Federal and Postal Disability Retirement: Disarming the Doctor

To some extent, there is indeed a “difference” and a “distinction” between an Administrative process of law, and a “legal” or “courtroom” (i.e., “adversarial”) process of law.  Doctors are, by either personal & professional direct experience, or from hearing or reading about others, keenly aware of the horrors of the “legal” process.  Malpractice lawsuits, personal injury lawsuits, subpoenas, depositions, being cross-examined by a defense attorney (or the Plaintiff’s attorney, whichever may be the case) on the stand — these are all intimidating factors that are deliberately avoided. 

Because of such negative experiences, perspectives, memories or viewpoints about the legal process, it is often an unfortunate fact that doctors “run for cover” whenever there is even a hint that one is being asked to involve him or herself in such a “legal process”.  Doctors will outright refuse to write a medical report; one may be dropped as a patient suddenly and without warning; there may be considerable delays and obfuscation in responding to a request for a written narrative report.  These are merely some of the underlying reasons why an SF 3112C should never be used — because it does not properly explain what it means to “get involved” in the administrative process.  To this extent, it is important to have an attorney who will carefully, and with great tact, explain the process of obtaining Federal Disability Retirement benefits — and thereby “disarm” the doctor from being intimidated.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Thank the Medical Professionals

If not for the doctors, disability retirement would obviously not be a possibility.  Of course, one may make the self-evident statement that being supportive of a Federal Disability Retirement application is simply part of a doctor’s job; and, to some extent, that would be true.  Doctors should indeed be willing to write up supportive medical narrative reports for their patients. 

Nevertheless, it is because of the doctor, the effort expended, the willingness to testify at a Merit Systems Protection Board Hearing, that the Office of Personnel Management even listens, or reverses a prior denial, and grants a disability retirement application.  Especially when a case gets denied twice by the Office of Personnel Management, it becomes crucial to have the cooperation of the treating doctor to testify in an MSPB Hearing.  This is normally done by telephone, thereby making it a minimal imposition upon the doctor’s time.  Indeed, I often only take a total of 30 minutes of the doctor’s time, including preparation and actual testimony, for an MSPB Hearing.  But the very fact that the doctor is willing to testify — to speak to the Administrative Judge directly to give his or her medical opinion — is often enough to convince OPM to change course, and grant the disability retirement benefits. 

Sincerely,

Robert R. McGill

OPM Disability Retirement: The Patient/Applicant

Before even thinking about starting the process of filing for Federal Disability Retirement under FERS or CSRS, it is important for the patient/applicant to approach his or her doctor and get an initial commitment of support. For, ultimately, the most essential lynchpin of a disability retirement application hangs on the support of a doctor — from the first and initial stage, all the way to the Merit Systems Protection Board (where live telephone testimony may be necessary).

The “patient” needs to approach the doctor with sensitivity. It is probably not even a good idea to talk about anything beyond the first stage of the process — instead, the focus should be about how “support” for a disability retirement application is actually part of the rehabilitation and healing process of medical treatment. For, ultimately, a disability annuitant under FERS or CSRS is not asking to be “totally disabled” by the doctor (and, indeed, most doctors do not want to release their patients into the retirement “pasture” of full disability); rather, it is simply a medical support of reasoning that a particular patient is no longer a “good fit” for a particular kind of job. Don’t scare the doctor off with a view of the “long process”; rather, the initial commitment is all that is needed — for the first stage of the process.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: The Doctor

Doctors hate administrative duties.  They went to medical school, and they want to practice medicine, not law.  If they wanted to engage in vast amounts of paperwork, they would perhaps have gone to law school.  As such, paperwork, writing medical narrative reports for their patients, providing medical opinions in a report — they are part and parcel of the dreaded “paperwork” — somewhat like filling out all of the forms for medicare, medicaid, insurance, etc. to get paid. Such paperwork is often left to the “administrative staff”, and therefore doctors are only sporadically required to actually prepare any paperwork.

