Federal Employee Medical Retirement: A Real-life Hypothetical

Assume the following hypothetical:  A Federal or Postal employee who is 48 years old, with 25 years of Federal Service, engages in a type of work which is repetitive, day in and day out (yes, even this sentence is repetitive and redundant), full time, over the course of those 25 years.  

One day, while moving a piece of furniture at the direction of his spouse, he feels a sudden and sharp pain in his back.  He has to sit down and rest for a while.  The “for a while” turns into a visit to the emergency room, then to his family doctor.  The MRI shows a disc bulge at L5-S1, with multi-level disc degeneration, spinal stenosis, and other degenerative changes.  Despite multiple modalities of treatments, including epidural steroidal shots, physical therapy, variances of medication regimens, etc. (and you can even add a surgical intervention), the pain continues to worsen and deteriorate his medical condition.  The chronic pain prevents him from performing his job.  Whether sedentary or physical, the high distractability of the pain results in his poor performance.  

Can he/she file an OWCP claim?  Such a claim is submitted and rejected, because the issue of causality cannot be established.  An appeal is filed, and it is again denied.  The treating Neurologist and Orthopaedic Specialist are unwilling to establish a direct causal link.  But one argues:  Do those 25 years of repetitive work account for nothing?  Can it all have occurred because of the singular occurrence?  Does my medical condition reflect that of a person twice my age merely because of a single incident?  

It is precisely because causality is the crux of OWCP, that Federal Disability Retirement under FERS or CSRS is an important benefit for all Federal and Postal employees. OWCP/FECA is a benefit which is great for the limited role it plays; Federal Disability Retirement is a benefit with wider applicability, and the chance for the Federal or Postal employee to enter into another phase of life.

Sincerely,

Robert R. McGill, Esquire

Back Pain and Disability Retirement for Federal Workers

Back pain — diagnosed by many different designations and causes, including Degenerative Disc Disease, Spondylolisthesis, spinal arthritis, multi-level disc bulges, disc impingement upon the thecal sac, sciatica, failed back syndrome, etc. — presents a variety of interesting dilemmas and creative solutions when formulating, preparing and constructing a narrative to describe and delineate the impact upon one’s Federal Disability Retirement application under FERS or CSRS.

What is interesting is how back pain — chronic cervical, lumbar or thoracic pain, often with accompanying radiating features which include symptoms of numbness, tingling and pain to the extremities — can impact both one’s sedentary job, or one’s very physical job.  Both can be equally and severely impacted.

Then, of course, there is the conundrum of the “catch-22” — without pain medications, one has such a high distractability of pain that one cannot perform either the sedentary job or the very physical job; yet, with pain medications, the sedation which results prevents one from performing the essential elements of one’s job.  Either way, back pain presents a serious medical issue in filing for Federal Disability Retirement benefits under FERS or CSRS.

For Federal and Postal employees contemplating filing for Federal Disability Retirement benefits under FERS or CSRS, back pain is a serious medical condition which is a valid and viable basis for an effective application, if formulated and presented properly.

Sincerely, Robert R. McGill, Esquire

OPM Disability Retirement: The Time to Make the Decision (Part 2)

The medical condition known as “Fibromyalgia” is analogous to the manner in which Federal and Postal employees approach the decision-making process in filing for Federal Disability Retirement benefits under FERS & CSRS.  Let me explain:  Fibromyalgia, as the Office of Personnel Management often likes to characterize, often manifests itself with chronic and diffuse pain which “waxes and wanes” — meaning, in simple terms, that there are good days and bad days; days when the pain is unbearable, excruciating and debilitating; and days when one can “manage” the extent of the pain and mental dysfunction and confusion. With that context, the Office of Personnel Management often tries to argue that it is not “so bad” as to qualify for Federal Disability Retirement benefits under FERS & CSRS. 

By analogy, people with all sorts of medical conditions — from physically debilitating neck and back pain; from Orthopaedic injuries, arthritis, chronic pain, visual impairment, etc.; to psychiatric disabilities of Major Depression, anxiety, panic attacks, PTSD — some days, one can seem to manage the disability; on other days, one cannot get through the day, let alone perform the essential elements of one’s job.  But deep down, one knows that one cannot continue forever on the same course.  To continue is to slowly wither away by a thousand cuts, one cut at a time, one cut per day.  And so, just as the Office of Personnel Management is plainly wrong (for Fibromyalgia is a chronic and debilitating medical condition which clearly qualifies for disability retirement), so the person who procrastinates in making the decision to file for Federal Disability Retirement benefits under FERS & CSRS is simply waiting for the inevitable.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: Standard Forms Do Not Mean “Standard Responses”

The problem with “Standard Forms” is that they often appear to solicit “standard responses”, and in a Federal Disability Retirement case under the Federal Employees Retirement Systems (FERS) or the Civil Service Retirement System (CSRS), nothing could be further from the truth.  Indeed, it is often because a Federal or Postal employee/applicant who confronts and begins to fill out SF 3112A, Applicant’s Statement of Disability, the very “blocked” appearance of the form, and the constricting questions themselves, makes it appear as if a “standard response” is required.  Don’t be fooled.

By way of example, take a “special animal” — that of a Federal Aviation Administration Air Traffic Controller who must take a disqualifying medication, loses his or her medical certification from the Flight Surgeon, and thinks that filing for Federal Disability Retirement benefits is a “slam dunk”.  Nothing could be further from the truth.  Or, a Customs & Border Patrol Agent who goes out on stress leave, or suffers from chronic back pain.  Are there “standard responses” in filling out an Applicant’s Statement of Disability?  There are certain standard “elements” which should be considered in responding to the questions, but don’t be constricted by an appearance of “standard responses” to a “standard form”.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Do Psychiatric Disabilities Still Carry a Stigma?

Do Psychiatric Conditions still carry a stigma?  Does the Office of Personnel Management, or the Merit Systems Protection Board, treat Psychiatric medical conditions any differently than, say, bulging discs, degenerative disc disease, or carpal tunnel syndrome, etc.?  Is there a greater need to explain the symptoms of psychiatric conditions, in preparing an Applicant’s Statement of Disability, than conditions which can be “verified” by diagnostic testing?  Obviously, the answer should be: There is no difference of review of the medical condition by OPM or the MSPB. 

Certainly, this should be the case in light of Vanieken-Ryals v. OPM.  Neither OPM nor an MSPB Judge should be able to impose a requirement in disability retirement cases involving psychiatric disabilities, that there needs to be “objective medical evidence,” precisely because there is no statute or regulation governing disability retirement which imposes such a requirement that “objective” medical evidence is required to prove disability.  As I stated in previous articles, as long as the treating doctor of the disability retirement applicant utilizes “established diagnostic criteria” and applies modalities of treatment which are “consistent with generally accepted professional standards,” the evidence presented concerning psychiatric disabilities should not be treated any differently than that of physical disabilities.  As the Court in Vanieken-Ryals stated, OPM’s adherence to a rule which systematically demands medical evidence of an “objective” nature and refuses to consider “subjective” medical evidence, is “arbitrary, capricious, and contrary to law.”  Yet, when preparing the Applicant’s Statement of Disability, it is always wise to utilize greater descriptive terms.  For, when dealing with medical conditions such as Bipolar disorder, Major Depression, panic attacks, anxiety, etc., one must use appropriate adjectives and “triggering”, emotional terms — if only to help the OPM representative or the Administrative Judge understand the human side of the story.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement & Treatment Compliance Issues

While the issue of ‘causality’ is not one which often comes up in OPM disability retirement cases (by obvious contrast, of course, is the fact that causality, whether it was caused while working, on the way to work, outside of the parameters of work, etc, is often an issue in OWCP/DOL cases), there are certain cases where such an issue may be important to address. Baker v. OPM, 782 F.2d 993 (Fed. Cir. 1986) is actually a case which continues to remain of interest, in that, there, the Court noted that where obesity had a causal impact upon the appellant’s back pain, and since the appellant failed to follow medical instructions to lose weight, therefore the cause of the back pain was not as a primary and direct result of a medical condition, but rather because of non-compliance of reasonable available corrective or ameliorative action.

Thus, there are certain areas where you will be in danger of having your disability retirement application denied: one such area, where the Merit Systems Protection Board has been fairly consistent, is non-compliance of a prescribed medication regimen. In other areas, however, especially where surgery is recommended but where the percentage of success cannot be easily quantified, there is much more leeway. Disability Retirement is an area of law which encompasses a wide range of complex and potential “legal landmines”, and it is often a good idea to seek the counsel of an experienced attorney to help guide your way.

Sincerely,

Robert R. McGill, Esquire