Disability Retirement for Federal Government Employees: Use of Collateral Sources

Context is important.  Identifying the relevance of importance, however, is discretionary, and requires some insight into the impact which a differentiated distinction might require.

Allow for some expansive explanation:  In attempting to obtain OWCP/DOL benefits, one may want to argue against the validity of a medical evaluation — i.e., by attacking the claimed “independence” of the medical evaluation (argument:  the doctor is being compensated by the Department of Labor; 25% of his practice is devoted to such evaluations, and out of that, 95% of his evaluations are found to be in favor of the Department of Labor, etc.).  But the fact that one may want to attack the relevance and validity of an  independent medical examination within the context of the Office of Worker’s Compensation, does not mean that when one files for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, that one should necessarily and unequivocally discard the received report from OWCP.

There may well be statements contained in such a report which may be useful in arguing to OPM that one’s Federal Disability Retirement application should be approved.  Can one argue positively that it is an “independent” medical examination?  Absolutely.  In fact, the contrary argument should be made:  that because the doctor was selected by another government agency (Department of Labor), it is all the more so that the medical opinions of the particular doctor are relevant and of significant impact.  One must be careful, of course, in using such collateral sources for support of one’s Federal Disability Retirement application, but so long as the proper context is identified and understood, one should always consider the use of such “other” sources of support — but never to replace the primary importance of one’s treating doctor.  Context, properly understood, can result in substantive argumentation of relevant and significant import.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: A Real-life Hypothetical

Assume the following hypothetical:  A Federal or Postal employee who is 48 years old, with 25 years of Federal Service, engages in a type of work which is repetitive, day in and day out (yes, even this sentence is repetitive and redundant), full time, over the course of those 25 years.  

One day, while moving a piece of furniture at the direction of his spouse, he feels a sudden and sharp pain in his back.  He has to sit down and rest for a while.  The “for a while” turns into a visit to the emergency room, then to his family doctor.  The MRI shows a disc bulge at L5-S1, with multi-level disc degeneration, spinal stenosis, and other degenerative changes.  Despite multiple modalities of treatments, including epidural steroidal shots, physical therapy, variances of medication regimens, etc. (and you can even add a surgical intervention), the pain continues to worsen and deteriorate his medical condition.  The chronic pain prevents him from performing his job.  Whether sedentary or physical, the high distractability of the pain results in his poor performance.  

Can he/she file an OWCP claim?  Such a claim is submitted and rejected, because the issue of causality cannot be established.  An appeal is filed, and it is again denied.  The treating Neurologist and Orthopaedic Specialist are unwilling to establish a direct causal link.  But one argues:  Do those 25 years of repetitive work account for nothing?  Can it all have occurred because of the singular occurrence?  Does my medical condition reflect that of a person twice my age merely because of a single incident?  

It is precisely because causality is the crux of OWCP, that Federal Disability Retirement under FERS or CSRS is an important benefit for all Federal and Postal employees. OWCP/FECA is a benefit which is great for the limited role it plays; Federal Disability Retirement is a benefit with wider applicability, and the chance for the Federal or Postal employee to enter into another phase of life.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: OWCP Independence & Instersection

When Federal and Postal employees call to inquiry about Federal Disability Retirement issues from the Office of Personnel Management, the initial part of the conversation often involves separating the distinction and differences between OPM Disability Retirement and temporary total disability benefits obtained through the Office of Worker’s Compensation Programs, Department of Labor (OWCP/DOL).

The two are distinct, independent, and do not intersect except when it comes to having both benefits approved — in which case the “intersection” between the two is comprised of choosing one benefit over the other, and allowing the other to remain in an inactive status.  The fact that each is separate, independent and non-intersecting (for the most part), however, does not mean that documentation from one entity cannot be used to prove or otherwise enhance the provability of the other (yes, the double-negative makes it more difficult to understand — but what it means is that you can use documentation from OWCP sources to help prove your OPM Disability Retirement).

Thus, while there are two separate “language games” (to use a term coined by the 20th Century Philosopher, Ludwig Wittgenstein) involving usage of terms which are somewhat foreign to each other — such as “MMI”, “percentage disability ratings”, whether it is an “on-the-job” injury or not, etc., the fact that OWCP issues embrace a medical condition which impacts one’s ability or inability to perform one or more of the essential elements of one’s job, can certainly be a valuable tool in the arsenal of weapons to be used in proving a Federal Disability Retirement case.  On the other hand, discretion is a tactical tool which also needs to be applied…

Sincerely,

Robert R. McGill, Esquire

Medical Retirement for Disabled Federal Workers: OWCP & Federal Disability Retirement

Whether or not one remains on Department of Labor, Office of Worker’s Compensation Programs (DOL/OWCP) benefits, of receiving Temporary Total Disability compensation, and for how long, should not be the determining factor as to whether to file for Federal Disability Retirement benefits from the Office of Personnel Management, whether under FERS or CSRS.  

