CSRS & FERS Medical Disability Retirement: A Hypothetical

The case-law opinions from the U.S. Merit Systems Protection Board, as well as from the U.S. Court of Appeals for the Federal Circuit, upholds the statement added onto Question 4 of Standard Form 3112A, the form which specifically requests the Applicant’s statement of disability, which asserts:  “We consider only the disease and/or injuries you discuss in this application”.

Failure to identify a particular medical condition can have an adverse impact upon one’s application for Federal Disability Retirement benefits.

Take the following hypothetical: a Federal or Postal employee is terminated from Federal Service; he or she files for Federal Disability Retirement benefits within one (1) year of being separated from service.  While the Statute of Limitations has already been met because the filing has occurred within the 1-year timeframe, during the process of awaiting a decision from the U.S. Office of Personnel Management, the treating doctor has diagnosed with greater specificity the primary and underlying cause of the medical condition.

In his or her haste to file, the (now former) Federal employee quickly noted the diagnosed medical conditions in response to question 4, but nowhere is there an indication of the newly-diagnosed medical condition.  During the wait, it is now more than 1 year from the time of separation.  The quandary:  The Federal Disability Retirement application cannot be withdrawn, because the 1-year Statute of Limitations has already passed, and so he or she is no longer able to re-file.  No additional medical conditions can be added onto the SF 3112A.

Is there a problem? The answer:  Under this hypothetical, potentially yes.

Even if OPM approves the case, there may be future difficulties if OPM approves the Disability Retirement application based upon a medical condition listed, but resolved.  Care in identifying and properly annotating the medical conditions must be taken in preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Workers: Listing, Prioritizing and Weaving

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, the Federal or Postal employee who is formulating the Applicant’s Statement of Disability on Standard Form 3112D must describe the medical conditions which will be proven to impact upon one’s inability to perform one or more of the essential elements of one’s job.

Submission of the “list” of medical conditions will concretize and place boundaries around the issue to be litigated. Once submitted through the Agency or the U.S. Postal Service, then forwarded to Boyers, PA and assigned a CSA Number, the medical conditions described will be the only ones which can be argued.  Further, once a Federal Disability Retirement application is approved, the approval letter will have an attachment which describes and identifies those medical conditions which the Office of Personnel Management found the applicant to be disabled for (is this the feared split infinitive?).

Thus, by way of example, if a Federal or Postal employee filed for Federal Disability Retirement benefits based upon medical conditions X, Y and Z, and OPM based its approval only upon medical condition Y, then for any future Medical Questionnaire requesting an updated status on the annuitant’s medical condition, it is only medical condition Y which would be relevant.

As such, in the very preparation of the applicant’s statement of disability, important decisions must be made which will have significant future consequences:  which medical conditions to list; how to prioritize the medical conditions; whether to weave secondary conditions into the applicant’s statement, and to what extent, etc.

While some of the issues will be determined by the medical narrative report(s) prepared by the treating doctors, it is ultimately the responsibility of the Federal or Postal employee who is considering filing for Federal Disability Retirement benefits — along with his or her attorney — to set the course for future events in a manner which will ensure not only present success, but future security.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: The Aggregate of Conditions

In debate, there are two primary methodologies of attacking:  the micro-approach, where each individual strand of an opponent’s argument is dismantled, leaving the opposition with no singular weapon to use; or the macro-approach, where — because some of the individual arguments may withstand scrutiny — the universal umbrella of the argument as a whole is attacked, thereby dismantling the entirety of the whole.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, OPM will utilize one of the two approaches.  At times, OPM will selectively choose one or two of the medical conditions, barely mentioning the rest, then attack the lack of documentary support on those particularized medical conditions.  Or, at other times, OPM will make sweeping generalizations and fail to specifically identify, and selectively ignore, the details of individual medical conditions.  Regardless of the methodology of approach, the ultimate result of either approach is a denial.

The question is how one responds to either approach.

