Medical Retirement (for US Federal Employees): Administering Treatment versus Administrative Functions

Doctors rarely have any problems with administering treatment based upon clinical encounters and subjective narratives from their patients; yet, when it comes to providing a medical report and performing similar administrative functions, the sudden pause, hesitation, and sometimes outright refusal, is rather puzzling, if not disconcerting.

Such trepidation from the doctor can obviously result in a difficult wall for purposes of preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS.

For, much of medical evaluation, diagnosis, prognosis and prescribing of treatment encompasses receipt of subjective responses from the patient:  where the pain is present; the nature and extent of the pain; the history and chronicity of manifested symptoms; even functional capacity evaluations must necessarily be an observation of the subjective actions & reactions of the participant.  Of course, there are often distinguishable “objective” factors — swelling; carcinogenic versus benign tumors; broken bones, etc.

On the other hand, even MRIs and other diagnostic tools reveal only that X exists — not that X results in symptom Y.  An example would be a bulging disc — while the abnormality itself may show up on an MRI, whether the individual experiences any pain from the abnormality may differ from subject to subject.

This is why, despite the willingness of a doctor to treat based upon most factors being “subjective” in nature, it becomes a puzzle why the same doctor shows an unwillingness to write a report stating that, because of the medical conditions for which patient M is being treated, one must necessarily conclude that he or she cannot perform essential elements X, Y and Z of his or her job.

It is the jump from treatment-to-disability-determination which is often problematic for the treating doctor.  All of a sudden, the excuses flow:  “I am not trained to make such determinations”; “There is no objective basis for your pain” (then why have you been treating me for over a decade and prescribing high levels of narcotic pain medications?); “I can’t say whether you can or cannot do your job”; and many other excuses.

The switch from administering treatment, to treating administrative matters, is one fraught with potential obstacles.  How one approaches the treating doctor will often determine whether such obstacles can be overcome — and whether one’s Federal Disability Retirement application can be successfully formulated.

Sincerely,

Robert R. McGill, Esquire

Postal and Federal Disability Retirement: The Positive/Negative Approaches

The inverse of a thing can often be just as effective as the original matter; the ultimate endpoint may be the same, but stated in a different way.

Thus, in preparing, formulating, and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, the preferred approach is the “positive” one, where one’s treating medical doctor will affirmatively connect the dots, create the nexus between one’s medical conditions and the positional duties of one’s Federal or Postal job, and thereby providing the foundational basis of a Federal Disability Retirement application.

However, there are instances where the “inverse” approach, or the Negative entrance into the bureaucratic nightmare called Federal Disability Retirement, might have to be entertained.  Such an approach is a more complex process, within the context of an unwilling doctor.  It takes a thorough review of the doctor’s statements which should include, “Patient X is unable to do X, Y and Z” or “Patient A has limitations in the following areas…”

Thereafter, of course, it is the Applicant for the Federal OPM Disability Retirement who must (or his or her FERS Disability attorney, obviously) take the position description and argue the 1-to-1 correspondence between the medical condition, the limitations expressed by the treating doctor, and the positional elements which are applicable.

In the end, if the doorway to success is achieved through either means, the efficacy of the effort is what matters, and not the pathway in getting there.

Sincerely,

Robert R. McGill, Esquire

 

OPM Disability Retirement: The Delicate Balance between Persistence, Perseverance, and Pestering

Persistence, perseverance, pestering…is it all the same?  The first of the three implies an enduring deliberation of effort, and is neutral as to whom it applies to; the second is normally in reference to the individual who is engaging in the effort; and the last carries with it a negative connotation, like a gnat who is attracted to the smell of someone’s shampoo or body odor.

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 important to distinguish the subtle differences between the three words applied.  For, in the end, it is not the words, but the actions which each describes, which is important for the entire administrative process.

Persistence may be appropriate for the relationship between the patient and one’s doctor, in pursuing medical treatment, and support for one’s Federal Disability Retirement application. Perseverance may be seen as a valiant character issue, for a multitude of things, including undergoing medical procedures, trying to continue to work despite medical obstacles, exhausting all avenues with an agency, etc.  Pestering, if seen from a doctor’s viewpoint, reflects an attitude which may betray a desire to support one’s Federal Disability Retirement application.

There is often a delicate balance between the three, and one must be sensitive to such a balance in preparing, formulating and filing for Federal Disability Retirement benefits from OPM.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: The Supportive Physician

Perspectives vary; varying perspectives often lead to conflict; and conflict represents the divergent paths which pursue different directions, or follow a parallel route.

Physicians who have been practicing medicine for a number of years quite often see the therapeutic benefit of employment, and the negative impact of being identified as “disabled”, with progressive physical manifestations of deterioration, and psychological destruction of futility and hopelessness.  It is not mere coincidence that the high rate of mortality is correlated to two primary life events:  birth (where the infant’s susceptibility to being exposed to an expansive and threatening environment brings with it inherent dangers), and retirement (where the propelling teleological motivation of man suddenly comes to an end).

