Federal Employee Disability Retirement: Life Choices

We all have to make them; and though we may alternatively want to curl up into a fetal position and wish the blunt world to stop bothering us, the decisions we make, and take responsibility for, reflect the state of maturity which binds us to age, experience and level of moral maturity.  It is, to a great extent, a superficial and shallow connotation and reference point; for, as the inevitability of choices to be made result from living in circumstances of our own making, so to imply that there is anything “substantive” in speaking about them undermines the very relevance of implication itself.

To live is to be confronted with daily choices; only the dead remain silent and require not the paths to pick.  Thus do mundane and pithy sayings originate.  Life is full of choices; the choices we make in life determine the future course of events yet indeterminate, but somewhat foreseen and predictable. Often, we avoid them not because of consequences untold, but for knowing the folly of our decisions.

For Federal employees and U.S. Postal workers who suffer from a medical condition, such that the medical condition foretells of impending signs which the Federal agency and the U.S. Postal Service have, or will, impose and initiate, the time to begin preparing one’s Federal Disability Retirement application is “now”.  Yes, the Federal and Postal employee has up to one (1) year to file for Federal Disability Retirement benefits through the U.S. Office of Personnel Management, in order to meet the Statute of Limitations for filing an OPM Disability Retirement; but as it often takes many, many months to prepare, submit and get an approval from OPM, so the decisions we make today will have future consequences untold but foreseen if choices are not embraced in a timely manner.

Life presents many choices, alternatives, and lists of items like entrees on a menu; but in the end, the choice made means that when the plate of food arrives, a check for payment will follow soon afterwards, and it is the expectation of the price to be satisfied which should prompt and motivate any decisions of delay for the Federal or Postal Worker who intends on procrastinating in the preparation, formulation and filing of a Federal Disability Retirement application through OPM, whether the Federal or Postal employee is under FERS, CSRS, or CSRS Offset.

Sincerely,

Robert R. McGill, Esquire

 

OPM Form SF 3112C and the Sufficiency of the Physician’s Statement

Confusing necessity and sufficiency is always a precarious matter. That which is necessary may not be sufficient for a given purpose, and failure in understanding such a fundamental distinction can be fatal to a Federal Disability Retirement claim.

SF 3112C requires that a physician complete and provide essential medical information in the pursuance of a Federal Disability Retirement application. The form itself — SF 3112C — is the vehicle by which the medical documentation is obtained. It is “necessary” in the sense that SF 3112C delineates a guideline of the type of information which is needed in order to become eligible for Federal Disability Retirement benefits.

The form itself — SF 3112C — however, is to a great extent irrelevant (although, the U.S. Office of Personnel Management has recently required that a signed SF 3112C be included in the final Federal Disability Retirement packet, despite SF 3112E clearly stating that an “equivalency” of the form would satisfy the lack thereof, as in the attachment of the medical documentation itself), and it is instead the medical documentation through which SF 3112C is obtained, which is what is important.

Regardless, while the OPM SF 3112C constitutes the vehicle, is necessary, but is ultimately irrelevant in and of itself, it is a necessary form to the extent that it mandates the delineation of what information is required for eligibility and entitlement to Federal Disability Retirement benefits.

Will following the guidelines in accordance with what SF 3112C states, result in a successful OPM Disability claim? That is the question of “sufficiency”, as opposed to “necessity”.

Over the years, case-law and statutory interpretation and expansion of Federal Disability Retirement laws have greatly altered the landscape of a Federal Disability Retirement claim. SF 3112C is the vehicle of necessity, although the form itself is an unnecessary one. The greater question is whether it is sufficient to meet the legal weight of preponderance of the evidence, and that question must ultimately be answered by questioning the efficacy of the form itself.

Sincerely,

Robert R. McGill, Esquire

SF 3112C

OPM Standard Form 3112C: Physician’s Statement:

Forms tend to intimidate; the more official the appearance, the greater heightening of anxiety in close encounters of this kind.  Beyond the alien look of some forms (for those who have already identified the two references to Steven Spielberg’s 1977 Science Fiction film, you have revealed what generation you are from), the size of the font, the extent of warnings issued (i.e., “Privacy Act and Public Burden Statements”, etc.), and most importantly, the cogency and clarity of understanding for a third-party being requested to provide valuable and necessary information on behalf of a patient — these are all important considerations to entertain.