The answer is often based upon the construction of the Applicant’s Statement of Disability.  This is where it is important to weave the particular with the aggregate, where the construction of each individual medical condition is argued to depend upon the greater whole, and where the cumulative impact of the various medical conditions constitute an inseparable whole.  The flexibility of language allows for this; the medical narrative report should reflect this.

This is why spending valuable time at the front end of a Federal Disability Retirement case is important; for the later stages of the administrative process may well depend upon it.

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

Federal Employee Medical Retirement: Choosing the Medical Conditions

Often, in preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, the question is asked as to which medical conditions should be included in a Federal Disability Retirement application.  The obvious answer, of course, is to identify the “most serious” of the medical conditions, with a secondary consideration being the ones which impact one’s ability to perform the essential elements of one’s job.

Whether to list “all of them” is a separate question, and then there are the subtleties which further delve into a more detailed analysis of the creation of an effective nexus between one’s medical conditions, the job description which one is supposed to be doing, and the provability of the medical conditions identified and described.

Inasmuch as a Federal Disability Retirement application under FERS or CSRS is a “paper presentation” to the Office of Personnel Management (and yes, the concept of a “paper presentation” still applies even if and when OPM converts entirely to the technological next-step of a paperless system; the Federal or Postal employee must still present a formatted application), the admixture of legal and medical issues will ultimately come about.

The conceptual distinction between the diagnosis and the symptomatologies; the extent of willingness of what a treating doctor will state; the concordance between the diagnosis, the symptoms described, and their impact upon the particular elements of one’s position description; the potential impact of being found “disabled” by the Office of Personnel Management based upon a “minor” medical condition which may resolve itself in the future, as opposed to a more serious-listed one; the nebulous areas of “syndromes” (as in Chronic Fatigue Syndrome) and the description of symptoms and making sure to relate the symptoms to a particular medical condition — these are all “subtleties” which involve an intersection between the legal standard of proof and the medical “facts”, in formulating a Federal Disability Retirement application under FERS or CSRS.  But that it were as easy as simply listing one’s medical conditions.  But, alas, OPM is a Federal bureaucracy, and the combination of “the law” and “a bureaucracy” can only lead to one result:  a conundrum.

Sincerely,

Robert R. McGill, Esquire

Early Retirement for Disabled Federal Workers: OPM & History of Medical Conditions

There is a distinction to be made between one’s medical history and an extensive discussion of workplace issues which may have contributed to a causal impetus for a medical condition.  

The Office of Personnel Management is rarely interested in receiving information concerning the history or causation of a medical condition — especially from the Applicant in a Federal Disability Retirement application.  While the treating doctor may briefly refer to the historical genesis of a medical condition in a narrative report, it is the focus of the present-to-recent-past impact of one’s medical conditions upon the essential elements of one’s job which the Office of Personnel Management is interested in reviewing.

Again, remember that a Federal Disability Retirement application is a “paper presentation” to an onerous, overbearing and overworked Federal bureaucracy, where one’s private affairs (the most private of all — one’s medical conditions and their impact upon one’s personal and professional conduct of affairs) are to be presented, received, and ultimately reviewed.  

History of the inception, origin and impact of a medical condition may be peripherally relevant to the treating doctor, and it would be appropriate to include such historical background in a medical report; but for the Applicant, to delve too deeply and extensively upon such historical context may place the peripheral into a central focus where it should not be.

Sincerely,

Robert R. McGill, Esquire

Federal Worker Disability Retirement: The “Grab-bag” Approach

In preparing, formulating, and filing a Federal Disability Retirement application under FERS or CSRS, there is always the question of which medical conditions to include in the Applicant’s Statement of Disability (prepared on SF 3112A).  One approach which many Federal and Postal employees take (which, in my opinion is the wrong one to embrace), is to name every medical condition, symptom and suspected symptom one has suffered from, or is suffering from.  This might be characterized as the “shotgun” or “grab-bag” approach. 