Ultimately, the two systems of benefits and compensation are meant to address two different issues. OWCP is meant to address the issue of a Federal or Postal worker who has been injured on the job, or from an occupational disease, and thus causation is an issue with OWCP compensation and benefits.  Further, OWCP is not meant to be a retirement system — although, in more recent years, the U.S. Postal Service and some other Federal Agencies have started to use it “as if” it is a retirement system for its employees, encouraging the filing for such benefits in order to shed the agency of workers who are not “fully” productive.  

What often happens, however, when a Federal or Postal worker continues to remain on OWCP is that it become a default retirement system.  One can easily become comfortable in receiving the Temporary Total Disability payments, and indeed, because of the high rate of pay and the appearance of greater benefits because no taxes are taken out of the amount paid, one can continue to survive on such payments.  But because it is not a retirement system, the day can suddenly dawn when OWCP finds that the Federal or Postal worker is no longer entitled to such compensation.  For that reason, and sometimes for that reason alone, it is important to secure the benefit of a Federal Disability Retirement annuity.

Sincerely,

Robert R. McGill, Esquire

Federal Worker Disability Retirement: Work as the Causal Inception

In a claim filed with the Office of Workers’ Compensation Programs (OWCP), causality and whether it is work-related, occupationally related, etc., are issues which will inevitably arise, precisely because the statutory mandates which govern OWCP rules and regulations require proof of a causal connection.

Under Federal Disability Retirement for FERS & CSRS employees, however, such work-related causality is not an issue, because it is not a requirement that a medical condition was “caused” while performing one’s Federal or Postal job, or that there be some connection to an occupational hazard or inherent workplace relationship.  That does not mean, however, that there cannot be a workplace connection; merely that, whether or not there is any such relationship between the medical condition and the work environment, it is not an issue which possesses any significant relevance to the filing of a Federal Disability Retirement application.  

These “fine distinctions” can be confusing for non-lawyers (and, indeed, even for lawyers who are supposedly trained in being able to analytically dissect multiple compounding concepts within statutory language).  

“Causality” to the workplace can, however, be discussed and even referred to in a medical report, or in the Applicant’s Statement of Disability (Standard Form 3112A), as a provision for historical and background context, but it is not an essential element to prove in a Federal Disability Retirement application under FERS or CSRS.  Too much emphasis on the historical context, however, can lead to the unforeseen and dangerous consequence of having one’s case characterized as a “situational disability“, and one must always be cognizant of such a danger.

Sincerely,

Robert R. McGill, Esquire

OWCP Payments & FERS/CSRS Disability Retirement

There are many Federal and Postal workers who have been receiving OWCP payments (Temporary Total Disability benefits) for years.  Such payments can, indeed, continue for many years, or for a few months, depending upon the length of time it may take for a medical condition to persist.  

The problem with relying upon OWCP as a retirement system is that, strictly speaking, it is not a retirement system.  The Department of Labor can begin the process of sending the benefit recipient to a “Second Opinion” doctor, and the process of attempting to cut off OWCP benefits has thus begun.  

Further, there is often the problem of reliance upon OWCP, resulting in a Federal or Postal worker failing to file for Federal Disability Retirement benefits within 1 year of being separated from Federal Service.  This sometimes happens because the Federal or Postal Worker begins to feel secure in the monthly OWCP benefit, and because it pays a higher rate than FERS or CSRS Disability Retirement benefits.  However, one should never be fooled by the tenuous nature of OWCP — it is not meant to be a retirement system, and most Federal and Postal workers who have experienced first-hand the treatment by OWCP/DOL will attest to the fact that they can be sudden, arbitrary, and difficult to deal with.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: OWCP Disability & OPM Disability

A good indicator that an individual is on OWCP Disability, and not on OPM (Office of Personnel Management) Disability, is that the Federal or Postal employee did nothing other than to file a “CA” form.  Further, OWCP Disability is granted for occupational diseases, or for injuries sustained while “on the job”.  Another indicator (an important one) is that, in order to file for Federal Disability Retirement benefits under FERS or CSRS, multiple forms must be filled out, including:  Application for Immediate Retirement; Applicant’s Statement of Disability; a Supervisor’s Statement; and multiple other forms.  