This presents a peculiar problem for a potential disability retirement applicant, because in order to obtain Federal Disability Retirement benefits under FERS or CSRS, an applicant must have a doctor’s narrative report which delineates certain issues, addresses certain issues, and renders certain opinions.

Thus, the crucial question becomes: How does one approach a doctor and convince him or her that preparing a proper medical report is an integral aspect of treating the patient? The answer: It must be done with diplomacy, sensitivity, caution, guidance, and understanding, all bundled into one. Above all, it begins with a relationship — a patient-doctor relationship that has been formed over many, many years. And, indeed, that is the requirement under the case-laws at the Merit Systems Protection Board governing disability retirements — that those opinions rendered by treating doctors of long duration are accorded greater credibility than single-examination doctors. And it all makes sense.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The "No Other Choice" Case

Then, of course, there are cases where an individual has “no other choice” than to file for disability retirement. Sometimes, it is a chance that is taken — the chance of paying an attorney. Yes, adverse removal actions can impact one’s chances of obtaining disability retirement benefits. A case study: A recent client was removed from a Federal Agency for criminal conduct (obviously, no names will be used, and the facts will be somewhat altered to protect the client’s confidentiality of information). The individual was nowhere near retirement age; but suffice it to say that he/she had been a loyal employee for 20 years. He/she had a medical condition — a psychiatric condition, which pre-dated the criminal conduct. He/she hired me to obtain disability retirement.

What choice did the person have? He/she really had “no other choice” other than to walk away with nothing, or take the chance of paying an attorney (in this case, me). I was blunt about the entire affair: Normally, I am able to get most of my clients approved at the first or second stage of the process, and I will normally ascribe a “success-rate” to a case; in this instance, the probable rate of success, in my opinion, was lower than my normal prediction. Nevertheless, he/she wanted to go forward with it. I contacted the doctors and guided them into writing a forthright medical report; today, the client is receiving his/her disability retirement annuity. Did the person “deserve it” despite the criminal conduct? Absolutely! His/her medical condition pre-dated the criminal conduct, and in fact was a major factor in the actuation of the criminal conduct itself. I am happy for the client, and from a professional standpoint, it is always satisfying to win a case where a client entrusted a case in which he/she had “no other choice” — but once the choice was made, to have made the right choice.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Time to File

A question often asked is, when is it the right time to file for Disability Retirement? Must you wait until one has been disabled for over a year? Do you have to file for Social Security first, before filing for OPM Disability Retirement? Should the Agency be notified at the beginning of the process, or some time later down the road? What is the best time to approach my doctor about getting his or her support for disability retirement? These are all “timing” questions — each important in its own right, as are all such timing questions.

Since the processing from start to finish, to obtain disability retirement benefits, may take 6 – 8, sometimes 10 months, it must be timed financially — is there enough sick leave, annual leave; should donated leave be requested? Once LWOP is taken, should one remain on LWOP throughout the entire process? As to whether one must wait for a year of being “disabled” before one can file — the answer is “no”. So long as the doctor believes that the medical disability will last for at least a year (within reasonable medical probability), one has the proper medical basis to file for disability retirement. As to filing for Social Security, the Office of Personnel Management actually only needs to see the receipt, showing that one has filed for SSD, at the time of approval of the disability retirement application. And how about notifying the Agency?

This is a question which should be decided after discussion of several factors, with one’s attorney, who may provide for proper legal advice, the potential consequences of informing the Agency, etc. Ultimately, timing questions are a matter of particular importance — particular to the situation and circumstances of each individual case. With that in mind, it is often a good idea to have the counsel of an experienced attorney in the area of Federal Disability Retirement.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Physician II

This blog is written in response to a question posed: in the event that an individual is unable to have a medical report written by a treating physician for circumstances beyond his or her control (i.e., such as death of a treating physician; uncooperativeness of a doctor; need to move to a different locality and need to switch to another doctor for whatever reason, etc.), would or can a physician’s medical narrative report written by a doctor of “short tenure” still be effective? The answer is, of course, as with all legal questions, “It Depends”.

