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: Professionals & Saving Time

In many areas of law, it is often the case that “professionals” prefer dealing with other professionals.  Thus, doctors will often encourage their patients to obtain the services of a lawyer when it has come time to consider medical retirement.  

In preparing, formulating and filing for Federal Disability Retirement benefits under FERS or CSRS, submitted to the Office of Personnel Management, there are multiple factors to consider when engaging in the preparatory stages of the administrative process.  The reason why doctors often prefer to deal with attorneys when the patient is compiling the “paperwork” for Federal Disability Retirement is that it saves time.  

Time is a commodity which is scarce and valuable.  Doctors do not want to have to engage in multiple revisions or rewriting of medical reports.  Doctors are professionals who believe that their time is best spent in treating patients — and while such “paperwork” is a necessary part of a doctor’s practice, and one which ultimately assists the patient in furthering his or her medical condition and future well-being; nevertheless, if an administrative issue needs to be addressed, doctors will often prefer to accomplish such administrative tasks in the most efficient, expeditious manner possible.  

The same concept holds true for the Federal or Postal worker who is filing for Federal Disability Retirement benefits under FERS or CSRS.  While there is never a guarantee that a “professional” will present a compelling enough case to the Office of Personnel Management such that an approval of one’s Federal Disability Retirement application will be a certainty; nevertheless, it is normally the most effective road to success.  

As time is a valuable and scarce commodity, so such scarcity and value should be considered at the beginning of the process of preparing, formulating and filing for Federal Disability Retirement benefits under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

Early Retirement for Disabled Federal Workers: Collateral Disability Determinations

The key to effectively using collateral sources of disability determinations in a Federal Disability Retirement application under FERS or CSRS is to tailor its relevance in each individual circumstance.  Thus, for example, because the focus upon percentages of disability, or the issue of causal connection to the workplace, is a focal point of importance in an OWCP/Department of Labor case, but not in cases of Federal Disability Retirement under FERS or CSRS, such issues should be left alone.  However, the fact that there may be an “independent medical examination” by a Second-Opinion doctor, or a referee doctor in a Worker’s Comp case, can be used to one’s advantage.  

Often, a person who has been under the agonizing scrutiny and torture of the Worker’s Comp process will miss the point, and complain that the OWCP-appointed doctor “didn’t even exam me for 2 minutes”, or “didn’t listen to a thing I said,” but all the while missing the key ingredients in the doctor’s report:  (1) that the doctor can be effectively characterized as “independent” — not from an OWCP standpoint, but certainly from a FERS or CSRS Disability Retirement standpoint, because that particular doctor has no self-interest from OPM’s viewpoint, and (2) if the doctor’s opinion is that, while the causal connection (for example) may not have been established, does he nevertheless express an opinion that the Federal or Postal employee is unable to return to perform the essential functions of his or her job?  Often, the emotional uproar in an OWCP case, or in other similar cases (SSDI & Veteran’s Department disability determinations) causes the Federal or Postal employee to miss the primary point of the process:  to use the tools effectively in getting a Federal Disability Retirement application under FERS or CSRS approved.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for Federal & Postal Employees: OWCP & OPM Disability Retirement

Many calls come in where individuals have been on OWCP benefits for some time; it is, as I often explain, a difficult road to take, let alone stay on.  The compensation is certainly better, and in comparison to what Federal Disability Retirement benefits pay under FERS or CSRS, it can mean the difference between relative financial comfort and hardships.  But the difficulties which people — almost without exception — encounter with OWCP — from the constant harassment, to the threat of cutting off benefits, to repetitive examinations before Second Opinion and referee doctors, etc., makes for intolerable conditions.  Further, OWCP is not a retirement system, as I incessantly and redundantly state; it is a mechanism in which to allow for temporary compensation to be received while a Federal or Postal worker is recuperating from an on-the-job injury.  And that is the key concept — the Federal or Postal worker is expected, in the end, to recuperate and go back to work.  OPM Disability Retirement, on the other hand, is just that — a retirement from the Federal Service, for a medical condition which is expected to last for a minimum of 12 months, but as in most cases, as a permanent condition of the Federal or Postal employee.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for Federal & Postal Employees: OPM’s Arsenal

The names have been changed to protect the innocent.  Or, perhaps those who are impliedly involved herein are not so innocent after all.  Nevertheless, the names must be changed to protect confidentiality of sources, etc.  Every now and then, the Office of Personnel Management discloses their arsenal of weapons.  For instance, such an arsenal might be that a denial of a Federal Disability Retirement application was based upon a review by a retired contract doctor.  Now, let us analyze such an arsenal.  First, the term “retired” reveals an interesting concept.  It means that the individual no longer sees hundreds of patients on a daily basis, nor is actively practicing medicine.  Next, on a superficial level, we take the word “contract” — meaning thereby that the individual is paid to review the paper submissions — not to examine the applicant who is filing for Federal Disability Retirement benefits.  And, finally, the concept of a “doctor” — let us be certain as to the two preceding words, “retired” and “contract”, and that is the extent which one needs to understand in accepting the definition of the word “doctor”.  As opposed to:  the treating doctor of an applicant for Federal Disability Retirement.  Who would you choose to treat you?