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 obvious that one must have supportive medical documentation in order to prove, by a preponderance of the evidence, that the Federal or Postal employee is eligible for Federal Disability Retirement benefits.  Part of that medical evidence should include a narrative report from one’s treating doctor, or a doctor who can properly and thoroughly assess, evaluate, and conclude that the Federal or Postal employee  can no longer perform one or more of the essential elements of one’s job.

What constitutes “support”, however, can sometimes lead to divergent paths.  Doctors are trained to treat patients, not to perform administrative duties.  The divergence which potentially leads to conflict often involves the differing perspective of what will “help” the patient.  Federal Disability Retirement is a benefits which allows the Federal or Postal employee to remain productive in the workforce, by encouraging the Federal or Postal employee to seek outside employment.  This is the key component and concept which often lends persuasive effect upon a suspicious and cautious medical practitioner.

Explaining the process will hopefully allow for parallel paths, and not a route which results in different directions.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Patient-Doctor Relationship II

Part of a patient-doctor relationship (and I intentionally placed the term “patient” before the hyphenation to “doctor”, because the primacy of the relationship should recognize the order of importance) should necessarily involve a commitment from the doctor.  That commitment should entail the desire to do that which is necessary, within reasonable bounds and within the law, as well as the integrity of the doctor’s medical opinions, in order to look after the best interests of the patient.  

It is always a puzzle and a disturbing bit of news to find that a doctor who has performed surgery, who has prescribed multitudes of pain or psychotropic medications, has prescribed multiple diagnostic tests and have the patient undergo test after test, physical therapy sessions, clinical evaluations, etc. — and at the end of it all, to have the “final straw” which severs the patient-doctor relationship to be a refusal to provide a medical narrative report in support of a Federal Disability Retirement application.  Think how preposterous that sounds.  Thus, it is not enough to get some vague support when the issue is first broached; no, what is needed is the same level of commitment from the doctor, as when he or she first said to you, “Yes, I am going to treat you for your medical condition…”

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: The Doctor's Opinion

As an attorney who represents Federal and Postal employees to “obtain” Federal Disability Retirement benefits, it is important to make distinctions within the process of securing the Federal benefit:  while it is important to solicit and secure the medical opinion of the treating doctor, the resistance from such doctors — if in fact there is any resistance at all — most often comes about because the doctor doesn’t understand the “process”. 

Doctors are medical providers.  They are in the practice of medicine because they believe in applying the science of medicine to help their patients get better.  Helping someone obtain Federal Disability Retirement benefits under FERS or CSRS is not part of “practicing medicine”.  Yet, in many ways, it is.  It is part of practicing medicine because, to allow the patient to continue to work in a job which he or she cannot perform, will only exacerbate and worsen the medical condition. 

Further, doctors never like to “disable” their patients.  To counter this medical opinion, it is important to clearly inform the doctor what the process of Federal disability retirement is and is not.  It is the job of the attorney hired to represent a Federal or Postal worker to obtain disability retirement benefits, to clearly and cogently explain the entire process to the treating doctor.  That is what I do, at the very start, in representing my clients.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Doctor II

Work is good for a person — being productive, being useful, being a contributing member of a team, an agency, an organization; it provides a sense of self-worth, dignity, and therapy. On the one side, that is why a Federal or Postal worker takes such a long, careful and hesitant step before deciding to file for Federal Disability Retirement. On the other side, the treating doctor knows the medical, therapeutic and healing value of work.

That is often why doctors are reluctant to agree to support a Federal or Postal worker’s decision to file for disability retirement under FERS & CSRS. Such reluctance, however, is mostly due to an unfamiliarity with the legal standards required to obtain disability retirement. Most doctors are familiar with the Social Security process of filing for disability benefits; and, further, many doctors are familiar with State Worker’s Compensation benefits and process; and, to a lesser extent, Federal Worker’s Compensation programs. Very few doctors are familiar with Federal Disability retirement benefits under FERS & CSRS. That is why it is important to clearly, concisely, and thoroughly inform the treating doctor of the process — and, often, it is wise to have an attorney who can clearly explain and delineate the process.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Patient/Applicant

Before even thinking about starting the process of filing for Federal Disability Retirement under FERS or CSRS, it is important for the patient/applicant to approach his or her doctor and get an initial commitment of support. For, ultimately, the most essential lynchpin of a disability retirement application hangs on the support of a doctor — from the first and initial stage, all the way to the Merit Systems Protection Board (where live telephone testimony may be necessary).

The “patient” needs to approach the doctor with sensitivity. It is probably not even a good idea to talk about anything beyond the first stage of the process — instead, the focus should be about how “support” for a disability retirement application is actually part of the rehabilitation and healing process of medical treatment. For, ultimately, a disability annuitant under FERS or CSRS is not asking to be “totally disabled” by the doctor (and, indeed, most doctors do not want to release their patients into the retirement “pasture” of full disability); rather, it is simply a medical support of reasoning that a particular patient is no longer a “good fit” for a particular kind of job. Don’t scare the doctor off with a view of the “long process”; rather, the initial commitment is all that is needed — for the first stage of the process.

Sincerely,

Robert R. McGill, Esquire