Tag Archives: medical and surgical treatments in opm disability decisions

Federal Worker Disability Retirement: Recesses and Misguided Perspectives

Plato’s recognition of how perceptual fallacies occur became an incentive for his philosophical quest to unravel the essence of a thing, in contrast to the accidental qualities which may present themselves in their visual appearance. But misjudgments concerning what a thing “is” can occur not just because of visual disturbances; they can also result from subconscious misconceptions working in the far recesses of the mind, through isolation and fear.

Such an addition to the general philosophical inquiry would not progress until many centuries later, with the advent of Freud, Jung, psychology, and the recognition of the complexity of the human condition.  Indeed, the turmoil of human beings, especially in their interaction with relational issues, compounded in the workplace, the stresses of finance and the inability to make self-preserving decisions, often results from isolation and lack of proper guidance.  Guidance is part of the key to a release from worry, anxiety and effective decision-making.

For Federal or Postal employees who suffer from a compendium of complex medical conditions, including physical pain, psychiatric devastation from Major Depression, anxiety, panic attacks, PTSD; from profound exhaustion and fatigue; the medical condition itself may prevent one from tapping into the far recesses of one’s psyche in order to come to a proper decision on matters of great importance.

Federal Disability Retirement is an option which allows for the Federal or Postal employee to reach a point of restorative quietude away from the requirements of employment burdens, in order to seek the medical help necessary.  It does not require a standard of “total disability”, but merely one of proving that the Federal or Postal employee can no longer perform one or more of the essential elements of one’s job.  It must be submitted to the U.S. Office of Personnel Management, and thus is not a determination made by one’s own agency.

Isolation, fear, and the dangers of misguided perspectives which arise from the dark recesses of one’s mind — they must be counteracted by having a clarity of purpose, direction, and goals which provide for a brighter tomorrow.  If the rise of psychology does not accomplish this, then what good does it portend?

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: The Family Doctor and the Surgeon

I am often asked whether or not a medical report from the “specialist” will have a greater impact than a family doctor.  Implied in such a question, of course, is a perspective which tends to see the family doctor as somehow “less qualified”, sort of like comparing the technical deficiencies of a “country doctor” as opposed to a “real doctor” — one who works in an emergency room in a large metropolitan hospital.  Perspectives and prejudices have a way of defining judgments, and assumptions, presumptions and long-held beliefs, whether valid or not, often rule our lives. 

How can I answer such questions?  In the course of a Hearing before an Administrative Judge at the Merit Systems Protection Board, I have had family doctors testify who were unbeatable, and certainly overwhelming in his or her expertise and medical knowledge.  The years of experience in having to deal with thousands of patients, and confronting and treating medical conditions of every imaginable sort — and making decisions (including referring patients to “specialists” for concurring or confirming diagnoses and opinions) involving the “whole” patient’s medical condition and treatment — came through with such persuasive force and overwhelming confidence, that it was indeed the “family doctor” or the “country doctor” who ruled the day. 

Similarly, I have had the “specialist” testify in cases, who barely were able to coherently describe the connection between the medical condition and the essential elements of the job.  And, of course, sometimes the opposite is true — good surgeon, mediocre family doctor; mediocre specialist, great country doctor.  As in all things, in Federal Disability Retirement applications under FERS or CSRS, it is not so much that the credentials matter, as the character, experience, and “heart” of the doctor who treats the patient.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: Failing to Follow “Reasonable Treatment”

In fighting to prove one’s eligibility for Federal Disability Retirement benefits, a recurring argument which the Office of Personnel Management often alleges is that an applicant failed to follow the treatment recommendations of the treating doctor.

Such an argument can prove to be fatal to an applicant’s case, but it is good to know the parameters of what it means to “fail to follow” reasonable medical treatment.  For instance, non-compliance with a medication regimen can be fatal to a case.  Thus, OPM will successfully argue that an individual who has failed to follow the medication regimen of the treating doctor has thus failed to show that the individual could have returned to work precisely because non-compliance with a medication regimen would logically undermine the potential efficacy of the medical treatment.

On the other hand, invasive surgery is normally not required, and the Merit Systems Protection Board has stated that an “estimated probability of success of future surgery is speculative, just as a prediction as to the worsening of a condition may be, and will not necessarily provide a basis for denial of a disability annuity.”

These are two light-posts on the spectrum of what is deemed “reasonable treatment”.  Most issues concerning reasonable medical treatment fall somewhere between these two extremes, and the best course of action (obviously) is never to self-treat, or make medical decisions without the input of your treating doctor.  Indeed, to not follow the medication regimen of your doctor is a manner of self-treatment; on the other hand, to elect not to have surgery because of the speculative success/failure rate is a reasonable decision which the Merit Systems Protection Board will not second-guess.  What falls in-between these two extremes should always be with the guidance of “reasonableness”, in close consultation with your treating doctor.

Sincerely,

Robert R. McGill, Esquire