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.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Secondary Depression and Other Contingent Medical Conditions

Often, in preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, one must selectively choose, based upon the medical reports received from one’s requested doctors, the medical conditions upon which one’s Federal Disability Retirement application will be based.  

Sometimes, there is confusion as to which medical conditions should be listed, how it should be “prioritized” (how can one prioritize multiple medical conditions when any or all of them may have debilitating symptomatologies?) and whether some should be relegated to mere peripheral, ancillary discussion, as opposed to retaining a centrality of focus and prominence.  

For example, “Secondary Depression” is a term which often will accompany chronic and debilitating pain.  It may, over time, become a primary source of debilitating disability, but the reason why it is initially, and for some time thereafter, characterized as “secondary” is precisely because it is contingent upon the existence of the primary medical condition — that which results in the chronic and debilitating pain.  As such, if the secondary depression is listed as the primary basis for a Federal Disability Retirement application, but sometime later the originating medical condition which is the foundational cause of the depression gets better, then there is the potential ramifications that the secondary medical condition (“secondary depression”) will resolve itself.  

Such considerations can be important in determining which medical conditions to list, inasmuch as in a future time, if one is found to be disabled by the Office of Personnel Management for a secondary medical condition and is asked in a future Medical Questionnaire to have one’s doctor determine the disability status at a later time, it may become an important issue.

Linking potential future problems to thoughtful preparation in the present time is important in preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Workers: The “Mixed Case”

The “Grab-bag” approach of annotating every medical condition on an Application for Federal Disability Retirement should be distinguished and differentiated from a “Mixed-Case” approach.  The former contains some unintended consequences (i.e., of being approved for a minor medical condition), while the latter is a formulation of multiple medical conditions, any one of which may be a basis for a Federal Disability Retirement application, but the combination of which will strengthen the case as a whole. 

By “Mixed-Case” does not necessarily include a mixture of psychiatric and physical conditions (although it might); rather, the conceptual term which is used here is meant to be a compendium of the primary medical conditions from which a Federal or Postal worker suffers, along with a descriptive narrative of the symptoms which are manifested. 

By preparing, formulating and completing an Applicant’s Statement of Disability (SF 3112A) in this manner, it satisfies the concerns which lead to the “Grab-bag” approach, but prevents the danger of having a Federal Disability Retirement application approved based upon a “minor” medical condition, by conceptually differentiating between diagnosed medical conditions v. symptoms, while at the same time including all of the medical conditions relevant to one’s Federal Disability Retirement application under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire