Postal and Federal Disability Retirement: The Volume-based Application

A declaration of the sheer volume of medical evidence submitted is often an indicator of the basis for which a Federal Disability Retirement application was formulated; for, in the end, if reliance of the successful outcome of a Federal Disability Retirement application is expected based upon the longevity and extent of a medical condition, the chances of an initial approval may be somewhat compromised to begin with.

Volume can never replace content; and from the perspective of the U.S. Office of Personnel Management, there is often an underlying suspicion that receipt of a thousand pages of medical documentation indicates merely that volume of treatment is being substituted for the substantive content of meeting the required legal standards.

Much of medical notation and treatment records merely reflect a particular appointment’s mechanical applications — continuation of previous treatment plan; refill of prescriptions; standard positive or negative responses to particular questions; prospective treatment modalities; and, as supportive evidence attached to a substantive medical report, they can reinforce the satisfaction of the legal criteria of establishing the necessary nexus between one’s medical condition and the inability to perform the essential elements of one’s job.  But left as a replacement for the doctor’s explicit statement confirming such a nexus, it remains a hollow voice within an expansive but empty chamber.

One should never mistake the legal distinction between “primary” evidence and “supportive” evidence.  The former is meant to establish the nexus between one’s medical condition and the essential elements of one’s job; the latter is submitted to reinforce the former.  When one utilizes the former as the substitute for the latter, it is like the self-delusion that just because you are the best player on a pick-up team in your neighborhood, you are ready to enter into the world of professional sports.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for US Government Employees: The Balance of Information

In every submission of documentary evidence for a Federal Disability Retirement application, whether under FERS or CSRS, there is the need for discretionary decision-making.

Not every piece of information is relevant or necessary; volume of attachments does not make for sufficiency of substantive content; allowing for certain information to “speak for itself” is often more effective than a long-winded explanatory addendum; and the extent of irrelevant or unimportant information attached or included may well have a decidedly negative impact upon a decision, both in terms of questions raised as to the reason for inclusion of such material, and the detracting nature of such information from the centrality and essence of the submission.

Balance of information is always a consideration.  As time is always of importance, so is maintaining the acuity of attention upon the case worker assigned to review, evaluate and decide upon a case.  Streamlining; making certain that the focus is always upon the nexus between one’s medical condition and the ability/inability to perform one or more of the essential elements of one’s job; and the editorial process of discretionary inclusion of relevant material — these should be the final steps in the formulation and compilation of a Federal Disability Retirement application just prior to submission to the U.S. Office of Personnel Management, whether under FERS or CSRS.

Balance the information — always in favor of relevance, importance, and substantive content.  Fluff is best left to descriptive articulation in a fictional genre.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Misunderstanding Leading to Irreversible Detriment

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, the Federal or Postal employee must first engage in a general foraging for information.

The act of gathering information is of importance; for, just like the animal in the wild who must “learn” to forage for food before the first winter comes, so the Federal or Postal employee who is contemplating filing for Federal medical/disability retirement benefits must develop the keen sense of how to gather the necessary, pertinent and relevant information concerning the entire bureaucratic process, and once gathered, to sift through the vast array of information to determine truth, falsity, relevance, effectiveness, and that which is erroneous or misleading — to one’s detriment.

Foraging is a learned tool, necessary in the wild, and a key component of the natural process of selectivity.  It begins with an inborn part of an animal’s nature, but must be honed in the wild — to be clever, quick, and be able to distinguish between that which is good for one’s diet, as opposed to that which may be poisonous.

By analogy, in the vast array of the universe of information “out there”, one must be able to quickly discern and bifurcate information concerning Federal or Postal Disability Retirement benefits, dividing between relevance and irrelevance, substance versus fluff, for purposes of failure versus defeat.  As information gathering leads to action upon the knowledge gained, so one must be cautious in determining the source of such information.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Workers: How and What

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, “how” one states something is often just as important as the “what” one says.

The latter is relevant for obvious reasons:  the subject of the statement is the “identifier” for purposes of directing the reader (in this case, the person who is handling your Federal Disability Retirement benefit application at the U.S. Office of Personnel Management) to focus upon a particular matter; but just as importantly, “how” it is said — i.e., the tone, tenor and context of the “what”.

How a medical report is stated will often determine the success of a Federal Disability Retirement application, more than what is expected to be said.  For, from the perspective of the Office of Personnel Management, the generic “what” (the subject matter of the application) will almost always contain the obvious:  that there is a medical condition; that the medical condition prevents one from performing one or more of the essential elements of one’s job; that the Federal or Postal worker will make statements and claims of an inability to perform certain key elements of one’s job because of one’s medical conditions, etc.

On the other hand, how it is stated:  Is it persuasive?  Does the doctor follow from a reasonable explanation to an unequivocal conclusion?  Is the doctor convincing?  While the “what” of a Federal Disability Retirement application, whether under FERS or CSRS, may be a necessary condition of a Federal Disability Retirement application, it may not be sufficient; sufficiency may be determined by how a Federal Disability Retirement application is prepared, formulated, and ultimately filed.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement for Federal Workers: How to Use Percentage Designations

Carefully.  With discretion.  With an intelligent approach.  Not indiscriminately (a double-negative which, in common parlance, means “discriminately”).  Quantification of pain, of a medical condition, of a loss of use of one’s body functions, ability to have the manual dexterity of the use of one’s fingers, hands, arms; of the flexion and range of motion of shoulders, etc., includes a level of subjectivity at best, and at worst, possibly misrepresents the extent and severity of a disability.

