OPM Disability Retirement: Treatment, Surgery and Medication Regimens

In contemplating preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, one needs to always bifurcate issues which are “legal”, “employment-related”, and “medical”, etc.  Of course, issues can easily cross over between neatly-construed, artificial boundaries, such that certain issues contains multiple areas.

For example, there is the question of compliance with medical treatment.  First and foremost, whether it concerns or impacts a Federal or Postal employee — or any employee of any organization — the question of whether an individual is complying with the treatment recommendations of a doctor is one which is, and should be, first and foremost a medical one.

In preparing a Federal Disability Retirement application, however, that same question can indeed cross over into becoming a legal issue concurrently, because non-compliance with certain types of treatment regimens can be a basis for a denial of a Federal Disability Retirement application by the Office of Personnel Management.

As to “which” treatment modalities would be a basis for a denial, in general terms, those treatment modalities which one might construe as “minimal” in nature, certainly qualify.  Thus, compliance with a medication regimen is certainly a basis for a denial in a Federal Disability Retirement application; refusing to undergo a prescribed course of physical therapy may be another.  On the other hand, deciding to forego surgery is normally not a basis for a denial of a Federal Disability Retirement application, if only because of the percentages of success even with surgery are tenuous at best, and even with surgery, there is always the question of whether the Federal or Postal employee would be able to perform all of the essential elements of the job anyway.

Questions of medical treatment compliance should first and always be considered a medical question, and only in a secondary sense, a legal question.  One’s health should be the penultimate concern; the legal consequences, an afterthought.

Keeping one’s priorities in order is always the best approach, whether contemplating filing for Federal Disability Retirement under FERS or CSRS, or not.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Spectrum of Medical Requirements

In considering a Federal Disability Retirement application under FERS or CSRS, a Federal or Postal employee must ask questions beyond the primacy of obtaining the necessary and proper medical care for treatment of one’s own medical condition.  Thus, evidentiary issues must be considered; issues of obtaining proper medical documentation; seeking the active support of a treating doctor, etc.  These are all “non-medical” considerations, which have little to do with the actual treatment and care of one’s medical condition, but have everything to do with preparing, formulating, and filing for Federal Disability Retirement benefits under FERS & CSRS.  

There is a distinction between the two (receiving the necessary medical care and preparing a Federal Disability Retirement application), and it is important to recognize the conceptual distinction, because the former can impact the latter.  For instance, on the spectrum of medical care (or refusal thereof) which can impact a Federal Disability Retirement application, refusal to undergo “facially reasonable medical treatment” can defeat a Federal Disability Retirement application.  

The question, of course, is how to interpret what constitutes “facially reasonable medical care”?  There are certain “obvious” ones, and then others which are not so obvious.  Normally, the Merit Systems Protection Board has held that refusal to undergo invasive surgery is not a bar to being eligible for Federal Disability Retirement benefits; on the other hand, refusing to take prescribed medications can, and often is, a bar to eligibility.  All else fall within the middle of the spectrum of such medical/legal requirements.  

Sincerely,

Robert R. McGill, Esquire