Medical Retirement Benefits for US Government Employees: Inconsistencies

While the legal standard of “preponderance of the evidence” is the statutorily mandated criteria to be applied as the burden of proof in a Federal Disability Retirement application under FERS or CSRS, the question which needs to be asked is:  Assuming that a Federal Disability Retirement application under FERS or CSRS contains sufficient medical documentation to meet the legal criteria, what is it that would undermine the application and result in a denial of the Federal Disability Retirement application?  

The overwhelming pattern of that which defeats a Federal Disability Retirement application from being approved — at any stage of the process — is the revelation of inconsistencies between various aspects of the application.  

Thus, whether it is the internal inconsistency of medical records versus the medical narrative report which the doctor has prepared; the apparent inconsistency between a Supervisor’s Statement and the Applicant’s Statement of Disability; or the potentially exaggerated inconsistency between the Applicant’s Statement of Disability and the Medical Narrative Report(s) — such are the fodder which the Office of Personnel Management is looking for in order to provide a substantiating and justifying basis to deny a Federal Disability Retirement application under FERS or CSRS.  

One must understand, however, that many inconsistencies are merely “apparent”, and can be easily explained — if needed to be explained at all.  Thus, for example, notations in the medical records/office notes where the treating doctor has annotated numerous instances of “improvement” from a previous office visit, are merely apparently inconsistent with a conclusion that a person can no longer perform one or more of the essential elements of one’s job.  

An exaggerated Applicant’s Statement, however, which overstates one’s medical conditions beyond what the doctor is willing to state, can be a more difficult inconsistency to overcome and correct.  It is important to always recognize the difference between apparent, inherent, and natural inconsistencies, and to understand that some inconsistencies need to be “left alone”, while others may need to be attended to.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement Benefits for Federal & Postal Employees: Knowing your own Case

In preparing and submitting an application for Federal Disability Retirement benefits under FERS & CSRS, it is important to know your own case.  This will often take some time and effort, but it is worthwhile, for many reasons:  Knowing and understanding the extent to which your doctor will support you; understanding fully the medical terminology which your doctor has used; knowing that what you say in your Applicant’s Statement of Disability (SF 3112A) does not contradict or otherwise invalidate what your doctor states in his or her medical report — these are all important aspects of a Federal Disability Retirement case.

Often, doctors use medical terminology which, read in the context in which it is written, can be misunderstood and mininterpreted.  Such misreading then leads to a misstatement by the applicant in his or her Applicant’s Statement of Disability, thinking that it is supported by the medical documentation which is submitted. Even if it is an honest error, such a self-contained contradiction can harm a case, as when the Office of Personnel Management is able to point to a doctor’s report and is able to state:  While you claim X, your own doctor states Y…

Sincerely,

Robert R. McGill, Esquire