Further, when quantification of the disability of a particular body part is further interpreted to represent a part of a greater whole — as in OWCP/FECA’s attempt to assign a percentage disability of the “whole person”, or when the Department of Veteran’s Affairs calculates a combined percentage rating which is not merely the addition of all lesser individual ratings — it needs some explaining.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, one should obviously utilize all of the available tools, evidence, compilation of documentary evidence, etc., all of which, in their combined entirety, could help to provide persuasive evidence in obtaining an approval from OPM in a Federal Disability Retirement application.  But use of those tools, how it is used, what is used, how it is explained, and whether the explanation is adequate, are all important keys to keep in mind.

OPM is an independent agency.  When you attempt to dictate an outcome based upon a decision of another agency, such an attempt will often appear to be a threat to the very independence of an agency; something which needs to be kept in mind.  What should be submitted is rarely an issue; how it is stated is always a concern.

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

OPM Disability Retirement: Spectrum of Medical Requirements

In considering a Federal Disability Retirement application under FERS or CSRS, a Federal or Postal employee must ask questions beyond the primacy of obtaining the necessary and proper medical care for treatment of one’s own medical condition.  Thus, evidentiary issues must be considered; issues of obtaining proper medical documentation; seeking the active support of a treating doctor, etc.  These are all “non-medical” considerations, which have little to do with the actual treatment and care of one’s medical condition, but have everything to do with preparing, formulating, and filing for Federal Disability Retirement benefits under FERS & CSRS.  

There is a distinction between the two (receiving the necessary medical care and preparing a Federal Disability Retirement application), and it is important to recognize the conceptual distinction, because the former can impact the latter.  For instance, on the spectrum of medical care (or refusal thereof) which can impact a Federal Disability Retirement application, refusal to undergo “facially reasonable medical treatment” can defeat a Federal Disability Retirement application.  

The question, of course, is how to interpret what constitutes “facially reasonable medical care”?  There are certain “obvious” ones, and then others which are not so obvious.  Normally, the Merit Systems Protection Board has held that refusal to undergo invasive surgery is not a bar to being eligible for Federal Disability Retirement benefits; on the other hand, refusing to take prescribed medications can, and often is, a bar to eligibility.  All else fall within the middle of the spectrum of such medical/legal requirements.  

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

OPM Disability Retirement: Tools to Use

I am often asked, when filing for Federal Disability Retirement benefits under FERS or CSRS, Will you use … ?  From the range of tools of evidence to use — including VA disability ratings, to OWCP “CA” forms, MMI ratings, Veterans Administration records, Second opinion doctor’s report, referee opinion report, letters from the Agency indicating unavailability of work; letters from the agency indicating the extent and limitation of willingness to provide for an “accommodation” (whether legally sufficient to rise to the level of meeting the definition of what it means to be an “accommodation” under the law), and multiple other tools — all of it is a matter of legal discretion.  

The general rule that I utilize is that, If it is helpful to my client’s case to prove to the Office of Personnel Management that my client’s Federal Disability Retirement application under FERS or CSRS will be enhanced and aided by the material, then I will use it.  The discretionary issue which the attorney representing an applicant for Federal Disability Retirement benefits is essentially to “match” the document or piece of evidence with the particular issues which must be proven, and that is a matter of carefully reviewing each piece of evidence in compiling a compendium of evidence which makes up the “whole”.  It takes time, patience, and sufficient legal knowledge to understand which issues are important in proving a Federal Disability Retirement case under FERS or CSRS to the Office of Personnel Management.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Government Employees: The Medical Records

Federal Disability Retirement under FERS & CSRS is essentially “connecting the dots” between one’s medical conditions (whether singular or multiple) and the impact of the medical condition(s) upon one’s ability to perform all of the essential elements of one’s job.  The treatment records, also, are helpful in the matter of connecting the dots, as the Office of Personnel Management will often request a copy of the medical records — evidence of treatment over the years — in order to ascertain the extent of the medical conditions claimed.  

This can sometimes present a problem, when a Federal or Postal employee has switched doctors, has quietly endured the pain of the medical condition with little or no treatment over the years, or where the doctor fails to annotate any legible or detailed notes in his or her treatment notes.  Normally, however, there is a consistency of evidence between treatment/office notes and the medical narrative which the doctor prepared; or, between the diagnostic results and the clinical findings and conclusions of the treating doctor.  Where there is a lack of medical records “backing up” the narrative report of the doctor, often a Functional Capacity Evaluation or an “independent medical evaluation” by a referral doctor will help a case.  As always, there are ways to counter the problems which arise, in order to meet the eligibility criteria as proposed by the Office of Personnel Management in a Federal Disability Retirement case.

Sincerely,

Robert R. McGill, Esquire