Disability Retirement for Federal Workers: Causation Irrelevancy

Causation and the issue of causality involves the occurrence of X as a result of an action Y.  There are direct causes, intermediate causes, interceding causes, etc., which concern whether or not an immediate linkage can be established between the action Y and the effect X.

Thus, if the white billiard ball strikes the Number 7 ball, and the latter moves forward, we say that X (the white ball) caused Y (the Number 7 ball) to move.  On the other hand, if the rooster makes its traditional cry at 7 a.m. as the sun is rising, and does so only when the sun rises, we may informally say, in an imperfect sense of causation, that “because” the sun rose, the rooster crowed.  We rarely ascribe a direct cause between X and Y, however.

For OWCP/Department of Labor cases, causation is a relevant and significant aspect of proving a case — for, in a FECA case, one must prove, as one of the elements of eligibility, the fact that the injury was “caused” by the job, while on the job, while related to the job, etc.  A significant amount of time is thus expended in proving the issue of causality in a Department of Labor, Office of Workers’ Compensation claim.

For FERS & CSRS Disability Retirement cases, however, under the auspices of the U.S. Office of Personnel Management, causation is not an issue.  A Federal or Postal Worker can be injured while on vacation; he or she can have the injury while at work, and concurrently (or sequentially) file for OWCP benefits and OPM Disability Retirement benefits; or the injury or medical condition can simply “occur” during his or her tenure with the Federal government.

In any and all events, it is essentially an irrelevancy.  The issue is not “how” it occurred; rather, the point is to show that, once occurred, in what manner does it impact one’s ability to perform the essential elements of one’s job.

While causation in a FERS or CSRS Disability Retirement application may be of some historical interest, it should not be a central focus of any applicant’s statement of disability.  To do so would be to make a peripheral issue a central one, and conversely, to allow for the central issue to become less focused.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: History, Causal Connection, Exacerbation & Pre-existing Conditions

In OWCP/Department of Labor cases, there are important elements to prove in order to obtain FECA benefits — i.e., the history of the event (the “how” it happened); causality (the where and when it happened, in order to establish workplace connection); whether the injury involved an exacerbation of a prior injury; and whether any prior injury entailed a pre-existing condition.  

Any or all of the previously-listed elements can have an impact in a Department of Labor, Federal Worker’s Compensation Claim.  

In a Federal Disability Retirement claim through the U.S. Office of Personnel Management, however, none of the elements identified heretofore have a direct relevance upon a Federal or Postal employee’s eligibility for Federal Disability Retirement benefits.  

There can be, however, some indirect issues.  Thus:  History of one’s medical condition is normally only collaterally relevant; causality is rarely of any significance, precisely because there is no requirement that the medical condition was caused by or in connection with one’s work — except to the extent that one must show that one became unable to perform one or more of the essential elements of one’s job while a Federal or Postal employee; exacerbation may have some relative importance, if only because if one has been able to perform the essential elements of one’s job while suffering from a medical condition, you might be required to show why you cannot do the job “now” as opposed to those years of having performed the job previously.  And, finally, the pre-existence of a medical condition — pre-existing one’s Federal employment — would only become an issue if one were to be able to perform the job, and there comes a point when the medical condition worsens; but that is merely a matter of showing the deteriorating impact of one’s medical condition.  

Ultimately, the point is that FERS & CSRS Disability Retirement is conceptually and practically different from OWCP cases, and the potential Disability Retirement applicant should not confuse the two.  To do so would be to defeat the capacity and ability to wisely choose.  

Alternatives exist if, and only if, one is aware of the choices to be made.  Wisdom comes about when one becomes aware of differences between two or more choices.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: Dependent Contextual Information

The historical context of one’s medical condition is an issue which is mostly irrelevant for the First and Second Stages of a Federal Disability Retirement application, submitted to the U.S. Office of Personnel Management, whether under FERS or CSRS. This is because OPM is not interested — or, more accurately, the law does not recognize as relevant in analyzing the eligibility criteria applied in a Federal Disability Retirement application — of “how” or “why”.

While such contextual information may be relevant for OWCP/FECA cases because of the issue of causality and its importance in such cases, the overriding and determining factor in a Federal Disability Retirement application is whether a Federal or Postal employee has a medical condition; how that medical condition prevents one from performing one or more of the essential elements of one’s job; and whether the medical condition will last a minimum of 12 months.

Outside of that contextual information (actually, such information is more accurately identified as content-information), OPM in pragmatic terms has no patience for the historical background of such information.  Obviously, however, some contextual narrative should be included in any Applicant’s Statement of Disability, in order to make the statement meaningful.

One last point:  While historical context may not be relevant for the Initial Stage and the Reconsideration Stage, it may be very important if one finds oneself before an Administrative Judge at the U.S. Merit Systems Protection Board.

Sincerely,

Robert R. McGill, Esquire

USPS and Federal Disability Claims: Medical Conditions which Predate Federal or Postal Employment

Often, there is a concern about medical conditions which one suffers from, which “predate” employment in the Federal Sector, or with the U.S. Postal Service.  Such conditions are often identified as “preexisting medical conditions” — meaning, thereby, that they exist prior to an event.

In the context of OWCP (Federal Worker’s Compensation), under the aegis of the Department of Labor, such an issue normally involves the assertion and allegation (by the Department of Labor, Office of Worker’s Compensation Programs) that a Medical Condition-X already existed prior to Event-Y — the latter normally constituting the “on-the-job” accident or occurrence, or an occupational disease, etc.  Because causation — the “what caused the injury” issue — is important in OWCP/DOL cases, the concern of preexisting conditions is normally a point of contention between the Federal worker and the Federal Government/Department of Labor.

However, in OPM Disability Retirement cases, because causation is not an “issue” of concern (the “how” or “where” it happened is not a relevant legal criteria of proof), it rarely becomes a point of conflict between the Office of Personnel Management and the Federal or Postal employee.

It can become of interest, however, for the Office of Personnel Management, in a Federal Disability Retirement application, if a Federal or Postal worker has been hired and working in a particular job, with a specific medical condition for many years, successfully, but then files for Federal Disability Retirement benefits.  The reason it may become of some interest, however, is not as to the “causation” issue (of the “how” or “where” it happened), but rather, to the question:  Why is it that the Federal or Postal employee who has had a Medical Condition-X all of these years can now claim not to be able to perform Essential Elements Y & Z now?

That is the point where a medical condition existing prior to one’s Federal or Postal employment may be of some interest to the U.S. Office of Personnel Management.  It is, however, easily addressed; it just needs to be discussed in the right way.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The OWCP Intersection

Federal Disability Retirement benefits under FERS or CSRS is oblivious and unconcerned with whether or not a particular medical condition occurred “on-the-job” or not.  Rather, the focus is upon (A) the existence of a medical condition along with the symptomatologies and their manifestations, and (B) the impact of the medical condition(s) upon one’s ability/inability to perform all of the essential elements of one’s job.  

Thus, “causality” in all of its forms is an irrelevant issue — whether “how it happened”, “where it happened”, “what happened”, etc.  Causation is a legal/medical issue which may be interesting, and is certainly one which the Office of Worker’s Compensation Programs inquires about, but it is a “non-starter” for purposes of Federal Disability Retirement benefits under FERS or CSRS.  

As such, when a Federal or Postal employee who has been injured on the job, or who has incurred a medical condition from a worksite because of inherently hazardous medical triggers reasonably related to the particular occupation of an individual, an inordinate amount of focus is often paid as to the “causality” of a medical condition.  While this may be of historical interest — both to a doctor as well as to FECA/OWCP — it is an issue which should play a lesser role of importance in a Federal Disability Retirement application.  

For eligibility in filing a Federal Disability Retirement application under FERS or CSRS, where something happened, what happened, or when it happened, is far less important than how much of an impact a medical condition has, and for how long, upon one’s ability/inability to perform the essential elements of one’s Federal or Postal job.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Government Employees: Stress

“Stress” is always the “problem child” in a Federal Disability Retirement application under FERS or CSRS.  If a Federal or Postal employee is no longer able to perform one or more of the essential elements of one’s job because of an intolerance to a certain level of stress, then certainly it should be considered as a basis for preparing, formulating and filing a Federal Disability Retirement application, either under FERS or CSRS.  However, treatment modalities must be engaged — normally, via a psychiatrist or psychotherapy.