In this busy world, where doctors must wear multiple hats — of administrative overloads, compliance with billing requirements in Medicare, Medicaid, and numerous other government portals, etc.; of earning sufficient income in order to pay staff, salaries and practice expenses; of ensuring privacy protections; and, finally, beyond all of the headaches associated with running a medical practice — of actually engaging in patient care becomes almost a secondary issue. Time is limited; time is a commodity of invaluable substance; time is a restrictive resource when the exhaustion of the modern world impinges upon the daily necessity of making a living.

And so the Federal or Postal Worker who is filing for Federal Disability Retirement benefits hands, sends, or faxes a government form, demanding that a doctor complete another issuance of what can only be kindly termed as a nuisance or a headache.  The normal response of the treating doctor is to procrastinate, ignore, or, worse yet, to put together a bundle of treatment records and send them off.

OPM Form 3112C, the so-called Physician’s Statement, is the crucial linchpin of a Federal Disability Retirement application; yet, the form itself is an intimidating venue which can predispose a Federal Disability Retirement application to a preview of failure. Are there alternatives? SF 3112C itself is put forth as if it is a necessary prerequisite in the entire process of filing for Federal Disability Retirement. The answer can be found in another form — SF 3112E — where it clearly states: Attach SF 3112C, Physician’s Statement (or its equivalent).

It is the equivalency which is the key to a successful Federal Disability Retirement application, for the Federal Employee on long-term sick leave (SL) or the injured Postal worker who is preparing, formulating and filing for Federal Disability Retirement benefits, whether one is under FERS or CSRS, through the U.S. Office of Personnel Management.

Equivalencies matter, and what constitutes such “equal-ness” in acceptable form, is the key to a successful Federal Disability Retirement application.

Sincerely,

Robert R. McGill, Esquire

 

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

 

CSRS & FERS Medical Disability Retirement: Choices

One immediately hears it in the voice — of the frustration and desire to simply give up.  But “giving up” is simply not a choice, if one refuses to acknowledge such an option and fails to place it on the roster of listed alternatives.  Part of the human factor in preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, is the chasm of the unknown.

No, there is never a guarantee that one’s Federal Disability Retirement application will be approved, just as there is never a certainty that one’s treating doctor will support the patient’s need to apply for Federal Disability Retirement benefits.  It is the unknown — from whether the application for Federal Disability Retirement benefits is sufficient to obtain an approval from the U.S. Office of Personnel Management, to whether the doctor’s report is “strong enough”; from what steps the agency will take to try and undermine a Federal Disability Retirement case, to the long and seemingly endless wait while one’s case simply sits on the desk of some Case worker at the U.S. Office of Personnel Management — the aggregate of all of these constitute and comprise the “unknown”.

There are cases where a thin sliver of medical documents result in a quick and uncomplicated approval; others, where a voluminous binding of reports, diagnostic tests and medical records result in scant attention and a denial. Often, it seems somewhat arbitrary.

It is the “unknown” and “unknowable” factors which heighten the time of anxiety.  But through the entire administrative process, the singular choice should always be clear:  to move forward.  And sometimes, to do so is to merely wait, and disregard the unknown or unknowable.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement for Federal Workers: Narrowing the Options

In preparing, formulating and filing for Federal Disability Retirement benefits under FERS or CSRS, clarification of the direction, purpose and choices/options available is often helpful in compiling an effective and compelling Federal Disability Retirement case.  

Often, there is hesitancy in preparing the application, and such hesitancy and pause are a sign that there is a part of the Federal or Postal worker who is hoping that the medical condition will either resolve itself, or that somehow — in some nebulous and obscure thought-processes — procrastination will result in resolution and continuation in the career one has chosen.  

Narrowing the options with a perspective of reality-based evaluation of one’s situation, however, is important in taking the initial steps.  “Preparation” constitutes thinking about the various options, including questioning the circumstances of one’s medical history, present reality, and future expectations.  

Thus, some questions might be:  Can I continue to work at this job until retirement?  If I continue to work at this job till retirement, will my health have been impacted so detrimentally that I will be in a debilitated state such that “retirement” would be a meaningless goal?  What is my doctor saying?  Will my doctor support me in an application for Federal Disability Retirement benefits?  How is my agency acting/reacting?  Will they continue to tolerate less than full performance and productivity?  What are my choices — work till retirement, file for Disability Retirement, or walk away without anything?  

Such narrowing of choices and options, through proper questioning, is the initial preparatory step 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

Medical Retirement for Federal Workers: Responsibility of the Applicant

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, the importance of adequately conveying persuasive information to the Claims Representative at the Office of Personnel Management must be a primary goal of the Federal or Postal employee.  