Think about it this way: Disability retirement has to do with proving that, because of a medical condition, an employee of the Federal Government is no longer able to perform one or more of the essential elements of his/her job. This simple statement, when broken down, actually has a number of limitless components: What is the job? What are the specific elements? What are the medical conditions? What are the symptoms? How do the symptoms impact the person? Does it require medications? Does it require surgery? Are there other treatment modalities? What specific symptoms impact which specific job elements? And on and on.

Thus, these questions and the answers to such questions can normally be answered only by a treating physician — one who has, over the course of a long tenure of treatment, come to intimately know the patient. At the same time, think of the following issue: A doctor whose primary source of income being to write up “disability determinations” for individuals, and whose name repetitively appears in the Office of Personnel Management — that doctor’s reputation will quickly become questioned. The issue of an effective medical narrative has an inherent component: The credibility of the writer (the doctor), and credibility is usually determined by the tenure of the patient-doctor relationship. Are there exceptions? Absolutely. As with everything else in life, credibility can always be established with the truth — for instance, if a recent change in doctors occurred because of a move, the doctor can simply state that fact, refer to prior medical records reviewed, and move on to the substance of the opinion. Alas, credibility is what always counts.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: Actions from the Federal Government or the Postal Service

I often receive telephone calls from Federal and Postal employees worried about what their Supervisor will write in the SF 3112B (Supervisor’s Statement) — the lies, half-truths, and vindictive statements that some Supervisors will, for whatever reason, attempt to have that “last parting shot”. Such acts by supervisors are, for the most part, and fortunately, the exception, and not the rule; but each time it happens, it is despicable to the exponential degree — especially in light of the context of attempting to harm a Federal or Postal employee who has a serious medical disability, and needs the financial security offered by disability retirement.

As a general rule, the best approach to take is to follow the rule of thumb of the wise man: Do not worry about those things over which you have no control; focus upon those things over which you do have control. Remember that this is a medical disability retirment — with the emphasis upon the term “medical”. Having said that, a disability retirement application must first and foremost focus upon obtaining the most excellent medical report. If this is accomplished, then in 99% of the cases, it will nullify and make irrelevant anything which the Supervisor puts down on the Supervisor’s Statement. This is the best and wisest approach to take; do not waste your time, emotional energy, or any further part of your life worrying about a Supervisor who lacks the fundamental compassion to be honest and truthful about an individual who has shown years of loyalty to the Federal Service. He/she is not worth it.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: Failing to Follow “Reasonable Treatment”

In fighting to prove one’s eligibility for Federal Disability Retirement benefits, a recurring argument which the Office of Personnel Management often alleges is that an applicant failed to follow the treatment recommendations of the treating doctor.

Such an argument can prove to be fatal to an applicant’s case, but it is good to know the parameters of what it means to “fail to follow” reasonable medical treatment.  For instance, non-compliance with a medication regimen can be fatal to a case.  Thus, OPM will successfully argue that an individual who has failed to follow the medication regimen of the treating doctor has thus failed to show that the individual could have returned to work precisely because non-compliance with a medication regimen would logically undermine the potential efficacy of the medical treatment.

On the other hand, invasive surgery is normally not required, and the Merit Systems Protection Board has stated that an “estimated probability of success of future surgery is speculative, just as a prediction as to the worsening of a condition may be, and will not necessarily provide a basis for denial of a disability annuity.”

These are two light-posts on the spectrum of what is deemed “reasonable treatment”.  Most issues concerning reasonable medical treatment fall somewhere between these two extremes, and the best course of action (obviously) is never to self-treat, or make medical decisions without the input of your treating doctor.  Indeed, to not follow the medication regimen of your doctor is a manner of self-treatment; on the other hand, to elect not to have surgery because of the speculative success/failure rate is a reasonable decision which the Merit Systems Protection Board will not second-guess.  What falls in-between these two extremes should always be with the guidance of “reasonableness”, in close consultation with your treating doctor.

Sincerely,

Robert R. McGill, Esquire