Further, there are always issues which will come about in basing the primary medical condition as “stress” — aside from the fact that it is a generic designation which will often have corollary designations, such as Major Depression, Generalized Anxiety Disorder, etc.  For example, can one define “tolerance to stress” as an essential element of one’s job?  It is certainly an inherent element, implicit in many multi-tasking jobs and ones which require a high level of responsibilities or is subject to timeliness in quotas and work production.  But when issues concerning stresses which arise as a result of “personnel issues” (i.e., interaction with supervisors, coworkers, etc.), then it becomes a “problem-child” which is best avoided, for numerous reasons, including the possibility and danger of having one’s Federal Disability Retirement application denied based upon a “situational disability“.  Concepts and thoughts to ponder, when preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Office Notes (Continued…)

The Office of Personnel Management has every right to establish a consistency of medical treatment and opinions rendered on the part of the doctor, the specialist, the medical facility, etc.  One of the reasons why Federal Disability Retirement benefits are (in great part) determined by the opinion of the “treating doctor”, as opposed to a determination made by a medical doctor who makes such disability determinations but is not the applicant’s “treating doctor”, is that such a determination (in the eyes of Federal Disability Retirement laws, statutes, MSPB case laws, etc.) can best be rendered by a medical specialist who has a long-standing relationship with the patient/applicant, over a long period of time, to determine the extent, severity, chronicity, etc., of the medical condition claimed.  

With this in mind, there often arises a conflict of sorts:  On the one hand, most people who are attending to their medical needs, are not thinking in terms of “getting Federal Disability Retirement benefits” during the time of treatment.  The critical point of when the line becomes drawn, where treatment & chronicity begin to conflict; or where, despite every attempt by the doctor to prescribe treatment modalities, there appears to be a medical condition which is “intractable”, is often a difficult one to determine.  In most cases, the office/treatment notes will reveal the line, which may come about gradually.  At other times, one may have a doctor who thinks that he or she can successfully treat any and all conditions, and reflects such a “positive” outlook in every office notation.  This is often not helpful, when it comes time to filing for Federal Disability Retirement benefits under FERS or CSRS.  To counter this, a frank discussion with the doctor at some point may become necessary.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: Psychiatric Disabilities — Origin versus Situational (Continued…)

The “origin” of a medical disability, from the perspective of a Claims Representative at the Office of Personnel Management, may be relevant for purposes of adjudicating a Federal Disability Retirement application under FERS or CSRS.  Note that physical disabilities rarely become an issue in the context of the origination of the medical disability, precisely because it is irrelevant whether or not a medical disability occurred on the job or not.

The origin of a psychiatric disability, however, is potentially relevant from OPM’s perspective, because it may give rise to the argument that it is a “situational” disability — one that is contained, limited, and ultimately circumscribed within the situation of the particular office of the specific agency in which the Federal or Postal Worker works.  

Thus, from this argument, the logical extrapolation is that while the Federal or Postal worker is unable to work in the specific office or location, he or she is nevertheless able to perform all of the essential elements of the particular job — but in another agency, another office, another location, etc.  Thus, the concept of “situational disability” arises, with the consequential argument that one is in fact NOT prevented from performing one or more of the essential elements of one’s job — but rather, it is the “situation” which is at fault. This is why the citation of correlative EEOC complaints, hostile work environment accusations, etc., are dangerous to make in the context of filing for Federal Disability Retirement benefits under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: The (non) Problem of Causality & Causation

In a Worker’s Comp (DOL/OWCP/FECA) case, causation and causality often loom as significant issues, and doctors often have to walk a difficult line in making unequivocal statements, or somewhat equivocating statements, as to the “cause” of a medical condition or injury.

Such statements can sometimes be the singular focus as to the success or failure of an OWCP case.  Why?  Because OWCP compensable injuries and medical conditions must be related to the job — either as something caused by an accident while on the job, or in some way occupationally related.

In Federal Disability Retirement cases under FERS or CSRS, one can be on a skiing vacation and incur a medical condition or disability, and so long as that person is unable to, because of the medical condition, perform one or more of the essential elements of one’s job, one is thereby eligible for Federal Disability Retirement benefits under FERS & CSRS.

Sometimes, however, the issue of causation comes into the picture, but can work in a detrimental way, but need not.  Let me clarify:  In a chemical sensitivity case, or a psychiatric condition which finds its originating “causation” from the workplace, the doctor may want to relate the “cause” of the medical condition directly to the workplace.

This is fine, so far as it goes — and, ironically, most doctors (because they have no idea about FERS or CSRS Disability Retirement) think they are doing their patients a favor by relating it as “causally related” to the workplace.  More often than not, however, it can open up a “can of worms” — of being characterized by the Office of Personnel Management as a “situational disability”, which must be avoided like the plague.

Sincerely,

Robert R. McGill, Esquire