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

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