Federal Employee Medical Retirement: A Real-life Hypothetical

Assume the following hypothetical:  A Federal or Postal employee who is 48 years old, with 25 years of Federal Service, engages in a type of work which is repetitive, day in and day out (yes, even this sentence is repetitive and redundant), full time, over the course of those 25 years.  

One day, while moving a piece of furniture at the direction of his spouse, he feels a sudden and sharp pain in his back.  He has to sit down and rest for a while.  The “for a while” turns into a visit to the emergency room, then to his family doctor.  The MRI shows a disc bulge at L5-S1, with multi-level disc degeneration, spinal stenosis, and other degenerative changes.  Despite multiple modalities of treatments, including epidural steroidal shots, physical therapy, variances of medication regimens, etc. (and you can even add a surgical intervention), the pain continues to worsen and deteriorate his medical condition.  The chronic pain prevents him from performing his job.  Whether sedentary or physical, the high distractability of the pain results in his poor performance.  

Can he/she file an OWCP claim?  Such a claim is submitted and rejected, because the issue of causality cannot be established.  An appeal is filed, and it is again denied.  The treating Neurologist and Orthopaedic Specialist are unwilling to establish a direct causal link.  But one argues:  Do those 25 years of repetitive work account for nothing?  Can it all have occurred because of the singular occurrence?  Does my medical condition reflect that of a person twice my age merely because of a single incident?  

It is precisely because causality is the crux of OWCP, that Federal Disability Retirement under FERS or CSRS is an important benefit for all Federal and Postal employees. OWCP/FECA is a benefit which is great for the limited role it plays; Federal Disability Retirement is a benefit with wider applicability, and the chance for the Federal or Postal employee to enter into another phase of life.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement for Disabled Federal Workers: OWCP & Federal Disability Retirement

Whether or not one remains on Department of Labor, Office of Worker’s Compensation Programs (DOL/OWCP) benefits, of receiving Temporary Total Disability compensation, and for how long, should not be the determining factor as to whether to file for Federal Disability Retirement benefits from the Office of Personnel Management, whether under FERS or CSRS.  

Ultimately, the two systems of benefits and compensation are meant to address two different issues. OWCP is meant to address the issue of a Federal or Postal worker who has been injured on the job, or from an occupational disease, and thus causation is an issue with OWCP compensation and benefits.  Further, OWCP is not meant to be a retirement system — although, in more recent years, the U.S. Postal Service and some other Federal Agencies have started to use it “as if” it is a retirement system for its employees, encouraging the filing for such benefits in order to shed the agency of workers who are not “fully” productive.  

What often happens, however, when a Federal or Postal worker continues to remain on OWCP is that it become a default retirement system.  One can easily become comfortable in receiving the Temporary Total Disability payments, and indeed, because of the high rate of pay and the appearance of greater benefits because no taxes are taken out of the amount paid, one can continue to survive on such payments.  But because it is not a retirement system, the day can suddenly dawn when OWCP finds that the Federal or Postal worker is no longer entitled to such compensation.  For that reason, and sometimes for that reason alone, it is important to secure the benefit of a Federal Disability Retirement annuity.

Sincerely,

Robert R. McGill, Esquire

Federal Worker Disability Retirement: Work as the Causal Inception

In a claim filed with the Office of Workers’ Compensation Programs (OWCP), causality and whether it is work-related, occupationally related, etc., are issues which will inevitably arise, precisely because the statutory mandates which govern OWCP rules and regulations require proof of a causal connection.

Under Federal Disability Retirement for FERS & CSRS employees, however, such work-related causality is not an issue, because it is not a requirement that a medical condition was “caused” while performing one’s Federal or Postal job, or that there be some connection to an occupational hazard or inherent workplace relationship.  That does not mean, however, that there cannot be a workplace connection; merely that, whether or not there is any such relationship between the medical condition and the work environment, it is not an issue which possesses any significant relevance to the filing of a Federal Disability Retirement application.  

These “fine distinctions” can be confusing for non-lawyers (and, indeed, even for lawyers who are supposedly trained in being able to analytically dissect multiple compounding concepts within statutory language).  

