CSRS & FERS Medical Disability Retirement: The Treating Doctor

There is efficacy and motivational bias.  Sometimes, unintended consequences result in the coalescence of both, but where the result is unaffected by the underlying reason for acting upon an event.

In OWCP cases, the motivational bias almost always includes the intent of the Department of Labor to try and save money, and to steer the injured worker to undergo treatment (if one can call it that) and oversight with one of “the company” doctors who can quickly declare a person to be healed and ready for return to full-time duty, despite protestations of pain, discomfort and limitation of movement, all to the contrary.

It is no accident that the ever-present Worker’s Comp Nurse who infringes upon the patient-doctor relationship by imposing her presence upon each visit, agrees whole-heartedly with any such assessment of full recovery, and ignores the pleas of the patient/OWCP benefit-recipient.

By contrast, those who are filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, are encouraged to speak with their longstanding treating doctors, as opposed to merely going to a doctor whose motivational bias may stem from the source of one’s payment.

Treating doctors who have a long tenure of doctor-patient relationships have little underlying motivation to do anything but look out for the best interests of the patient.  If Disability Retirement is the best course, then that will be what the treating doctor will support.  It is ultimately the relationship that has been established over the many years, which makes for all the difference.  And that difference is worth its incalculable weight in gold.

Sincerely,

Robert R. McGill, Esquire

Postal and Federal Disability Retirement: Agency Actions Are Merely Persuasive

Whether it is one’s own agency which acts, or some third-party agency, the effect of such actions upon a Federal Disability Retirement application under FERS or CSRS is merely persuasive, and not determinative, from the viewpoint of the Office of Personnel Management, whether under FERS or CSRS.  

Such actions may include:  Disqualification based upon a medical condition, whether because of the primary, underlying medical condition, or a secondary condition resulting from a prescription medication; determination by the Agency based upon a fitness for duty review; failure to pass certain physical fitness standards; declarative statement by the Agency that no accommodations can be accorded, whether because of one’s medical condition or other influencing factors; a conclusion reached by an Occupational Nurse or doctor; acceptance of a case by OWCP, Department of Labor; approval by the Social Security Administration, the Veterans Administration, etc. — all of these “third party” determinations can be persuasive for a Federal Disability Retirement application, but are not necessarily determinative in coming to a conclusion of approval by the Office of Personnel Management.  

Why “persuasive” as opposed to “determinative”?  Because of two fundamental reasons:  (1)  The Office of Personnel Management is an independent agency, mandated by statute, regulation and case-laws, to make its own determination of eligibility of each Federal Disability Retirement application, separate and apart from any other agency, and (2) such agencies which make such determinations are not medical facilities (although a doctor or nurse may have some involvement in the decision-making process), and this is ultimately a “medical” disability retirement, and not an agency retirement system mandated by law.  

As such, one must still prove by a preponderance of the evidence that one is eligible for Federal Disability Retirement benefits, based upon the nexus between one’s medical conditions and one’s essential elements of the Federal or Postal job.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: The Family Doctor and the Surgeon

I am often asked whether or not a medical report from the “specialist” will have a greater impact than a family doctor.  Implied in such a question, of course, is a perspective which tends to see the family doctor as somehow “less qualified”, sort of like comparing the technical deficiencies of a “country doctor” as opposed to a “real doctor” — one who works in an emergency room in a large metropolitan hospital.  Perspectives and prejudices have a way of defining judgments, and assumptions, presumptions and long-held beliefs, whether valid or not, often rule our lives. 

How can I answer such questions?  In the course of a Hearing before an Administrative Judge at the Merit Systems Protection Board, I have had family doctors testify who were unbeatable, and certainly overwhelming in his or her expertise and medical knowledge.  The years of experience in having to deal with thousands of patients, and confronting and treating medical conditions of every imaginable sort — and making decisions (including referring patients to “specialists” for concurring or confirming diagnoses and opinions) involving the “whole” patient’s medical condition and treatment — came through with such persuasive force and overwhelming confidence, that it was indeed the “family doctor” or the “country doctor” who ruled the day. 

Similarly, I have had the “specialist” testify in cases, who barely were able to coherently describe the connection between the medical condition and the essential elements of the job.  And, of course, sometimes the opposite is true — good surgeon, mediocre family doctor; mediocre specialist, great country doctor.  As in all things, in Federal Disability Retirement applications under FERS or CSRS, it is not so much that the credentials matter, as the character, experience, and “heart” of the doctor who treats the patient.

Sincerely,

Robert R. McGill, Esquire