Federal Disability Retirement: Doctors and the Peculiarities of Treatment

Efficacy of treatment is the goal for a doctor; and upon information that such efficacy has failed to render improvement or incremental signs of progress, many doctors lose interest, or become suspicious.

Social Security Disability, of course, requires a higher standard of proof — one of essentially “total disability”, where one is no longer able to engage in “substantially gainful activity” — and, as such, is an implicit admission of medical failure.

FERS & CSRS Disability Retirement, however, is merely an acknowledgement that there are certain medical conditions which, limited in their scope and impact, prevent a person from performing one or more of the essential elements of a particular kind of job.  Such a person who goes out on Federal Disability Retirement benefits can still remain productive in the work-world, by pursuing another, different kind of vocation.

As such, from a medical point of view, conveying the distinction between the two is like the difference between identifying a hill as opposed to a mountain:  both may have some elevation, but the extent and scope between the two goes well beyond a linguistic peculiarity.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: The Supportive Physician

Perspectives vary; varying perspectives often lead to conflict; and conflict represents the divergent paths which pursue different directions, or follow a parallel route.

Physicians who have been practicing medicine for a number of years quite often see the therapeutic benefit of employment, and the negative impact of being identified as “disabled”, with progressive physical manifestations of deterioration, and psychological destruction of futility and hopelessness.  It is not mere coincidence that the high rate of mortality is correlated to two primary life events:  birth (where the infant’s susceptibility to being exposed to an expansive and threatening environment brings with it inherent dangers), and retirement (where the propelling teleological motivation of man suddenly comes to an end).

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, it is obvious that one must have supportive medical documentation in order to prove, by a preponderance of the evidence, that the Federal or Postal employee is eligible for Federal Disability Retirement benefits.  Part of that medical evidence should include a narrative report from one’s treating doctor, or a doctor who can properly and thoroughly assess, evaluate, and conclude that the Federal or Postal employee  can no longer perform one or more of the essential elements of one’s job.

What constitutes “support”, however, can sometimes lead to divergent paths.  Doctors are trained to treat patients, not to perform administrative duties.  The divergence which potentially leads to conflict often involves the differing perspective of what will “help” the patient.  Federal Disability Retirement is a benefits which allows the Federal or Postal employee to remain productive in the workforce, by encouraging the Federal or Postal employee to seek outside employment.  This is the key component and concept which often lends persuasive effect upon a suspicious and cautious medical practitioner.

Explaining the process will hopefully allow for parallel paths, and not a route which results in different directions.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: Listening to the Doctor

It is amazing how unaware we often are of our very surroundings, even when the circumstances and scenario directly impact us.  Doctors see dozens of patients per day, and the administrative aspects of their medical practice rarely engender excitement; for, while being a proponent of a patient to assist in the entirety of the recuperative process, writing a medical narrative report is not the crux (for most doctors) of that process.

However, when a doctor makes statements which clearly reveal the extent of administrative support that they are willing to provide, it is time to listen.  For example, if your treating doctor says something to the effect of, “Your job is clearly killing you,” or “you shouldn’t be doing this line of work,” or sometimes even the non-subtle approach of:  “You need to medically retire” — the response for the Federal or Postal employee who is seeking to file for Federal Disability Retirement benefits should not be one of remaining silent, unaware, smiling distractedly, or even responding with, “Yes, I know, but…” with a trail of silence.

That scenario is precisely the moment to seize, and to say to the doctor, “Doctor, I think that you are right.  Will you be willing to write a medical narrative report which would support me in my quest to obtain Federal Disability Retirement benefits, which would then allow me to recuperate from my medical condition?”  Such a conversation must have the cooperative participation of both the doctor and the patient.  For, if the doctor does not bring the subject up, and the Federal or Postal employee begins the process of seeking to prepare, formulate and file for Federal Disability Retirement benefits under FERS or CSRS, the type of conversation-opener described herein will have to take place, anyway.

If the doctor brings up the subject during any clinical examination or encounter, the pursuance of such a conversation should be taken advantage of.  The old saying that the doctor knows best is certainly illustrated when one’s treating doctor has opened the door to supporting the Federal or Postal employee in the quest to obtain Federal Disability Retirement benefits from the Office of Personnel Management.

