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, Esquire

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

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

FERS & CSRS Disability Retirement for Federal and USPS Workers: The Reluctant Doctor II

Dealing with the Reluctant Doctor — one who presumably has been treating the potential applicant for Federal Disability Retirement benefits for at least several months, but often for several years — is a rather “touchy” subject.  

On the one hand, the build-up of confidence, confidentiality, and security developed over many years of having a doctor-patient relationship is at stake; on the other hand, the Federal or Postal employee has come to a critical point in his or her future, career and professional life, where the support of the treating doctor in the preparation, formulation and filing of a Federal Disability Retirement application has become necessary.  

Doctors, by nature dislike the administrative aspects of preparing lengthy medical narrative reports.  Yet, most doctors recognize the necessity of that aspect of their practice, and are willing to perform the service as part of their duty to their patients.  A diplomatic, sensitive balance must be struck, but one that is honest and placed within the appropriate context of one’s health and future well-being.  

In essence, the doctor must be asked about his or her support in preparing a Federal Disability Retirement application under FERS or CSRS, but in the context of a larger discussion concerning one’s health, treatment modalities, permanency and chronicity of disabling medical conditions, and future treatment.  In essence, the “reluctant doctor” must be persuaded to disrobe his or her reluctance, for the sake of the patient’s health.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: The Reluctant Doctor

In preparing, formulating, and filing a Federal Disability Retirement application under FERS or CSRS, the linchpin (sometimes spelled “lynchpin”) is comprised of a supportive doctor who is willing to provide substantive medical evidence, by a preponderance of the evidence, that a Federal or Postal employee is no longer able to perform one or more of the essential elements of one’s job, and that the medical condition will last a minimum of 12 months.  

Originally, a linchpin referred to a metal fastener which prevented a wheel from becoming separated or dislodged from the axle.  Similar to the conceptual analogy of the “weakest link” in a chain, the idea of viewing a Federal Disability Retirement application in such terms and perspective is to recognize the centrality of a foundation, and how everything else is supported by that foundation.  If the foundation itself is weak, then the chain may snap, and the wheel may fall off the wagon, and everything which is supported by the foundation may come tumbling down.

Such a weak linchpin may be characterized by “The Reluctant Doctor.”   For, ultimately, it will be the treating doctor’s opinion which will provide the primary basis of a Federal Disability Retirement application under FERS or CSRS.  To presume the support of one’s treating doctor may reveal an unfounded sense of confidence.  To declare that, “Of course my doctor will support me.  He’s been my doctor for X number of years,” is to be naive about the psychology of doctors.

Doctors enjoy engaging in the practice of medicine; they abhor the administrative necessities of supporting their patients in preparing a Federal Disability Retirement application.  The Reluctant Doctor is fairly widespread; it is up to the potential applicant, or his/her attorney, to explain the process, beginning with a simple request for an assurance of support from the patient — the applicant who will be filing for Federal Disability Retirement benefits under FERS or CSRS.

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