Tag Archives: medical narrative for federal disability claims

Disability Retirement from the U.S. Office of Personnel Management: Concurrent Actions

Idioms often convey an underlying truth recognized and identified by a specific culture or population; they are statements from an experiential aggregation of similitude, based upon a shared set of values.  The phrase, “When it rains, it pours”, is easily a recognizable idiom; that when things go wrong, multiple wrong things tend to occur altogether, all at once.  It is somewhat of a tautology, as when “X is Y, X are Ys”.  But it is in the very pluralization of the outcome which makes the differentiation significant.

For Federal and Postal employees contemplating filing for Federal Disability Retirement benefits, whether the Federal or Postal employee is under FERS or CSRS, the engagement of the administrative and bureaucratic process of preparing, formulating and filing for FERS Disability Retirement benefits rarely results in a vacuum.

Often (or perhaps one is forced to begin with the prefatory clause, “All too often”), the long and complex history of harassment, complaints, formal complaints, grievances, lawsuits, EEO filings, etc., precede the filing of a Federal Disability Retirement application, thereby complicating one’s Federal Disability Retirement application with much baggage, historical aggregation of enmity and acrimony, and creating a simple set of causal facts into a convoluted compendium of complexities.  All of a sudden, the soft sounds of rain turn into a downpour of ferocious flooding.

In such cases, in formulating one’s Federal Disability Retirement application, it is important to bifurcate the compounded complexities, and to simplify, streamline and segregate.  From the viewpoint of the U.S. Office of Personnel Management, the very agency which receives and decides upon all Federal Disability Retirement applications, the mixing of concurrent actions and issues merely complicates matters.

As we all do, we would prefer to hear the soft patter of rain, and not the thunderous mess of a downpour.  Even the plants in the garden recognize that.

Sincerely,

Robert R. McGill, Esquire

 

CSRS & FERS Medical Disability Retirement: Listening to the Doctor

It is amazing how unaware we often are of our very surroundings, even when the circumstances and scenario directly impact us.  Doctors see dozens of patients per day, and the administrative aspects of their medical practice rarely engender excitement; for, while being a proponent of a patient to assist in the entirety of the recuperative process, writing a medical narrative report is not the crux (for most doctors) of that process.

However, when a doctor makes statements which clearly reveal the extent of administrative support that they are willing to provide, it is time to listen.  For example, if your treating doctor says something to the effect of, “Your job is clearly killing you,” or “you shouldn’t be doing this line of work,” or sometimes even the non-subtle approach of:  “You need to medically retire” — the response for the Federal or Postal employee who is seeking to file for Federal Disability Retirement benefits should not be one of remaining silent, unaware, smiling distractedly, or even responding with, “Yes, I know, but…” with a trail of silence.

That scenario is precisely the moment to seize, and to say to the doctor, “Doctor, I think that you are right.  Will you be willing to write a medical narrative report which would support me in my quest to obtain Federal Disability Retirement benefits, which would then allow me to recuperate from my medical condition?”  Such a conversation must have the cooperative participation of both the doctor and the patient.  For, if the doctor does not bring the subject up, and the Federal or Postal employee begins the process of seeking to prepare, formulate and file for Federal Disability Retirement benefits under FERS or CSRS, the type of conversation-opener described herein will have to take place, anyway.

If the doctor brings up the subject during any clinical examination or encounter, the pursuance of such a conversation should be taken advantage of.  The old saying that the doctor knows best is certainly illustrated when one’s treating doctor has opened the door to supporting the Federal or Postal employee in the quest to obtain Federal Disability Retirement benefits from the Office of Personnel Management.

Sincerely,

Robert R. McGill
OPM Disability Attorney

 

Medical Retirement Benefits for US Government employees: Consistency

Consistency, in addition to coherence, is an important element which must always be recognized and reviewed in filing an application for Federal Disability Retirement under FERS or CSRS.  Coherence of an application has to do with the element of “fitting all the pieces” together so that everything coheres in a rational, logical, and often sequential manner.  Coherence often has more to do with form, than with substance.  Consistency has to do with the substantive issues — the actually claims and statements made by a doctor; the opinions rendered in relation to the knowledge obtained; and whether everything “agrees” with everything else, in the very substance of the statements and claims made.

Inconsistencies are precisely what the Office of Personnel Management aggressively searches for, in determining the validity of a Federal Disability Retirement application.  Coherence can often be ignored; indeed, in many Federal Disability Retirement applications filed without an OPM Disability Attorney at the First Stage of the process, I have often found that, when it has been denied and people come to me at the Second, Reconsideration Stage, that the application prepared by the applicant is almost entirely incoherent.