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: OPM over OWCP

I still get many emails and phone calls about the onerous, “over-the-top” behavior, and the bullying tactics of OWCP/DOL temporary total disability payments & requirements — everything from constant, incessant and unending, harassing letters, to requiring further evaluations from second and third opinion doctors (or so-called doctors), to constantly requiring one’s treating doctor to justify the continuing disability status, thereby endangering the continuation of the doctor-patient relationship.  And who can criticize or blame the doctor for wanting to drop a patient for the amount of hours he/she has to put into, for “non-medical” issues, and for the time expended which the doctor will never be paid for? 

Yes, Worker’s Comp pays more.  Yes, it is non-taxable.  Yes, there are monetary reasons for staying on OWCP.  But the truth is, money doesn’t buy peace of mind or a life of lesser stress.  OWCP is meant to be a temporary means of providing income — it is not designed for the long term, and indeed, the Office of Worker’s Compensation makes that abundantly clear by their actions.  OPM Disability retirement under FERS or CSRS pays much less, but it allows for independence and a semblence of freedom, not even to mention a life of some dignity.

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: Problems with the OWCP Paradigm

The problem with basing one’s future stability upon an “OWCP Paradigm”, or “model”, are multiple in nature.  To begin with, you cannot work at another job while receiving OWCP temporary total disability payments.  Thus, while you may be an injured worker, and unable to perform the essential elements of your Federal or Postal job, you may nevertheless be able to be productive in some other capacity, and may be capable of starting a business or working in some other field.  This is true if you are on OPM Disability retirement:  You can go out and get another job, and make up to 80% of what your former position currently pays, and continue to receive your disability annuity.  This is a good deal, in my view, because it provides an incentive to go out and become productive, and to plan for the future. 

Furthermore, OWCP/Department of Labor is notorious for cutting off benefits at the first sign that you are anything less than fully cooperative with their dictates.  OWCP may send you to a “second opinion” doctor who finds that you are “completely recovered”, thereby endangering your Worker’s Comp benefits.  Or, in order to save money, they may dictate to you that you must work as a Wal-Mart greeter, and pay you the difference between a menial job (not of your choice) and what they are paying you.  If you refuse, OWCP may simply ascribe what they believe you can earn, and pay you the difference — or not pay you anything.  While OWCP has procedures for appealing decisions, it is a long and arduous road to take.

These are only some of the problems associated with basing one’s future upon a Worker’s Compensation paradigm.  That is not to say that one should not file for and accept OWCP payments — it definitely pays more, and for a temporary period of payments in order for an injured Federal or Postal employee to remain financially solvent in order to recover from one’s work-related injuries, it is a good program.  As a paradigm for planning for one’s future, however, there is much to be desire.

Sincerely,

Robert R. McGill, Esquire

Postal and Federal Disability Retirement: The Initial Federal or USPS Disability Process

Many people get confused when they first consult with an attorney about USPS or Federal Disability Retirement benefits.  Indeed, before consulting with an attorney, an individual who is faced with a medical condition which (1) is beginning to impact one’s ability to perform one or more of the essential elements of one’s position and (2) will likely last at least a year — such an individual should first take the time to research various websites to “get the facts” about Federal Disability Retirement. 

I have had many individuals tell me that they didn’t even know that such a benefit existed; that when they were separated from their U.S. Government gency, the Postal worker or Federal employee was never informed that he or she could file for Federal Disability Retirement.  Unfortunately, ignorance of the law is not a valid excuse; if you don’t file for disability retirement benefits under FERS or CSRS with the Office of Personnel Management within one (1) year of being separated from service with the Federal Government, you will have lost your right to file — forever. 

Furthermore, it is dangerous to “take comfort” in the fact that the Department of Labor/The Office of Worker’s Compensation Programs deemed you to be 100% disabled.  That “100%” disabled status may last a lifetime, or it may last only so long as your particular OWCP caseworker is working on your case.  The next caseworker may take it upon him or herself and decide that, Well, no, perhaps you are not 100% disabled, and perhaps sending you to a “Second Opinion” doctor (who, it just so happens, is receiving about 95% of his or her income expounding such “second opinions”) will result in a medical finding that you miraculously “recovered” and are able to go back to work.  Benefits cut off.  You waited a year or more after being separated from Federal Service to find this out, without having filed for Federal Disability Retirement benefits.  You are then, unfortunately, “out of luck”.  Make sure that you file in a timely manner; make sure that you do not take comfort in being on OWCP rolls.  Don’t forget —  Postal or Federal Disability Retirement is an annuity that you can rely upon as a “base income” for your financial security.

Sincerely,

Robert R. McGill, Esquire