CSRS & FERS Medical Disability Retirement: The Aggregate of Conditions

In debate, there are two primary methodologies of attacking:  the micro-approach, where each individual strand of an opponent’s argument is dismantled, leaving the opposition with no singular weapon to use; or the macro-approach, where — because some of the individual arguments may withstand scrutiny — the universal umbrella of the argument as a whole is attacked, thereby dismantling the entirety of the whole.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, OPM will utilize one of the two approaches.  At times, OPM will selectively choose one or two of the medical conditions, barely mentioning the rest, then attack the lack of documentary support on those particularized medical conditions.  Or, at other times, OPM will make sweeping generalizations and fail to specifically identify, and selectively ignore, the details of individual medical conditions.  Regardless of the methodology of approach, the ultimate result of either approach is a denial.

The question is how one responds to either approach.

The answer is often based upon the construction of the Applicant’s Statement of Disability.  This is where it is important to weave the particular with the aggregate, where the construction of each individual medical condition is argued to depend upon the greater whole, and where the cumulative impact of the various medical conditions constitute an inseparable whole.  The flexibility of language allows for this; the medical narrative report should reflect this.

This is why spending valuable time at the front end of a Federal Disability Retirement case is important; for the later stages of the administrative process may well depend upon it.


Robert R. McGill, Esquire

Diagnosed medical conditions v. symptoms

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, the medical reports and treatment notes, office notes, etc., will often bifurcate and conceptually distinguish between a “diagnosis” of a medical condition, and the description of “symptoms” which the patient experiences.

Thus, as a simplified example, on a physical level, one might have the diagnosis of “Shoulder Impingement Syndrome” or “Rotator Cuff Tendonitis” in a specific category in a medical report under “Diagnosis”, but in a narrative paragraph discussing the history of the symptoms manifested by the individual, there may be a reference to “chronic pain”, or “radiating pain”.  Similarly, in psychiatric cases, one might be diagnosed with “Major Depressive Disorder” or “Generalized Anxiety Disorder“, without being officially diagnosed with “Panic Disorder” or “Agoraphobia”, but in a discussion concerning the Federal Employee’s symptomatologies, there may be a reference to having “panic attacks” or being fearful of leaving the house or going out into the public.

The conceptual bifurcation between “diagnosis” and “symptoms”, however, may (and perhaps should) be carefully brought together in completing the Applicant’s Statement of Disability.  Thus, while “pain”, “chronic pain”, “radiating pain”, etc., may not officially qualify as the officially diagnosed medical condition in a medical report, in preparing and formulating an Application for Federal Disability Retirement benefits, it is important to interweave such symptoms if they are a prominent part of one’s medical conditions.  Similarly, “Panic Attacks”, even if merely described as a symptom, may be an important part — if not the “essence” of a psychiatric condition — of one’s medical condition, and it is important to include it as part of the diagnosis.  For, when an approval is granted from the Office of Personnel Management, the identified medical diagnosis should, if at all possible, include the most debilitating of medical conditions.

That which is conceptually distinguished on a medical report need not necessarily dictate what is described and delineated on one’s Application for Disability Retirement.  Just some thoughts.


Robert R. McGill, Esquire