The narrative prepared is often illogical; the doctor’s report often takes a “shotgun” approach, without the coherence of a methodology of addressing the essential issues which OPM is looking for.  Either by form or by substance, it is always better to have problems with form, rather than substance.  But if you ask me, it would be “best” (good, better, best) if both form and substance are carefully prepared — meaning, that a Federal Disability Retirement application is both coherent and consistent.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: The Necessary Doctor

Ultimately, the doctor who is necessary is the one who will be supportive.  Whenever the question is asked of me whether it is “necessary” to have the support of this or that doctor, my answer is generic in nature:  It is better to have one excellent narrative report in support of one’s Disability Retirement Application, than to have 5 mediocre or lukewarm reports.  Excellence in a Federal Disability Retirement application is encapsulated by the level of passion and support by the treating doctor.  The character and texture of a medical report is not just a set of factual listings of medical conditions and a dry statement of an opinion; rather, the underlying sense of a doctor’s firm and passionate belief in a patient is often evident in the intangible underpinnings of a good report.  There are simply some reports written by a doctor where one knows that it is improbable that the Office of Personnel Management will want to entangle themselves in; the unequivocal voice, tone and tenor of such a report can make the difference between getting an initial approval of an Application for Federal Disability Retirement under FERS or CSRS, or a denial, resulting in the necessity of going to another stage of the process.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: The Doctor

Out of all of the elements comprising a Federal Disability Retirement application — the various aspects, including medical, personal, impact-statement, statement of disability, Supervisor’s Statement, etc. —  the essence of it all must be coordinated around the core of the case:  the medical narrative report.

That alone has multiple, inherently complicating factors:  Why won’t the surgeon write the report?  Why is it that the Pain Management doctor, or the Internal Medicine doctor, or the Family Physician is the one often most cooperative and willingIs the Chiropractor’s opinion sufficient?  Is it helpful?  How detailed must the report be?  How long must you be a patient in order to establish the threshold of having a “longstanding doctor-patient relationship“?  Are medical records in and of themselves sometimes sufficient to obtain Federal Disability Retirement benefits?  Is it sufficient to get a Therapist to do the report, without the Psychiatrist?  Can a therapist alone win a case? Must I undergo a Functional Capacity Evaluation?  Can I use reports from an OWCP Second Opinion doctor?  If my Psychiatrist only sees me for five minutes each time and prescribes the medication, is it necessary for him/her to write a report?  How detailed must the report be?  Is the doctor going to understand, let alone actually read, the SF 3112C?  These are just some of the questions which one is immediately confronted with, in beginning the process of putting together a Federal Disability Retirement application under FERS or CSRS.  It is a complex, overwhelming process.

Sincerely,

Robert R. McGill, Esquire

Federal & Postal Service Disability Retirement: Differing Legal Criteria

Similar benefits, at the State, Local, Private levels, and at the Federal level, each contain differing legal criteria for eligibility. Thus, for instance, Social Security Disability benefits require one set of standards of eligibility; private disability insurance policies require a different set of standards; and state disability benefits often differ from state to state.  This is of course true of Federal Disability Retirement benefits under FERS and CSRS — where the legal standard of eligibility is different from Social Security, Worker’s Comp, and State or private disability criteria.

Often, a question is asked whether a medical narrative report which is prepared for submission to the Office of Personnel Management can be used for submission for other “similar” benefits.  The short answer is, “It all depends”, but the long answer is that, in most cases, one must be very cautious.  When I represent a Federal or Postal employee under FERS or CSRS, one of the first steps in preparing a viable case is to request of the treating doctors a detailed medical narrative report.  One must understand that the treating doctor has, generally speaking, next to no idea as to the legal criteria that must be met under FERS or CSRS.  Furthermore, the treating doctor has no legal knowledge as to the differences between private disability insurance policies, State, Social Security, OWCP or FERS & CSRS.  It is the job of the Attorney to make sure and guide the treating doctors as to the criteria which must be met as to the particular and specialized field for which the medical narrative is being prepared.  This must be done with care, and with detailed guidance.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: Summer Doldrums & the Physician’s Statement

I have often pointed out in past blogs and articles that I do not have my clients sign the Physicians Statement (SF 3112C), for multiple and various reasons, not the least of which is that it is a confusing form, and in smaller print than necessary, leaving the impression to the doctor that what is requested is far more complex than what is actually required.  In its place, for my clients, I write a 4 – 5 page letter outlining the type of medical narrative report which I need.  This is the summer months; everyone from OPM representatives to lawyers, to doctors and Federal and Postal employees, take time off to recover from the hard work throughout the rest of the year.  When doctors take off for some “summer fun”, it just means that they have less time to spend on administrative matters — such as writing up a medical narrative report for their patients.  Because of this, it is important to try and simplify the matter as much as possible, and a blanket submission of the SF 3112C without some explanatory guidance, is not the best course of action.  Doctors need guidance, and in this busy world, it is best to streamline the process for them as much as possible.

Sincerely,

Robert R. McGill

OPM Disability Retirement: The Client

Waiting for the approval/disapproval, the determination, the decision,etc., when the Federal Disability Retirement packet is sitting on OPM’s desk, is a passive modality of existence.  Up to that point, however, it is often a good idea to be actively involved in the process.

Whether having an Federal Disability Attorney or not, it is good to “flag” interim dates, to keep on top of how long it has been since the initial letters have been sent out to the doctors, to call the doctors and (diplomatically) ask for a reasonable time-frame within which to have the medical narrative reports written; to ask whether or not a fee is required to prepare the narrative report, and if so, how much, and if prepayment will expedite the report.

Then, once it arrives at the Agency H.R. people (or, in the case of the Postal Worker, the H.R. Shared Services Center in Greensboro, North Carolina), it is a good idea to periodically call (about every two weeks) to see what stage in the process your application is at.  Thereafter, once it is forwarded to the finance office, then on to Boyers, PA, it is a matter of waiting for the CSA number to be assigned, and then the long, arduous wait.

Sincerely,

Robert R. McGill, Esquire
Federal Disability Lawyer