Sincerely,

Robert R. McGill
OPM Disability Attorney

 

FERS & CSRS Disability Retirement for Federal and USPS Workers: The Reluctant Doctor II

Dealing with the Reluctant Doctor — one who presumably has been treating the potential applicant for Federal Disability Retirement benefits for at least several months, but often for several years — is a rather “touchy” subject.  

On the one hand, the build-up of confidence, confidentiality, and security developed over many years of having a doctor-patient relationship is at stake; on the other hand, the Federal or Postal employee has come to a critical point in his or her future, career and professional life, where the support of the treating doctor in the preparation, formulation and filing of a Federal Disability Retirement application has become necessary.  

Doctors, by nature dislike the administrative aspects of preparing lengthy medical narrative reports.  Yet, most doctors recognize the necessity of that aspect of their practice, and are willing to perform the service as part of their duty to their patients.  A diplomatic, sensitive balance must be struck, but one that is honest and placed within the appropriate context of one’s health and future well-being.  

In essence, the doctor must be asked about his or her support in preparing a Federal Disability Retirement application under FERS or CSRS, but in the context of a larger discussion concerning one’s health, treatment modalities, permanency and chronicity of disabling medical conditions, and future treatment.  In essence, the “reluctant doctor” must be persuaded to disrobe his or her reluctance, for the sake of the patient’s health.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Tendencies

There are certain tendencies which seem to exhibit themselves on a spectrum of behaviors, and the pattern is fairly common.  As such, it is important to be aware of the natural tendencies of all parties involved when filing for Federal Disability Retirement benefits under FERS or CSRS.  For instance, it is a common tendency for the doctor — Family Doctor, Orthopaedic Surgeon, Neurologist, Psychiatrist, etc. — to avoid having to write a medical narrative report for a Federal Disability Retirement application.

What to do about it?  To try and place the doctor at ease by explaining the process in as direct, simple and concise manner as possible; then to tie the importance of the request for a Medical Narrative Report to the overall treatment plan for the patient — you.  To have an attorney involved can further ease the natural anxiety of a doctor — but it helps to have the client/patient forewarn the doctor as to the role and involvement of the attorney.

Attorneys and doctors are “natural enemies” (i.e., attorneys sue doctors; doctors hate to be sued; ergo, doctors have a natural tendency to dislike lawyers).  If the patient/client, however, approaches the doctor and explains that the lawyer who is representing him or her is there to explain the process, to guide the doctor in the preparation of the entire packet, including giving guidance to the doctor in formulating a medical narrative report, then the tendency towards anxiety and reluctance to assist in a Federal Disability Retirement application can be lessened and overcome.  Tendencies are there to be recognized, then to be adjusted in order to achieve a positive outcome.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: A Doctor’s Comfort Level

Doctors are funny creatures.  Administrative matters are often distasteful; yet, most doctors recognize that it is a necessary evil as part of the general practice of medicine.  Doctors often act arrogantly; yet, their arrogance is often in reaction to questions and statements which they deem to be irrelevant or insolent.  In filing for Federal Disability Retirement benefits under FERS & CSRS, it is obviously important to get the active, affirmative support of a treating doctor.  How does one go about doing this?  It is ultimately up the patient.  Remember — we are speaking about a “treating doctor” — not a stranger, but a person who, normally over the course of many years, has come to know, evaluate and treat the potential applicant who is filing for OPM Disability Retirement benefits.  Over the years, therefore, hopefully a relationship has grown to fruition.  Asking the treating doctor to support you in a Federal Disability Retirement application — or, if an attorney is hired, to let the doctor know that his or her legal representative will be requesting a medical report — should be the culmination of that special relationship which has developed:  the doctor-patient relationship, one which has grown over the many years of contact, discussion, conversation, and treatment.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement for Federal and Postal Employees: Doctors Do Want to Help

It is rare that a treating doctor fails to help, or refuses to help.  Yes, “getting involved” in a “legal case” is not only a headache, but for a doctor, it is often an intimidating experience, and many doctors have become “gun shy” over the years because of the negative experiences which have befallen them when getting involved in the legal side of his or her medical practice.

Look at it from the doctor’s viewpoint.

