Medical Retirement for Federal Workers: Testing a Relationship

If the advent of a crisis is a true test of a relationship, then the satisfaction of an ongoing need in response to the crisis is the harbinger of sincerity.  Testing the relationship is often the secondary trauma one must experience in life; for, the feeling of isolation which often accompanies a crisis — that sense that no one else can fully understand the experience; that others, while empathetic words of condolences may be uttered, can always seek the refuge of their comfortable zones of privacy and go on with their lives — is further exacerbated by the island of singularity which one recognizes in the face of finding one’s self in the the human condition of crisis.

For the Federal and Postal employee who suffers from a medical condition, such that the chronicity and progressive decline of that medical condition impacts one’s ability to perform all of the essential elements of one’s job, the testing of relationships must necessarily occur.  The test of that doctor-patient relationship, to see whether and to what extent one’s longstanding treating doctor will support the need for Federal Disability Retirement; the test of the worker-to-coworker relationship; the employer-employee relationship; they all become tested, to observe their elasticity, their durability, and their sincerity.

Fortunately, it is not one’s own agency which makes a determination on a Federal Disability Retirement application, but rather, a separate, independent agency — the U.S. Office of Personnel Management.  But one’s own agency is required to complete certain portions of a Federal Disability Retirement application, and those required parts will also be a partial test.  For the Federal and Postal employee who must endure the crisis of a medical condition.

Federal Disability Retirement is a process which will test many things — not the least of which will involve who were and are one’s true friends.

Sincerely,

Robert R. McGill, Esquire

 

OPM Disability Retirement: The Delicate Balance between Persistence, Perseverance, and Pestering

Persistence, perseverance, pestering…is it all the same?  The first of the three implies an enduring deliberation of effort, and is neutral as to whom it applies to; the second is normally in reference to the individual who is engaging in the effort; and the last carries with it a negative connotation, like a gnat who is attracted to the smell of someone’s shampoo or body odor.

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 important to distinguish the subtle differences between the three words applied.  For, in the end, it is not the words, but the actions which each describes, which is important for the entire administrative process.

Persistence may be appropriate for the relationship between the patient and one’s doctor, in pursuing medical treatment, and support for one’s Federal Disability Retirement application. Perseverance may be seen as a valiant character issue, for a multitude of things, including undergoing medical procedures, trying to continue to work despite medical obstacles, exhausting all avenues with an agency, etc.  Pestering, if seen from a doctor’s viewpoint, reflects an attitude which may betray a desire to support one’s Federal Disability Retirement application.

There is often a delicate balance between the three, and one must be sensitive to such a balance in preparing, formulating and filing for Federal Disability Retirement benefits from OPM.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Office Notes (Continued…)

The Office of Personnel Management has every right to establish a consistency of medical treatment and opinions rendered on the part of the doctor, the specialist, the medical facility, etc.  One of the reasons why Federal Disability Retirement benefits are (in great part) determined by the opinion of the “treating doctor”, as opposed to a determination made by a medical doctor who makes such disability determinations but is not the applicant’s “treating doctor”, is that such a determination (in the eyes of Federal Disability Retirement laws, statutes, MSPB case laws, etc.) can best be rendered by a medical specialist who has a long-standing relationship with the patient/applicant, over a long period of time, to determine the extent, severity, chronicity, etc., of the medical condition claimed.  

With this in mind, there often arises a conflict of sorts:  On the one hand, most people who are attending to their medical needs, are not thinking in terms of “getting Federal Disability Retirement benefits” during the time of treatment.  The critical point of when the line becomes drawn, where treatment & chronicity begin to conflict; or where, despite every attempt by the doctor to prescribe treatment modalities, there appears to be a medical condition which is “intractable”, is often a difficult one to determine.  In most cases, the office/treatment notes will reveal the line, which may come about gradually.  At other times, one may have a doctor who thinks that he or she can successfully treat any and all conditions, and reflects such a “positive” outlook in every office notation.  This is often not helpful, when it comes time to filing for Federal Disability Retirement benefits under FERS or CSRS.  To counter this, a frank discussion with the doctor at some point may become necessary.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Patient-Doctor Relationship

In filing a Federal Disability Retirement application with the Office of Personnel Management, it is always preferable (though not an absolute mandate) to have medical reports and records from a “treating” doctor of some tenure.  What constitutes a “treating doctor” is fairly uncontroversial — it means that the report rendering an opinion concerning one’s physical or mental ability to perform all of the essential elements of your job should be prepared by a doctor who has provided medical treatment, and generally has a patient-doctor relationship.  The duration of the tenure which then creates such a “patient-doctor” relationship does not necessarily put a specific time frame upon a doctor.  It can mean anywhere from a month to a decade, in my view.

