Federal and Postal Disability Retirement: To Enter the Gates Blindly

Being naive is a quality and character trait which is distinguishable from innocence; in this world where information and the opportunity to obtain wisdom is vast and limitless, retaining the former quality may be unpardonable, whereas maintaining a level of innocence may reveal a life of self-discipline, where one has deliberately placed lines of demarcation around one’s life, and insisted upon not being sullied by the world around us.

One can remain innocent, yet not be naive.  While the converse may also be possible, it is important not to deliberately avoid the harsh reality around us.

Thus, in preparing, formulating, and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, it is important that one enters into the metaphorical gates of the U.S. Office of Personnel Management with eyes of wisdom and experience, and not be saddled with the blind naiveté of thinking that the administrative process will be one of fairness and just analysis.

Assume that OPM will attempt to selectively read medical reports and records with an eye to deny; presume that they will ignore crucial evidentiary documentation which upholds one’s case; expect that legal “triggers” such as the Bruner Presumption or the holding in Trevan will be unimpressive.

That is why that which may be implicit, needs to always be made explicit, and repetitively so.  While it may be advantageous for one to enter the proverbial pearly gates with innocence, to enter through the gates of OPM with naiveté is merely inviting a door slammed shut.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement for Federal Workers: The Office of Personnel Management

The Office of Personnel Management (OPM) , located in Washington, D.C., is the agency which makes the decision on all Federal Disability Retirement applications, whether under FERS, CSRS or CSRS-Offset.  They are the responsible agency for the first two “stages” of the process of attempting to show eligibility and entitlement to a Federal Disability Retirement annuity.  By “stages” is merely meant the initial application stage of the process, as well as the second, “Reconsideration” stage of the process — where a Federal or Postal employee has the right to, within 30 days of an initial denial of a Federal Disability Retirement application, request that his or her case be “reconsidered”, and further have the right to submit any additional medical or other supporting documentation for review and consideration. 

If the case is denied a second time by the Office of Personnel Management, then the Federal or Postal employee who has filed the Federal Disability Retirement application, or the attorney representing the Federal or Postal employee, has a right to file an appeal to the Merit Systems Protection Board.  The Office of Personnel Management is taking quite a long time in making a decision on a Federal Disability Retirement application, and although they are attempting to get caught up with their workload, the volume of cases filed and received by OPM on a weekly basis has made such an attempt difficult.  As has been stated by this author many times, Patience is a virtue, and as such, Federal and Postal employees must be the most virtuous of all, because patience is what is needed to endure and survive the process.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: Sometimes, It’s “The Law”

An assumption is often made that the “Disability Specialist” at the Office of Personnel Management who reviews the Federal or Postal Disability Retirement application understands, comprehends, and applies the laws governing Federal Disability Retirement applications.

Now, such an assumption may be logical and reasonable, to the extent that one thinks (A) that those who aspire to working in a specific specialty have some knowledge or understanding of the specialty, and (B) if a decision is made which involves discussing “the law”, one presumes that the mere discussion of it proves some knowledge of it.

The problem with such reasoning, however (apart from the popular tripartite acronym which originates from the word “********-u-me”), is that it betrays the facts:  often, from reviewing the denial letters generated from the Office of Personnel Management, it is painfully clear that the administrative specialist, the legal specialist, or whatever other “specialist” designation has been embraced by the worker at the Office of Personnel Management, simply fails to apply all of the applicable laws which govern Federal Disability Retirement applications.

This is understandable, to this extent:  OPM representatives (other than those representing OPM at the MSPB level) are not lawyers, and as such, do not keep up with the latest evolution of the laws governing Federal Disability Retirement issues.  Whether that is a good thing or a bad thing, is another matter altogether.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Government Employees: The Medical Records

Federal Disability Retirement under FERS & CSRS is essentially “connecting the dots” between one’s medical conditions (whether singular or multiple) and the impact of the medical condition(s) upon one’s ability to perform all of the essential elements of one’s job.  The treatment records, also, are helpful in the matter of connecting the dots, as the Office of Personnel Management will often request a copy of the medical records — evidence of treatment over the years — in order to ascertain the extent of the medical conditions claimed.  

