then potentially the Request for Reconsideration stage; if denied at the Request for Reconsideration Stage, then the process involves an appeal to the Merit Systems Protection Board; then, if denied at the MSPB, a Petition for Full Review, and an appeal to the U.S. Court of Appeals for the Federal Circuit. Because the entire process may involve multiple forums, the extent of support requested from the outset should be understood to potentially involve such extensive time frames and stages.

Filing for FERS Disability Retirement benefits must be understood as potentially involving the entirety of the process, and not just a single-event occurrence.

Now, as to whether to inform the treating doctor at the outset the details of such potential support needed, is another matter. Such a full disclosure may, if presented wrongly, indicate such a daunting process that no one in his right mind would want to undergo such a process. Most doctors, however, already have an inkling of what an administrative process might involve, through contact with Social Security, which is the benefit most medical doctors have been involved with.  In any event, it is important to secure the support of the treating doctor and to have the comfort of knowing that he or she will continue such support through the entirety of the process, and not abandon you halfway through it.

That is why the mindset of understanding that preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS is important to obtain from the outset, that it is a process, and not an entitlement.

Sincerely,

Robert R. McGill, Esquire