“Causality” to the workplace can, however, be discussed and even referred to in a medical report, or in the Applicant’s Statement of Disability (Standard Form 3112A), as a provision for historical and background context, but it is not an essential element to prove in a Federal Disability Retirement application under FERS or CSRS.  Too much emphasis on the historical context, however, can lead to the unforeseen and dangerous consequence of having one’s case characterized as a “situational disability“, and one must always be cognizant of such a danger.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The OWCP Intersection

Federal Disability Retirement benefits under FERS or CSRS is oblivious and unconcerned with whether or not a particular medical condition occurred “on-the-job” or not.  Rather, the focus is upon (A) the existence of a medical condition along with the symptomatologies and their manifestations, and (B) the impact of the medical condition(s) upon one’s ability/inability to perform all of the essential elements of one’s job.  

Thus, “causality” in all of its forms is an irrelevant issue — whether “how it happened”, “where it happened”, “what happened”, etc.  Causation is a legal/medical issue which may be interesting, and is certainly one which the Office of Worker’s Compensation Programs inquires about, but it is a “non-starter” for purposes of Federal Disability Retirement benefits under FERS or CSRS.  

As such, when a Federal or Postal employee who has been injured on the job, or who has incurred a medical condition from a worksite because of inherently hazardous medical triggers reasonably related to the particular occupation of an individual, an inordinate amount of focus is often paid as to the “causality” of a medical condition.  While this may be of historical interest — both to a doctor as well as to FECA/OWCP — it is an issue which should play a lesser role of importance in a Federal Disability Retirement application.  

For eligibility in filing a Federal Disability Retirement application under FERS or CSRS, where something happened, what happened, or when it happened, is far less important than how much of an impact a medical condition has, and for how long, upon one’s ability/inability to perform the essential elements of one’s Federal or Postal job.

Sincerely,

Robert R. McGill, Esquire

OWCP Payments & FERS/CSRS Disability Retirement

There are many Federal and Postal workers who have been receiving OWCP payments (Temporary Total Disability benefits) for years.  Such payments can, indeed, continue for many years, or for a few months, depending upon the length of time it may take for a medical condition to persist.  

The problem with relying upon OWCP as a retirement system is that, strictly speaking, it is not a retirement system.  The Department of Labor can begin the process of sending the benefit recipient to a “Second Opinion” doctor, and the process of attempting to cut off OWCP benefits has thus begun.  

Further, there is often the problem of reliance upon OWCP, resulting in a Federal or Postal worker failing to file for Federal Disability Retirement benefits within 1 year of being separated from Federal Service.  This sometimes happens because the Federal or Postal Worker begins to feel secure in the monthly OWCP benefit, and because it pays a higher rate than FERS or CSRS Disability Retirement benefits.  However, one should never be fooled by the tenuous nature of OWCP — it is not meant to be a retirement system, and most Federal and Postal workers who have experienced first-hand the treatment by OWCP/DOL will attest to the fact that they can be sudden, arbitrary, and difficult to deal with.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Influences

The fear that failure experienced in one path & process will impact and influence another process is one that is often of concern.

When a Federal or Postal employee files for Federal Disability Retirement benefits under FERS or CSRS, there are often concurrent and parallel paths which are undertaken — whether it is concurrently filing for OWCP (Worker’s Comp) benefits; SSDI (which is a requirement under FERS, anyway); a third-party personal injury claim; application for unemployment benefits, etc.  And then, of course, there are EEOC Complaints which may be filed; collateral lawsuits, and other administrative and judicial processes which may be entered into in parallel fashion.

Do any of these other processes impact or influence a Federal Disability Retirement application under FERS or CSRS?

Fortunately, Agencies are like uncoordinated hands appended to multiple personnel with different brains and different neurological centers; rarely do they communicate with each other.

Even assuming, however, that some sort of communication does occur, because the applicable laws and criteria which govern each independent administrative process is different from each other, it is rare that a denial in one administrative process will adversely impact a Federal Disability Retirement application for a Federal or Postal employee under FERS or CSRS.  Imagine that — Federal agencies not coordinating with each other.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: Standard Forms Do Not Mean “Standard Responses”

The problem with “Standard Forms” is that they often appear to solicit “standard responses”, and in a Federal Disability Retirement case under the Federal Employees Retirement Systems (FERS) or the Civil Service Retirement System (CSRS), nothing could be further from the truth.  Indeed, it is often because a Federal or Postal employee/applicant who confronts and begins to fill out SF 3112A, Applicant’s Statement of Disability, the very “blocked” appearance of the form, and the constricting questions themselves, makes it appear as if a “standard response” is required.  Don’t be fooled.