One must be sympathetic to this approach, of course, if only because of the following reason:  OPM regulations and case-law supports the position that once an application for Federal Disability Retirement benefits has been filed with the Office of Personnel Management, a Federal or Postal employee cannot amend or add any further medical conditions without withdrawing the application and re-filing. 

Thus, a Federal or Postal employee who prepares and files an application for Federal Disability Retirement benefits is “locked into” what is stated on one’s SF 3112A.  Because of this, many Federal and Postal employees who prepare the application without the assistance of competent legal representation will take the “grab-bag” approach of listing every possible medical condition known to man. 

While this may seem like a reasonable, “safe” approach to take, remember that such an approach can have unintended consequences:  Upon an approval of the Federal Disability Retirement application, the approval letter may approve the Disability Retirement application based upon a minor medical condition which you no longer suffer from.  This, of course, can have negative consequences down the road.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Shotgun v. Tailored Approach

In filing a Federal Disability Retirement application, there is the “shotgun approach” — of peppering the application with any and all medical conditions which may prevent or otherwise impact one’s ability to perform one or more of the essential elements of one’s job.  The danger of this approach, of course, is that the Office of Personnel Management can (and does) stop at the first medical condition which they deem disables the applicant from performing any of the essential elements of one’s job. If the basis of such a disability retirement approval is a secondary, or somewhat inconsequential medical condition, then there is the danger in the future that, if you receive a Medical Questionnaire requesting an update on your medical condition, that you may have recovered from such a secondary medical condition and deemed to have been fully recovered.  Now, every now and then, in the approval letter issued by the Office of Personnel Management, it will not specify which medical condition was the basis for the approval which was rendered.  However, this is in a minority of approval letters, and is not worthwhile enough to consider taking a chance on such a shotgun approach.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Which Medical Conditions to List II

If you list all of the medical conditions you suffer from on the Applicant’s Statement of Disability (SF 3112A) in filing an application for Federal Disability Retirement benefits under FERS or CSRS, then you take the risk that the Office of Personnel Management may approve your disability retirement application based upon a condition which is only marginally serious (which can lead to some future problems, if OPM requests that you respond to an OPM Medical Questionnaire, inquiring about your current status and your disability).  On the other hand, if you fail to mention a medical condition, and you file your Federal Disability Retirement application, once you are assigned a CSA Number, you are precluded from amending or adding to the list of medical conditions described in your Applicant’s Statement of Disability.  Thus, discretionary decisions must be made.  You must strike a proper balance between listing the major medical conditions, and deciding which medical conditions truly impact your ability/inability to perform the essential elements of your job, and discern which conditions and symptoms are likely to remain chronic, or continue to deteriorate.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement Benefits for Federal & Postal Employees: Are all Doctors Necessary?

In a Federal Disability Retirement case under FERS or CSRS, is it necessary to obtain the medical opinion of each and every doctor for each and every medical condition listed on the Applicant’s Statement of Disability (SF 3112A)?  To put the question in another way, Must there be a one-to-one correspondence between the medical condition listed or described, and the doctor who is specifically treating the medical condition? 

Certainly, in today’s world of medicine, where specialization is the key to treatment because of the complexity of each field of medicine and the successful treatment of diseases and medical conditions, it has become a fact of life that patients are “referred out” to various specialists.  Thus, the Primary Care Physician is often merely the “gate-keeper” of referrals, coordinating the medical treatment of a patient by overseeing the referrals to various specialists who treat various medical conditions.

An applicant for Federal or Postal Disability Retirement benefits under FERS or CSRS who must prove, by a preponderance of the evidence, his or her eligibility for Federal OPM Disability Retirement benefits, must submit substantiating medical documentation to prove his or her entitlement. 

As with all such questions, the answer to the above question is, “It depends”.  A one-to-one correspondence is not necessarily required; where helpful, of course, the referral specialist’s medical opinion should be used.  However, one should never underestimate the importance and force of the coordinating physician — the Primary Care Physician himself/herself.

Sincerely,

Robert R. McGill, Esquire