Rarely does a doctor, without guidance and some “prodding”, execute an administrative duty such as preparing a medical narrative report for a patient, in a sufficiently excellent manner.  The work product of a doctor is normally defined by patient care, clinical examination, and prescribing an effective course of treatment.  It is up to the patient or his/her Federal Disability Attorney to remind the doctor as to “why” it is important to provide a medical narrative report in a Federal Disability Retirement application.  

Often, it is merely that the doctor does not understand the necessity of preparing a narrative report; or, as confusing as the entire administrative process of preparing a Federal Disability Retirement application is to the Federal or Postal employee, it is exponentially more confusing to the doctor, who is normally not part of the Federal workforce (unless he or she happens to be a doctor for the Department of Veterans Affairs, or is part of the Veterans Health Care System).  

It is ultimately the responsibility of the Federal or Postal employee to convey persuasive evidence and argumentation to the Office of Personnel Management, in order to meet that burden of proof, of showing that by a preponderance of the evidence the Federal or Postal employee has proven that he or she is eligible for Federal Disability Retirement benefits. While medical records, treatment notes, office notes, etc., can often be persuasive on their own, the applicant must be able to formulate a statement and refer to “the law” in order to convince the OPM Representative that his or her case meets that burden of proof.

Sincerely, Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: Listening to the Doctor

It is amazing how unaware we often are of our very surroundings, even when the circumstances and scenario directly impact us.  Doctors see dozens of patients per day, and the administrative aspects of their medical practice rarely engender excitement; for, while being a proponent of a patient to assist in the entirety of the recuperative process, writing a medical narrative report is not the crux (for most doctors) of that process.

However, when a doctor makes statements which clearly reveal the extent of administrative support that they are willing to provide, it is time to listen.  For example, if your treating doctor says something to the effect of, “Your job is clearly killing you,” or “you shouldn’t be doing this line of work,” or sometimes even the non-subtle approach of:  “You need to medically retire” — the response for the Federal or Postal employee who is seeking to file for Federal Disability Retirement benefits should not be one of remaining silent, unaware, smiling distractedly, or even responding with, “Yes, I know, but…” with a trail of silence.

That scenario is precisely the moment to seize, and to say to the doctor, “Doctor, I think that you are right.  Will you be willing to write a medical narrative report which would support me in my quest to obtain Federal Disability Retirement benefits, which would then allow me to recuperate from my medical condition?”  Such a conversation must have the cooperative participation of both the doctor and the patient.  For, if the doctor does not bring the subject up, and the Federal or Postal employee begins the process of seeking to prepare, formulate and file for Federal Disability Retirement benefits under FERS or CSRS, the type of conversation-opener described herein will have to take place, anyway.

If the doctor brings up the subject during any clinical examination or encounter, the pursuance of such a conversation should be taken advantage of.  The old saying that the doctor knows best is certainly illustrated when one’s treating doctor has opened the door to supporting the Federal or Postal employee in the quest to obtain Federal Disability Retirement benefits from the Office of Personnel Management.

Sincerely,

Robert R. McGill
OPM Disability Attorney

 

OPM Disability Retirement: Quality & Quantity of Medical Report

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, it is often asked as to the quantitative sufficiency of the medical documentation to be submitted.

Qualitative sufficiency for Federal Disability Retirement applications, at least on a generic level, is an easy one to answer — the substance of the medical documentation must meet the legal standard of proof.  If the Office of Personnel Management or the Merit Systems Protection Board approves the Federal or Postal employee’s Federal Disability Retirement application under FERS or CSRS, then obviously both the quality and quantity of medical documentation met the standard of proof.  

But an answer based upon “after the fact” circumstances is rarely useful; the generic answer of, “Submit medical evidence such that it meets the legal burden of proof, of Preponderance of the Evidence”, might be well and good, but what does that mean?  

Ultimately, the reason why such questions as to sufficiency of medical documentary submission cannot be answered in a generic manner, is that each particular case is unique, and any imposition of a general rule is dangerous because, the moment the general rule is followed and violated (with a denial from the Office of Personnel Management), then the rule becomes obsolete and irrelevant.  

The quality of the medical documentation to be submitted must ultimately show to OPM that each of the legal criteria are met, and that there is a nexus between one’s medical conditions and the type of work that one performs.  

Quantity of medical documentation is ultimately determined by the quality of the medical narrative.  While generic in scope, the general approach is that one should submit only the extent of medical documentation sufficient to prove one’s case; and in each particular case, what that proof must consist of, is unique, particularized, and ultimately personalized to the individual Federal or Postal Worker who is preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire