OPM Disability Retirement: The Non-nexus

Meeting an adequacy test may constitute sufficiency for some purposes, but not for others.  Thus, it may be enough in completing an FMLA form to have a diagnosis, along with answers to other questions on WH-380-E.  But mere identification of a medical condition via a diagnosis, along with a description of symptomatologies will not be enough to meet the sufficiency test in a Federal Disability Retirement application.

People often assume that having a medical condition in and of itself sufficiently explains the severity of one’s condition, and any implied “blank spaces” can be filled in by the mere existence of such a medical condition.  But Federal Disability Retirement, whether under FERS or CSRS, filed through, reviewed by, and approved or disapproved by the U.S. Office of Personnel Management, must be proven by a preponderance of the evidence that the medical condition itself prevents the Federal or Postal employee from performing one or more of the essential elements of one’s positional duties.

As such, the identification and description of a medical condition fails to comply with the adequacy standards in proving eligibility for Federal Disability Retirement benefits.  One must establish, through the conduit of a medical professional, the “nexus” or “connection” between one’s identified medical condition and the inability to perform one or more of the essential elements of one’s job.

The weight of the proof is upon the Federal or Postal applicant.

The foundation of such evidence begins with the identified medical condition, but in and of itself, it is a non-nexus — until it is squarely placed in the context of one’s official position and the duties required by one’s duties.  Thus, the non-nexus become the nexus-point when combined with the identification and description of one’s positional duties.

It is this realization of the step-by-step sequence of proof which constitutes adequacy and sufficiency of evidence, and one of which the Federal or Postal applicant for OPM Disability Retirement benefits must be aware.

Sincerely,

Robert R. McGill, Esquire

Early Medical Retirement for Federal Workers: Proof and Consequence

What if you possessed a piece of unique information, but no one else could see it? What if, by all appearances, you seemed perfectly healthy, but you weren’t?  What if you struggled every day to meet the stated professional objectives and goals, but were dying inside?

The silence of a medical condition is the consequence of a duality of contradictions:  many medical conditions, including psychiatric conditions, debilitate the “inner” person, and any such explanation to third parties is met with surprise, astonishment, disbelief and denial; but concomitantly, most people don’t want to hear about the troubles of others, anyway.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, one must always distinguish between the medical condition, and proving the medical condition. That X suffers from medical condition Y, unless it is an amputated limb and is self-evident to the outside world, is known only to the sufferer, and to those whom the sufferer relates.

Proving one’s medical condition is done through the objectification of the medical condition — i.e., through a medical doctor who clinically assesses, evaluates, and concludes with a diagnosis.  From there, the proper nexus must be built between the medical condition and the ability/inability to perform one or more of the essential elements of one’s job.  Having X is one thing; proving X is another.

Knowing the distinction will make all the difference 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

Diagnosed medical conditions v. symptoms

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, the medical reports and treatment notes, office notes, etc., will often bifurcate and conceptually distinguish between a “diagnosis” of a medical condition, and the description of “symptoms” which the patient experiences.

Thus, as a simplified example, on a physical level, one might have the diagnosis of “Shoulder Impingement Syndrome” or “Rotator Cuff Tendonitis” in a specific category in a medical report under “Diagnosis”, but in a narrative paragraph discussing the history of the symptoms manifested by the individual, there may be a reference to “chronic pain”, or “radiating pain”.  Similarly, in psychiatric cases, one might be diagnosed with “Major Depressive Disorder” or “Generalized Anxiety Disorder“, without being officially diagnosed with “Panic Disorder” or “Agoraphobia”, but in a discussion concerning the Federal Employee’s symptomatologies, there may be a reference to having “panic attacks” or being fearful of leaving the house or going out into the public.

The conceptual bifurcation between “diagnosis” and “symptoms”, however, may (and perhaps should) be carefully brought together in completing the Applicant’s Statement of Disability.  Thus, while “pain”, “chronic pain”, “radiating pain”, etc., may not officially qualify as the officially diagnosed medical condition in a medical report, in preparing and formulating an Application for Federal Disability Retirement benefits, it is important to interweave such symptoms if they are a prominent part of one’s medical conditions.  Similarly, “Panic Attacks”, even if merely described as a symptom, may be an important part — if not the “essence” of a psychiatric condition — of one’s medical condition, and it is important to include it as part of the diagnosis.  For, when an approval is granted from the Office of Personnel Management, the identified medical diagnosis should, if at all possible, include the most debilitating of medical conditions.

That which is conceptually distinguished on a medical report need not necessarily dictate what is described and delineated on one’s Application for Disability Retirement.  Just some thoughts.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Distinguishing between Diagnoses and Symptomatologies

In preparing, formulating and filing a Federal Disability Retirement application with the Office of Personnel Management, whether under FERS (Federal Employee’s Retirement System) or CSRS (Civil Service Retirement System), in preparing and formulating the Applicant’s Statement of Disability on Standard Form 3112A, it is important to distinguish between the medical conditions which are diagnosed, from the symptoms which are experienced by the Federal or Postal employee.  The focus is often upon the latter (the symptoms) as opposed to the former (the officially diagnosed medical conditions), as it should be because of the nature of the requirements in proving a Federal Disability Retirement case with the Office of Personnel Management.

By that is meant the following: Because one must prove by a preponderance of the evidence that one is eligible and entitled to Federal Disability Retirement benefits from OPM, by exhibiting a nexus between one’s medical conditions and one’s medical inability to perform one or more of the essential elements of one’s job, the descriptive analysis of such bridging between one’s medical condition and the impact upon one’s ability/inability to perform the essential elements of one’s particular job, is quite naturally focused upon the symptomatologies which one experiences.

The blurring of the lines between the “official” medical condition as itemized in a list of diagnoses, as opposed to the descriptive delineation of the exhibited symptoms, or the symptoms which are subjectively experienced and (often) correlated by objective radiological reports, is a natural occurrence. Often, the two are (and should be) deliberately intermingled in the narrative description of the Applicant’s Statement of Disability. However, one should always write the narrative portion of the SF 3112A with the view towards the future potential issues which may arise: that of being “disabled” for a specifically-identified medical condition.

Sometimes the OPM Representative will specifically identify a medical condition; sometimes, no such identification will occur. Then, there are times when the lines between “diagnosis” and “symptoms” naturally crosses — as in, “Chronic Pain Syndrome” as distinguished from “chronic pain”. Blurring the lines in a discussion is expected and should be applied in formulating one’s Applicant’s Statement of Disability; but such blurring should occur with deliberation and purpose, and not just because one does not recognize the distinction between the two.

As with everything in life, the consequences of doing something by accident are quite different from that which results from a purposive and deliberate action.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Workers: The “Mixed Case”

The “Grab-bag” approach of annotating every medical condition on an Application for Federal Disability Retirement should be distinguished and differentiated from a “Mixed-Case” approach.  The former contains some unintended consequences (i.e., of being approved for a minor medical condition), while the latter is a formulation of multiple medical conditions, any one of which may be a basis for a Federal Disability Retirement application, but the combination of which will strengthen the case as a whole. 

By “Mixed-Case” does not necessarily include a mixture of psychiatric and physical conditions (although it might); rather, the conceptual term which is used here is meant to be a compendium of the primary medical conditions from which a Federal or Postal worker suffers, along with a descriptive narrative of the symptoms which are manifested. 

By preparing, formulating and completing an Applicant’s Statement of Disability (SF 3112A) in this manner, it satisfies the concerns which lead to the “Grab-bag” approach, but prevents the danger of having a Federal Disability Retirement application approved based upon a “minor” medical condition, by conceptually differentiating between diagnosed medical conditions v. symptoms, while at the same time including all of the medical conditions relevant to one’s Federal Disability Retirement application under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Flexibility of Language

Language is inherently a flexible tool; it is meant to communicate, and while precision in communication is the defining purpose in the use of the tool, often the essence of language must nevertheless be flexible enough to embrace other, correlative concepts. To limit the tool of language often will lead to undermining the very purpose of the use of such language.  

In filing for Federal Disability Retirement benefits under FERS or CSRS, the use of language in preparing, formulating and describing the interaction between the medical conditions and how it impacts one’s job duties, must allow for some level of flexibility.  For example, if certain chronic symptomatologies result in a mis-diagnosis of a medical condition, should a later (revised) diagnosis be allowed to be argued to the Office of Personnel Management after it has been filed?  

The answer to the question is contained in how the Applicant’s Statement of Disability on Standard Form 3112A is formulated.  If one merely lists the diagnosed medical conditions without describing the symptoms, then the language used has restricted the flexibility of post-filing inclusion.  On the other hand, if one combines the various medical diagnoses, but also includes a descriptive discussion of the symptoms, then the answer is likely, “yes”.  The use of language should be one of precision; how one utilizes the tools of language, however, should remain flexible.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Those “Second-Class” Medical Conditions

We all know what the “Second-Class” medical conditions are:  Fibromyalgia, Chronic Fatigue Syndrome, Diffuse Pain, Chemical Sensitivity issues, etc.  To some extent, such medical conditions have always been a paradigm of a society — at one time, one could argue that all psychiatric conditions were treated in a similar manner:  accepted at some level as a medical condition, but stigmatized as somehow being less than legitimate.

In a Federal Disability Retirement application under FERS or CSRS, it is patently obvious that the Office of Personnel Management treats certain medical conditions as “second-class” conditions.  They often deny such cases at the initial stage of the process, and unless you point out a compendium of established case-law authorities, OPM will often get away with their groundless assertions.

Words matter, and which words and arguments are chosen to rebut the Office of Personnel Management matters much in a Federal Disability Retirement case.  Such medical conditions are not second-class medical conditions, and OPM should not be allowed to treat them as such.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Medical Conditions

In filing for Federal Disability Retirement benefits under FERS or CSRS, it is important to note that the Office of Personnel Management will often argue that the mere fact that a person suffers from a medical condition is not in and of itself a basis for granting disability retirement benefits.  So far as such a statement goes, the Office of Personnel Management is correct on the laws governing the eligibility criteria for Federal Disability Retirements (which is rare in and of itself).  Having a medical condition is not a sufficient cause in granting a Disability Retirement benefit.  As it is often argued in the world of philosophy, it is a necessary cause, but not a sufficient one.  In other words, one must indeed suffer from a medical condition (it is thus a “necessary cause”); however, suffering from a medical condition is not sufficient in and of itself to qualify for Federal Disability Retirement benefits under FERS or CSRS (it is not a “sufficient cause”).  One must, beyond having a necessary cause, prove that the medical condition is also the source and impact upon one’s inability to perform one’s job.  Thus, to the limited extent of its truth, suffering from a medical condition is indeed insufficient to obtain an approval from the Office of Personnel Management; it is not “proof enough” in and of itself.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Listing Specific Medical Conditions

Because the essence of an OPM Disability Retirement Application under FERS or CSRS goes to the symptomatologies and their impact upon one’s ability or inability to perform one or more of the essential elements of one’s job, it is therefore important to weave throughout the narrative of one’s Statement of Disability the symptoms, the impact, the descriptive events, which impact one’s ability/inability to perform the job.  Thus, while listing specific diagnosed medical conditions shoulder certainly be a part of any such application, the narrative itself should include the description of multiple symptoms resulting from the diagnosis.  Further, while the applicant is disallowed from “adding” any new medical conditions once it has been received by the Office of Personnel Management and assigned a CSA number, nevertheless, the applicant is not a medical doctor, and if a medical condition which later develops or becomes clarified during the process of review needs to be supplemented with an additional medical report or results of a diagnostic test, if the medical condition can be reasonably related to a described symptomatology or description in the original statement of disability, then in all likelihood, it will be allowed in for review.

Sincerely,

Robert R. McGill, Esquire