This can sometimes present a problem, when a Federal or Postal employee has switched doctors, has quietly endured the pain of the medical condition with little or no treatment over the years, or where the doctor fails to annotate any legible or detailed notes in his or her treatment notes.  Normally, however, there is a consistency of evidence between treatment/office notes and the medical narrative which the doctor prepared; or, between the diagnostic results and the clinical findings and conclusions of the treating doctor.  Where there is a lack of medical records “backing up” the narrative report of the doctor, often a Functional Capacity Evaluation or an “independent medical evaluation” by a referral doctor will help a case.  As always, there are ways to counter the problems which arise, in order to meet the eligibility criteria as proposed by the Office of Personnel Management in a Federal Disability Retirement case.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Patient-Doctor Relationship

In filing a Federal Disability Retirement application with the Office of Personnel Management, it is always preferable (though not an absolute mandate) to have medical reports and records from a “treating” doctor of some tenure.  What constitutes a “treating doctor” is fairly uncontroversial — it means that the report rendering an opinion concerning one’s physical or mental ability to perform all of the essential elements of your job should be prepared by a doctor who has provided medical treatment, and generally has a patient-doctor relationship.  The duration of the tenure which then creates such a “patient-doctor” relationship does not necessarily put a specific time frame upon a doctor.  It can mean anywhere from a month to a decade, in my view.

From the applicant’s perspective, it is important to understand that the person who is considering filing for Federal Disability Retirement benefits has been establishing and fostering that relationship, and this is important to see.  Those many years of going to the doctor, speaking to him or her about the most personal of problems — one’s medical conditions — is part of what creates that special bond identified as a “patient doctor relationship”.  It is a relationship which has been created and fostered through interactive needs, and that relationship should be strong enough to ask the doctor, when the time and need comes to fruition, for a medical report in support of one’s Federal Disability Retirement application.  So, at this point in the issue, as one is contemplating Federal Disability Retirement, does your interaction with your treating doctor constitute a “relationship”, or is it merely an economic exchange of goods and services?

Sincerely,

Robert R. McGill, Esquire

Go to:  Patient-Doctor Relationship (Part II)

CSRS & FERS Disability Retirement: The Lawless Supervisor

Every now and then (or perhaps more often than we like to think) a Supervisor will fill out the SF 3112B (Supervisor’s Statement) with such venom and innuendo and half-truths, as to make the disability retirement applicant out to be John Gotti’s half-brother and reincarnate of the conceptual paradigm of the greatest incompetent the Federal Government has ever seen (next to the Supervisor himself, of course). Or, it will state that the applicant has been “under investigation”, or that he/she has “mislead” the Agency, or other such half-truth, unsubstantiated allegation. The problem in addressing such a Supervisor’s Statement with the Office of Personnel Management (if, in fact, one has the opportunity to address the issue before it gets to OPM or, as is more often the case, if the disability retirement application is denied, and the Supervisor’s Statement is referenced in the initial decision of denial), is the following: If you address it too forcefully, or emphasize it, then you are in danger of focusing the “fight” on the truth or falsity of what the Supervisor has said. In other words, you have essentially allowed the Supervisor to win the fight by shifting your focus upon the venom of the Supervisor. It is more likely the wiser course of action to grant minimal attention to the Supervisor’s Statement; give it the due response it deserves, addressing the falsity of the statement, and how it is entirely unsubstantiated; and, sometimes, express outrage that OPM would have even considered such scandalous charges when it has been unverified; then focus most of the attention upon the validity and force of the Medical Narrative Report that accompanies the disability retirement application. For, after all, always remember that this is a “Medical Disability Retirement Application” — with the emphasis upon “medical”, and not “Supervisor”.