While one may fully understand the distinction between Federal Disability Retirement issues under FERS or CSRS, and those “other” issues (i.e., OWCP/FECA Department of Labor cases, or personal injury cases, etc.), from the treating doctor’s viewpoint, they are all “legal” issues.  And, from the doctor’s perspective and prior negative experiences, once you stick your neck out on behalf of a patient and get involved in a case, one never knows what it may lead to — court, depositions, cross-examinations, etc.  But there is indeed a difference and a distinction between those “other cases” and filing for Federal Disability Retirement cases.

To soothe the feathers of a doctor is important; to take the time to explain the process is vital; to make the job of the doctor as efficient and non-threatening is the key to a successful Federal Disability Retirement application under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

OPM SF 3112 Schedule C Form: The Doctor’s Statements

The lack of cooperation from a treating doctor, who is asked to provide a medical narrative report for a Federal Disability Retirement application under FERS or CSRS, may be based upon one of several factors.

It may be that the doctor merely refuses to engage in any type of administrative support for his patients; it may be that the doctor has private suspicions that, to openly admit that his/her patient must file for Federal Disability Retirement means that his/her treatments have failed, and thus, the patient/disability retirement applicant is considering filing a malpractice action, and asking him/her to write a supportive medical narrative is merely a ploy to set the groundwork for a later malpractice action; it may just be bad bedside manners; or it may be that the doctor does not understand the Federal Disability Retirement process, and how it differs for Social Security Disability, or Worker’s Comp.

If it is the latter reason, then it is the job of the attorney to make sure and explain, delineate, and inform the doctor of the nature, extent, and context of Federal Disability Retirement — and to show how an approval for disability retirement benefits will be the best thing for his/her patient.  This is where an attorney representing an applicant for Federal Disability Retirement benefits under FERS or CSRS becomes a crucial component in the preparation of such an application.

Sincerely,

Robert R. McGill, Esquire

 

OPM Disability Retirement: The Doctor II

Work is good for a person — being productive, being useful, being a contributing member of a team, an agency, an organization; it provides a sense of self-worth, dignity, and therapy. On the one side, that is why a Federal or Postal worker takes such a long, careful and hesitant step before deciding to file for Federal Disability Retirement. On the other side, the treating doctor knows the medical, therapeutic and healing value of work.

That is often why doctors are reluctant to agree to support a Federal or Postal worker’s decision to file for disability retirement under FERS & CSRS. Such reluctance, however, is mostly due to an unfamiliarity with the legal standards required to obtain disability retirement. Most doctors are familiar with the Social Security process of filing for disability benefits; and, further, many doctors are familiar with State Worker’s Compensation benefits and process; and, to a lesser extent, Federal Worker’s Compensation programs. Very few doctors are familiar with Federal Disability retirement benefits under FERS & CSRS. That is why it is important to clearly, concisely, and thoroughly inform the treating doctor of the process — and, often, it is wise to have an attorney who can clearly explain and delineate the process.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: The Doctor

Doctors hate administrative duties.  They went to medical school, and they want to practice medicine, not law.  If they wanted to engage in vast amounts of paperwork, they would perhaps have gone to law school.  As such, paperwork, writing medical narrative reports for their patients, providing medical opinions in a report — they are part and parcel of the dreaded “paperwork” — somewhat like filling out all of the forms for medicare, medicaid, insurance, etc. to get paid. Such paperwork is often left to the “administrative staff”, and therefore doctors are only sporadically required to actually prepare any paperwork.

This presents a peculiar problem for a potential disability retirement applicant, because in order to obtain Federal Disability Retirement benefits under FERS or CSRS, an applicant must have a doctor’s narrative report which delineates certain issues, addresses certain issues, and renders certain opinions.

Thus, the crucial question becomes: How does one approach a doctor and convince him or her that preparing a proper medical report is an integral aspect of treating the patient? The answer: It must be done with diplomacy, sensitivity, caution, guidance, and understanding, all bundled into one. Above all, it begins with a relationship — a patient-doctor relationship that has been formed over many, many years. And, indeed, that is the requirement under the case-laws at the Merit Systems Protection Board governing disability retirements — that those opinions rendered by treating doctors of long duration are accorded greater credibility than single-examination doctors. And it all makes sense.

Sincerely,

Robert R. McGill, Esquire