By way of example, take a “special animal” — that of a Federal Aviation Administration Air Traffic Controller who must take a disqualifying medication, loses his or her medical certification from the Flight Surgeon, and thinks that filing for Federal Disability Retirement benefits is a “slam dunk”.  Nothing could be further from the truth.  Or, a Customs & Border Patrol Agent who goes out on stress leave, or suffers from chronic back pain.  Are there “standard responses” in filling out an Applicant’s Statement of Disability?  There are certain standard “elements” which should be considered in responding to the questions, but don’t be constricted by an appearance of “standard responses” to a “standard form”.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Disability Retirement: Interaction with VER, A Continuing Dialogue

I sincerely hope that the proposed VERs which will be issued in the next couple of weeks will be economically viable and rewarding for those who qualify.  I say this because the primary criteria proposed for qualification involves those who are at least 50 years of age with at least 20 years of service, or any age with at least 25 years of service.  Anyone who has dedicated his or her life for a minimum of 20 years deserves something comparable to “full retirement” benefits.  My suspicions are raised, however, only because the motivating factor behind the offer is to target employees in specific locations where reductions in force or restructuring will be taking place — i.e., from the Post Office’s perspective, those places where greater “efficiency” can be obtained, at the cost of a person’s lifetime dedication and service to the Federal Government.  I realize that Adam Smith’s economic truth will always be at play — that self-interest leads to unintended consequences which, in a capitalist system, results in collateral benefits of employment, wide economic impact, etc.  But just make sure that, just as the Post Office is looking after its own interest first, that each Postal employee looks after his or her own interest, similarly — first.  Look at the VER carefully.  Compare it to disability retirement benefits carefully — not only in terms of “today’s” dollar value, but also into the future.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: OWCP, Light Duty & Federal Disability Retirement

As I stated in my previous blog, OWCP is not a retirement system. Instead, it is meant to return an injured worker back to productivity with his or her agency. This is done through means of providing for medical treatments; paying the Federal employee temporary total disability benefits during the time of treatment and recuperation; then, if the Federal or Postal employee is unable to return to the former position in full capacity, to offer a “modified position” to the employee.  At each step in the process of OWCP/DOL, the onerous and burdensome hand of the process becomes clear — for, if at any time, the employee refuses to follow the mandates given by OWCP, the real threat of having one’s temporary compensation suddenly terminated is always a possibility. 

Thus, in accepting OWCP benefits, there is a clear trade-off:  tax free compensation for the price of being completely governed by OWCP.  Then, when the modified job offer is given, you have no choice but to accept it, in whatever form, and must be accepted “as is” — otherwise, your temporary total disability payments will be terminated.  Remember, however, that accepting such a position does NOT preclude you from filing for disability retirement benefits, because the case-law governing Federal Disability Retirement has a “safety” feature:  in order to be considered a legally viable “accommodation” under the law, the modified job that is offered and accepted must have been one which was previously in existence, and vacant.  It cannot be your old job slot, modified by a piece of paper prepared by your agency and the Department of Labor.  It must be a true job.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: OWCP & Federal Disability Retirement

I often tell my clients that OWCP/DOL is not a retirement system. It is a system which was meant to address the medical injury resulting from a work-place accident or occupational hazard resulting in a medical issue arising, such that compensation is allowed for a period of time during a process of recuperation.

As unfortunate as it is, Worker’s Comp has become synonymous with “harassment” and “difficult”, where approval for wage compensation, for medical treatment (including necessary surgery) has meant months and months — and often years — of wrangling and fighting; of having an OWCP case manager or adjuster being rude, failing to respond, failing to return telephone calls, and just when it seems as if something may be done, the OWCP caseworker is switched to someone else who is equally unresponsive.

Then of course there is the intrusiveness — of the OWCP nurse who sits in with you and your doctor, in a context where it is as if the “enemy” is watching that relationship which is supposed to be sacred and private:  a conversation between a doctor and the patient. It is, as I have often told clients, “a hard road to travel.”  Yet, where the medical condition, injury or disability arises as a result of a work-place accident, obviously it is financially beneficial because it pays more. That is the bottom line.  Further, it is tax-free.  But it is not a retirement system. 

Disability retirement pays less; it matters not whether the injury or medical condition occurred “on the job”; you are not required to be examined by a “second opinion doctor”; you do not have to obtain prior approval from a case manager to go and seek medical treatment.  But the benefits are much lower; it is taxable.  However, is it disability retirement.  In such a retirement, you are meant to go out and to do other things in life, including other work.

Sincerely,

Robert R. McGill, Esquire