Sincerely,

Robert R. McGill, Esquire

OPM Federal Disability Retirement: Be Smart

Disability retirement under the Office of Personnel Management, and Worker’s Comp benefits from the Department of Labor, OWCP — normally, I explain that the two have nothing to do with each other, and “never the twain shall meet” (except, of course, insofar as one must choose one or the other; that causality or “on the job” issues are not relevant for OPM disability retirement; or that OWCP pays more but is not a retirement system, etc. — thus, all of those distinctions and differences which only serve to emphasize the separation between the two benefits).  However, there are instances when the applicant filing for OPM disability retirement benefits, and who (at the same time, coincidentally) has been under the thumb of OWCP, should “cross over” between the two — especially when he or she has received a favorable Second Opinion stating that the (so-called) Independent Medical Examination shows that the OWCP beneficiary is unable to return to the job.  In that instance, such a medical opinion can and should be used for OPM disability retirement purposes.  In fact, such a medical opinion is often viewed by OPM as “independent” and “unbiased”.  To a great extent, this is somewhat of an irony, because from the employee’s viewpoint, the Second Opinion Doctor is anything but an “unbiased” doctor (in most instances), inasmuch as OWCP/DOL is paying for his or her services.  But when that “unbiased” doctor gives a favorable opinion, then it can work to your advantage when filing for disability retirement benefits from the Office of Personnel Management.

Sincerely,

Robert R. McGill, Esqire

OPM Disability Retirement: Further Comment on Vanieken-Ryals

Vanieken-Ryals v. OPM, decided by the U.S. Court of Appeals for the Federal Circuit on November 26, 2007, has an interesting statement from the deciding Judge, which can be used as “firepower” for anyone who is attempting to obtain Federal Disability Retirement benefits (note of caution:  for lay non-attorneys, be careful in how you use it in trying to convince a lay, non-attorney OPM representative):  “In addition, neither the MSPB nor OPM discussed the content of Dr. [ ] or [ ] evidence in any meaningful way, which further demonstrates that it was not properly considered.  OPM, for example, resorted to a laundry list of “objective” tests and documents that the medical evidence did not contain rather than examining the evidence and evaluating what it did contain.”

Interpretation:  If OPM’s argument is to focus upon what is missing, they have violated their primary Agency/administrative responsibility — that of evaluating, in some “meaningful” manner, the medical evidence which was in fact submitted.  This can be used effectively for the Reconsideration Stage by diplomatically pointing out the error of OPM, and citing Vanieken-Ryals, and highlighting the relevant portions of the medical documentation previously submitted.

Sincerely,

Robert R. McGill, Esquire

Summary Legal Update for FERS & CSRS Disability Retirement

On my website, Federal Disability Retirement Lawyer, I give a more extensive explanation of a recent and important case impacting federal disability retirement applications, but I think that it is important for everyone filing, or contemplating filing, for disability retirement under FERS or CSRS, to be aware of the recent United States Court of Appeals case for the Federal Circuit, Vanieken-Ryals v. OPM, #2006-3260, decided on November 26, 2007, in which it was found that OPM’s adherence to the rule that they will refuse to “consider such medical evidence…for being ‘purely subjective’ is a critical legal error…and clearly prejudicial.”

Often, in cases involving cognitive impairment, psychiatric disabilities, disabilities involving diffuse and chronic pain, and those conditions such as Fibromyalgia, Chronic Fatigue, etc. the Federal Circuit Court in Vanieken-Ryals has essentially held that OPM’s adherence to “objective evidence” is “unsupported in the law, was arbitrary, capricious and contrary to law.”

The Judge therein stated that OPM must consider the medical evidence that is submitted, and cannot attack a medical condition unless there is a doubt as to the “credentials or veracity [of the doctor],” and this is especially true where the doctor has “utilized established diagnostic criteria and [is] consistent with ‘generally accepted professional standards’ ” of medical practice.

This is an important case for Federal disability retirement applicants to use when filing for psychiatric medical disabilities, and for those “hard to define” cases (again, e.g., Fibromyalgia, Chronic Fatigue Syndrome, etc.), because OPM will often declare as a basis for denial that the applicant lacked “objective medical evidence” or that there was no “objective diagnostic tests” showing the medical condition. This is, to use a very well-know legal term, now considered “baloney”. As long as the doctor has applied established diagnostic criteria and generally accepted professional standards, unless OPM can attack the credentials of the doctor, they must consider the medical evidence.

Sincerely,

Robert R. McGill, Esquire