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

OPM Disability Retirement: OWCP Doctors, and Others, Etc.

Can a doctor with whom one has been treating, but one which was obtained through the Federal Employees’ Compensation Act, Department of Labor (FECA/DOL), Office of Workers’ Compensation Program (OWCP), be an effective advocate for one’s Disability Retirement application?  Of course.

Often, however, there is a complaint that the “OWCP doctor” is not very responsive to a Federal or Postal employee’s attempt to approach the question of filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS.  As FERS & CSRS Disability Retirement is based upon proving by a preponderance of the evidence one’s medical inability to perform one or more of the essential elements of one’s job, it is crucial that the Federal or Postal employee contemplating filing for Federal Disability Retirement benefits have a supportive doctor.

While the Merit Systems Protection Board’s expanding case-law holdings continue to reinforce the idea that the most effective advocate in a Federal Disability Retirement case is a “treating doctor”, as such, medical reports obtained through 2nd opinion or “referee” consultations, or via filing for Social Security Disability benefits, may have some limitations on their usage; nevertheless, the weapons of arguing that an “independent” source of medical review also found that one could not perform one or more of the essential elements of one’s job, can be an effective substantive argument.

As for the OWCP-treating doctor, sometimes those forms completed by such a doctor will be enough to meet the eligibility requirements for OPM Disability Retirement — but that is an individual assessment based upon the uniqueness of each case.

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

CSRS & FERS Disability Retirement: OWCP, Light Duty & Federal Disability Retirement

As I stated in my previous blog, OWCP is not a retirement system. Instead, it is meant to return an injured worker back to productivity with his or her agency. This is done through means of providing for medical treatments; paying the Federal employee temporary total disability benefits during the time of treatment and recuperation; then, if the Federal or Postal employee is unable to return to the former position in full capacity, to offer a “modified position” to the employee.  At each step in the process of OWCP/DOL, the onerous and burdensome hand of the process becomes clear — for, if at any time, the employee refuses to follow the mandates given by OWCP, the real threat of having one’s temporary compensation suddenly terminated is always a possibility. 

Thus, in accepting OWCP benefits, there is a clear trade-off:  tax free compensation for the price of being completely governed by OWCP.  Then, when the modified job offer is given, you have no choice but to accept it, in whatever form, and must be accepted “as is” — otherwise, your temporary total disability payments will be terminated.  Remember, however, that accepting such a position does NOT preclude you from filing for disability retirement benefits, because the case-law governing Federal Disability Retirement has a “safety” feature:  in order to be considered a legally viable “accommodation” under the law, the modified job that is offered and accepted must have been one which was previously in existence, and vacant.  It cannot be your old job slot, modified by a piece of paper prepared by your agency and the Department of Labor.  It must be a true job.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: OWCP & Federal Disability Retirement

I often tell my clients that OWCP/DOL is not a retirement system. It is a system which was meant to address the medical injury resulting from a work-place accident or occupational hazard resulting in a medical issue arising, such that compensation is allowed for a period of time during a process of recuperation.

As unfortunate as it is, Worker’s Comp has become synonymous with “harassment” and “difficult”, where approval for wage compensation, for medical treatment (including necessary surgery) has meant months and months — and often years — of wrangling and fighting; of having an OWCP case manager or adjuster being rude, failing to respond, failing to return telephone calls, and just when it seems as if something may be done, the OWCP caseworker is switched to someone else who is equally unresponsive.

Then of course there is the intrusiveness — of the OWCP nurse who sits in with you and your doctor, in a context where it is as if the “enemy” is watching that relationship which is supposed to be sacred and private:  a conversation between a doctor and the patient. It is, as I have often told clients, “a hard road to travel.”  Yet, where the medical condition, injury or disability arises as a result of a work-place accident, obviously it is financially beneficial because it pays more. That is the bottom line.  Further, it is tax-free.  But it is not a retirement system. 

Disability retirement pays less; it matters not whether the injury or medical condition occurred “on the job”; you are not required to be examined by a “second opinion doctor”; you do not have to obtain prior approval from a case manager to go and seek medical treatment.  But the benefits are much lower; it is taxable.  However, is it disability retirement.  In such a retirement, you are meant to go out and to do other things in life, including other work.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: The Physician I

Initial inquiries concerning filing for Federal and Postal disability retirement benefits often ask the following question: Do I have a doctor to whom I can refer the individual? This question often follows upon the unfortunate circumstance that the individual does not have a very supportive doctor, or has been under the “medical care” of an OWCP-referral doctor.  The answer is always an unequivocal:  No.  The reason:  The Merit Systems Protection Board is very clear about the issue — that in Federal Disability Retirement cases, a medical report is persuasive when written by a doctor who has a long-standing patient-doctor relationship; has had regular contact with the individual; has had clinical contact over a sufficient period of time, such that the doctor can, within reasonable medical probability, provide a rational basis for stating that the individual is no longer able to perform one or more of the essential elements of his or her job. Thus, even before considering taking a disability retirement, it is important for the individual to make a proper assessment as to whether or not one’s doctor is “supportive”; if not, it may be a good idea to think about switching doctors, and finding one who is supportive.

Sincerely,

Robert R. McGill, Esquire