The term “disability” is often thrown about in confusing ways, such that a person who is on “disability pay” or “on disability” may think that one has filed for Federal Disability Retirement benefits under FERS or CSRS.  The confusion is an important one to recognize, because a person who is eligible and entitled to file for Federal Disability Retirement benefits under FERS or CSRS must do so either while a Federal or Postal employee, or within 1 year of being separated from Federal Service.  If a Federal or Postal employee fails to file within the statutory timeframe, he or she will lose this benefit forever.  That is why it is important to make a distinction between “OWCP Disability” and “OPM Disability”, precisely because while one is on OWCP Disability, one should also probably be considering filing for OPM Disability Retirement benefits at some point.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: Interaction with OWCP/DOL

I receive calls periodically as to whether it is of greater advantage to remain on Worker’s Comp (Department of Labor, Office of Workers Compensation Program — “OWCP”) as opposed to going out on OPM Disability Retirement.  My answer remains the same:  OWCP is not a retirement system; OPM disability retirement is indeed that — it is a retirement, where one is separated from Federal Service, and you go out and do what you want to with your life.  Every decision has consequences; every act which we engage in has inherent residual effects, and we have to balance such effects and consequences.  Thus, while OWCP benefits pay a higher rate (75% tax free with a dependent; 66 2/3% tax free without a dependent), there are restrictions:  You must comply with any and all requests (or demands) of the Department of Labor; you cannot go out and get another job, or start another career — because you are deemed “disabled” and are being paid for it.  On the other hand, OPM disability retirement pays less (for FERS, 60% the first year, 40% every year thereafter), but you have the freedom of retirement — you may go out and start another career, and make up to 80% of what your former position currently pays, without losing your disability annuity.  These — and many other factors — are some things to consider when weighing the differences between OPM disability retirement, and receiving OWCP/DOL benefits.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: Use of Medical Reports

People often ask me whether or not a certain type of medical report should or should not be used.  As with almost all such questions, the answer is, “It depends”.  On what?  On the content; in the manner it is written; and by whom.

This latter basis is often a determinative one.  For instance, should a medical report from a Chiropractor be used in an CSRS & FERS Disability Retirement case?  Let me answer this question in a circuitous manner — I handled an MSPB case years ago where I had no “medical” doctors testify, but I had two chiropractors testify (I needed both of them, not because two makes better than one, but merely because they treated my client in sequence over the relevant period of time).  To the great consternation of the OPM representative, we won the case.

Thus, chiropractors can provide valid medical opinions, and the MSPB has accepted the testimony of chiropractors — as well as therapists — standing alone, without the primary support of a medical doctor.  However, my customary approach in the utilization of therapists and chiropractors, as well as physicians’ assistants, nurses, etc., is that they are most effective as secondary support to a primary medical narrative from a medical doctor.

This will often present an interesting conundrum in that, often, chiropractors and therapists will write the more detailed, substantive, and interesting report than the medical doctor.  That is okay.  To use such reports as a piggy-back upon the short, concise and straightforward medical report is often the best way to use such valuable resources.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Denials

Denials received from the Office of Personnel Management are particularly difficult news to digest. It is not so much that the denial itself obviously represents “bad news” (that is difficult enough), but for the disability retirement applicant, it casts a long and foreboding shadow upon one’s financial and economic future. For, obviously, the income from the disability annuity is being relied upon; the applicant filed for Federal disability retirement benefits under FERS or CSRS based upon the assumption that it would be approved, and the future calculation of economic and financial stability was based upon the obvious assumption of an approval. Long-term plans are made based upon the assumption of approval. Further, it doesn’t help that the basis for the denial, as propounded by the Office of Personnel Management, is often confusing, self-contradictory, and without a rational basis. It is often as if the OPM representative just threw in a few names, referred to some doctor’s reports, and essentially denied it with a selective, almost pre-determined view towards denying the claim. This is unfortunate, because the Office of Personnel Management is under a mandate to make its decision based upon a careful and thorough review of the applicant’s supporting documention. However, when the denial is received, one must fight against the initial feelings of defeat and dismay; work is yet to be done, and a view towards the future must always be kept at the forefront. A time to give up is not now; it is time to fight onward, and to move forward.

Sincerely,

Robert R. McGill, Esquire