Tag Archives: ensuring a supportive physician even after opm application

Federal and Postal Disability Retirement: Tendencies and First Impressions

First impressions are funny animals; while potentially misguided and fraught with errors, they are difficult to shake off because of our natural inclination to form them.  Tendencies, on the other hand, are established over time, and tend (sic) to reliably reflect a routine of repetitive behavior.  In both cases, they are difficult traits to get rid of, sort of like a nagging cold or a hairball in one’s throat.

For the Federal and Postal employee contemplating filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, both traits are important to recognize.

First impressions — and from knowledge gained over time:  one’s agency; how will one’s supervisor act or react; one’s treating doctor; the extent of support one will receive; they will be the initiating basis and foundation in determining whether to go forward or not.

Tendencies — one’s own; is procrastination a problem?  Is avoidance an issue, such that it is best to jump into the process, knowing that delay is an identified enemy of one’s own best interests?

One’s formed personality and characteristic traits are established early in life; it is the remainder of our lives where we work to understand them, and to undo, supplement, or learn from those early first impressions and tendencies molded into our very being.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: Back to Fundamentals

In any endeavor, concern or current focus of attention, one can become embroiled in the morass of complexities which comprise the peripheral penumbras of the issue, and disregard the fundamental essence of the matter.  In proverbial terms, it is to overlook the individual trees while viewing the generality of the forest.  So, back to basics.

In a Federal Disability Retirement application, a person who is under FERS (Federal Employees Retirement System — normally those who entered into the Federal Workforce sometime after 1985, and who have a Thrift Savings Plan and contribute to Social Security) or under CSRS (Civil Service Retirement System — pre-1985, with no TSP) may become eligible for Federal Disability Retirement benefits, but must have the following minimum eligibility criteria met: under FERS, you must have at least 18 months of creditable service; under CSRS, you must have at least 5 years of creditable service.

There is a hybrid status applicable for some, called CSRS-Offset, also.  Once that eligibility criteria is met, then the Federal or Postal Worker can take the next step in determining whether one may want to proceed, by asking the following questions: Do I have a medical condition? Does that medical condition prevent me from performing one, if not more, of the essential elements of my position? What are some of the essential elements of my position which I cannot perform? Do I have a treating doctor who will be supportive of my case (remember, this is a medical disability retirement; as such, one must be able to establish through proof of medical documentation, that the medical condition impacts one or more of the essential elements of one’s job)?

These are some of the preliminary, basic questions which should be asked and answered, in order to begin the process of determining whether Federal Disability Retirement is the best pathway for the Federal or Postal employee suffering from a medical condition, in order to manage and maneuver one’s way through the thick forest of a bureaucracy known as the U.S. Office of Personnel Management, which is the agency which ultimately receives and reviews all Federal Disability Retirement applications, whether you are under FERS, CSRS, or CSRS-Offset.

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

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 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

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

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 Disability Retirement: Speaking with the Doctor

Communication is the key to a successful outcome:  such a trite truism is certainly applicable in a Federal Disability Retirement application under FERS & CSRS.  The primary focus when a Federal or Postal employee has a medical condition which is impacting his or her ability to perform all of the essential elements of his or her job, is to take care of the medical condition — i.e., to have the necessary treatments, to undergo the proper prescriptive treatment modalities, including surgery, medication regimens, pain management treatments, psychotherapeutic intervention, etc.

Beyond such treatment modalities, however, there may come a point in the life of a Federal or Postal employee when it is becoming apparent that the medical condition is simply “incompatible” with the useful and efficient retention in the Federal or Postal Service.  Such a determination is best made by the Federal or Postal employee, if possible, as opposed to having the Federal Agency or the U.S. Postal Service suddenly and unceremoniously make such a determination — in the form of a proposed removal based upon one’s failure to maintain a regular work schedule; or because of taking “excessive leave“; or putting a Federal or Postal employee upon a Performance Improvement Plan.  Such a determination may best be made by the Federal or Postal employee by communicating one’s concerns to the treating doctor, and asking some incisive questions.  Another trite truism:  The only stupid question is the one not asked.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: Don’t Assume

We are all familiar with the acronym-like adage which can be extracted from the word “assume”.  In preparing a Federal Disability Retirement application under FERS or CSRS, the first question that one must ask of one’s self is:  “Do I have a supportive doctor?”  If the answer is an unequivocal “No”, then entertaining even the thought of proceeding forward with the process is a virtual act of futility.  

Now, to all unqualified statements, there are exceptions to the rule.  There are, indeed, medical conditions where the mere treatment records, office notes, etc., reveal irrefutably of a medical condition of such severity that there is no question as to its impact upon one’s ability/inability to perform the essential elements of one’s job.  But that is rare.  If the answer to the original question is:  “He may be…”  “I assume he is supportive…”  “He seems supportive because…”   While these are niceties in one’s figment of one’s imagination, and foster a sense of security and a warmth for a doctor-patient relationship, such answers all have an undercurrent of an assumption.  Don’t assume, if you are planning to go forward with a Federal Disability Retirement application.  Instead, make an appointment with your doctor and have a frank and open discussion.

Sincerely,

Robert R. McGill, Esquire