Medical Retirement for Federal Workers: Medical Conditions & OPM

Clearly, there are certain medical conditions which the Office of Personnel Management “dislikes” or has a negative, suspicious view towards, in a Federal Disability Retirement application under FERS or CSRS.  One may attempt to rationally comprehend the innate bias towards certain groupings of medical conditions, but to do so would expend energy which, ultimately, results in an act of futility.

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, nowhere in the statute which provides for Federal Disability Retirement benefits is there notification or indication of a distinction between medical conditions.  As such, any pattern of hostility towards a particular medical condition, or a “type” of medical condition, must have evolved over time.  

The peculiar thing, of course, is the consistency in which all of the Claims Representatives at OPM have developed — of a similar pattern of reaction and behavior towards the “undesirable” medical conditions, as if they all work from a single template and have discussed, in conspiratorial hushed tones, a concerted effort to deny certain cases which are primarily based upon X medical conditions.  

That all said — and put aside as a note of interest but ultimately irrelevant — the way to rebut and overcome the inherent bias towards such medical conditions is to systematically reinforce the statutory requirements for eligibility, by explaining to the treating doctor(s) what is needed in order to overcome such bias.  Ignorance of the law is one thing; misapplication of the law is another.  Both must be overcome by guiding the treating doctor in how to meet the legal criteria, no matter what the medical condition.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Government Employees: The Origin of Psychiatric Disabilities

When preparing the Applicant’s Statement of Disability (Standard Form 3112A) in preparing to file for Federal Disability Retirement benefits from the Office of Personnel Management, it is important to keep the essence of the statement “on topic”.  By this, is meant that the primary focus of the applicant’s statement should be repetitively twofold:  First, what the medical conditions and their symptomatologies & manifestation of symptoms are, and Second, how those medical conditions and symptoms impact one’s ability/inability to perform one or more of the essential elements of one’s job.  

While history and origin of a medical condition may be somewhat relevant (unlike in an OWCP case, where causality and date of injury and where/how it happened are important elements in establishing that a medical condition was somehow job related), normally in Federal Disability Retirement cases the origin of a medical condition should not be emphasized, if only because OPM does not care about it.  If the origin of one’s psychiatric medical conditions (e.g., Major Depression, anxiety, panic attacks, etc.) find their source from conflicts within a job, such a history may be a red flag which can lead the Office of Personnel Management to conclude that the medical condition constitutes a “situational disability“.  In a final determination as to whether a medical condition can be characterized as “situational”, while it must be looked at in its full context, nevertheless, it is the origin of a psychiatric medical conditions which is the first point of reference in making such a determination.  

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

OPM Disability Retirement: The Case of Fibromyalgia

Fibromyalgia is one of those medical conditions that the Office of Personnel Management systematically “targets” as a condition which is prima facie “suspect”. This is despite the fact that there are cases which implicitly “admonish” OPM from engaging in the type of arbitrary reasoning of denying a disability retirement application because they “believe” that “no objective medical evidence” has been submitted, or that the “pain” experienced (diffuse as it might be) is merely “subjective”, or that the chronicity of the pain merely “waxes and wanes”, and a host of multiple other unfounded reasonings. Yet, cases have already placed a clear boundary around such arbitrary and capricious reasonings.

A case in point, of course, is Vanieken-Ryals v. OPM, a U.S. Court of Appeals for the Federal Circuit case, decided on November 26, 2007. In that case, it clearly circumscribes the fact that OPM can no longer make the argument that an Applicant’s disability retirement application contains “insufficient medical evidence” because of its lack of “objective medical evidence”. This is because there is no statute or regulation which “imposes such a requirement” that “objective” medical evidence is required to prove disability. 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'”, then the application is eligible for consideration. Further, the Court went on to state that it is “legal error for either agency (OPM or the MSPB) to reject submitted medical evidence as entitled to no probative weight at all solely because it lacks so-called ‘objective’ measures such as laboratory tests.” Statues are passed for a reason: to be followed by agencies. Judges render decisions for a reason: for agencies to follow. Often, however, agencies lag behind statutes and judicial decisions. It is up the an applicant — and his or her attorney — to make sure that OPM follows the law.

Sincerely,

Robert R. McGill, Esquire