From the applicant’s perspective, it is important to understand that the person who is considering filing for Federal Disability Retirement benefits has been establishing and fostering that relationship, and this is important to see.  Those many years of going to the doctor, speaking to him or her about the most personal of problems — one’s medical conditions — is part of what creates that special bond identified as a “patient doctor relationship”.  It is a relationship which has been created and fostered through interactive needs, and that relationship should be strong enough to ask the doctor, when the time and need comes to fruition, for a medical report in support of one’s Federal Disability Retirement application.  So, at this point in the issue, as one is contemplating Federal Disability Retirement, does your interaction with your treating doctor constitute a “relationship”, or is it merely an economic exchange of goods and services?

Sincerely,

Robert R. McGill, Esquire

Go to:  Patient-Doctor Relationship (Part II)

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

Medical Retirement Benefits for Federal & Postal Employees: The Treating Doctor

In a Federal Disability Retirement application under FERS & CSRS, what distinguishes the entire process of proving, by a preponderance of the evidence, that a Federal or Postal employee is unable to perform one or more of the essential elements of one’s job — from other processes, such as Social Security and OWCP — is that the evidentiary weight is placed upon a treating doctor.  There are “other” types of doctors other than treating doctors:  specialists who are referred to for consultative purposes; doctors who specialize in determining functional capacity & evaluate the functional limits of an individual; occupational specialists, etc.  Why a “treating” doctor?  Because we are talking about workers who, over time, find that he or she is no longer able to perform the essential elements of a job and, over that same time, it makes sense that a doctor would be treating that individual.  Disability Retirement is not normally filed as a result of a traumatic accident (although that can happen, also); rather, a Federal or Postal employee normally files a Federal Disability Retirement application because of a condition which develops over time.  That is why the “treating” doctor would be the best source of knowledge and information:  because, through clinical examinations, long-term doctor-patient relationship, the treating doctor can make a long-term assessment based upon all of the facts and circumstances of the patient.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Understanding the Doctor

A question I often ask the treating doctor at the end of a Hearing before an Administrative Judge at the Merit Systems Protection Board (obviously for Disability Retirement benefits under FERS & CSRS) is:  Do you have an opinion as to whether Mr. X/Ms. Y is a malingerer? The reason I ask such a question is to establish in the mind of the Administrative Judge, that after all of the clinical examinations, the treatment modalities, the diagnostic testing, etc., does the doctor have a personal opinion about the individual who is seeking to obtain Federal Disability Retirement benefits? 

Obviously, there are multiple questions which I ask as a follow-up; and, indeed, the question as to the status of the client/applicant requests a professional opinion about the patient — but implicit in that question is also a rather personal one.  It goes to the heart of who the patient/applicant is, and what the doctor believes about this particular applicant/patient.  For, to resolve any doubts about the underlying motive of the patient is not only important to the Administrative Judge in a Federal Disability Retirement application; it is equally important that the doctor is comfortable in his own mind, as to the clear and honest intention of his patient.  Conveying that comfort from the voice of the treating doctor to the ears of the deciding Judge, is no small matter.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: The Necessary Doctor

Ultimately, the doctor who is necessary is the one who will be supportive.  Whenever the question is asked of me whether it is “necessary” to have the support of this or that doctor, my answer is generic in nature:  It is better to have one excellent narrative report in support of one’s Disability Retirement Application, than to have 5 mediocre or lukewarm reports.  Excellence in a Federal Disability Retirement application is encapsulated by the level of passion and support by the treating doctor.  The character and texture of a medical report is not just a set of factual listings of medical conditions and a dry statement of an opinion; rather, the underlying sense of a doctor’s firm and passionate belief in a patient is often evident in the intangible underpinnings of a good report.  There are simply some reports written by a doctor where one knows that it is improbable that the Office of Personnel Management will want to entangle themselves in; the unequivocal voice, tone and tenor of such a report can make the difference between getting an initial approval of an Application for Federal Disability Retirement under FERS or CSRS, or a denial, resulting in the necessity of going to another stage of the process.

Sincerely,

Robert R. McGill, Esquire