Tag Archives: owcp opm disability retirement even with pre-existing condition

Federal Government and USPS Disability Retirement: Excessive Reliance

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under either the FERS or CSRS system, it is never a good idea to proceed with excessive reliance (or any at all, for that matter) upon expected or presumed actions on the part of one’s Agency.

The preponderance of the evidence in proving an OPM Disability Retirement application is always upon the Federal or Postal worker, and one should affirmatively and pro-actively proceed without regard to what the Agency or the Postal Service will do, says it will do, or might do during the process.

Yes, the Federal Agency has its own OPM disability forms to complete; yes, the U.S. Office of Personnel Management does review the entirety of the OPM Federal Disability Retirement forms packet, including the standard forms which the Federal agency must complete, along with other personnel information that is forwarded to OPM.

But the crux and essence of a Federal Disability Retirement applications always remains the medical information gathered and submitted, along with the Applicant’s Statement of Disability, in conjunction with the asserted nexus constructed between one’s medical condition and the positional duties of one’s job.

Any other approach is merely to run a fool’s errand for a fiefdom from which one is attempting to flee.

Sincerely,

Robert R. McGill, Esquire

 

Medical Retirement for Federal Workers: Preexisting Conditions

The concept of a “preexisting condition” necessarily entails a date before which something was in existence; thus, that condition X preexisted date-certain Y, such that X preexisted Y.  Such a condition — whatever the nature of “it” — is normally ascertainable by doctor’s notes, treatment records, etc.

The relevance of whether a certain medical condition “preexisted” a certain date, however, depends upon the issue and the forum.  For Federal OWCP cases administered under the Department of Labor, such an issue is often relevant in determining coverage, precisely because an on-the-job injury will entail causation not only regarding “how” and “where” the injury occurred, but further, encompassing whether a Federal or Postal Worker is making a claim based upon a new and heretofore unknown injury or medical condition, or is merely suffering from a condition which “preexisted” a particular date — either the date of employment, the date of claimed injury, etc.

In a Federal Disability Retirement case, whether under FERS or CSRS, filed through the U.S. Office of Personnel Management, the issue of a “preexisting medical condition” is rarely of any relevance, either on the issue of “when” or certainly not on the “how” or “where”.  OPM will often attempt to make an argument on the basis that one’s medical condition “preexisted” one’s inception date of Federal employment, but presumably the Federal or Postal employee who may have suffered from the condition was able to adequately perform the essential elements of one’s job anyway, but at some point the preexisting medical condition came to a point of progressive deterioration such that it began to impact one’s ability to perform one’s job — in which case it matters not anyway.

In a Federal Disability Retirement application, one should never be fearful of divulging the history of one’s medical condition; rather, it is the here and now which is of relevance: How the medical condition impacts one’s ability to perform the essential elements here in one’s present job, and how it now impacts such job performance.

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

Medical Retirement for Federal Workers: Chronic Medical Conditions

The concern is often expressed in the preparation, formulation and filing of a Federal Disability Retirement application under FERS, that if a medical condition has been suffered with for multiple years, and perhaps even “pre-existing” the time of Federal Service, and further, since the Federal or Postal employee has been able to perform the essential elements of the Federal or Postal job, how can it be characterized as a medical condition which prevents one from performing one or more of the essential elements of one’s job?

The answer to such a concern is actually quite simple: The Federal or Postal employee has been able to manage life, activities and the essential elements of one’s job for multiple years; the chronicity of the condition is simply an inherent part of the nature of the particular medical condition; whether because of age, or slow, progressively deteriorating impact upon the body or psyche, the medical condition has ultimately taken its “toll” upon one’s physical, mental and/or emotional capacity of the Federal or Postal worker.

Sometimes, there comes a point where the wall of tolerance to stress, pain or other increasingly debilitating symptoms can go no further.  The fact that the Federal or Postal worker has been able to perform the essential elements of the job for so many years is simply a testament to the endurance of the Federal or Postal Worker.  This is why it is important to maintain a blunt, honest and forthright line of communication with one’s treating doctor.  Often, the doctor will be the one who, for years, has encouraged the Federal or Postal worker to seek Federal Disability Retirement.

It may be that the time has come to take the doctor up on his or her advice, and to begin talking about the type of narrative and administrative support needed to obtain Federal Disability Retirement benefits under FERS.

Sincerely,

Robert R. McGill, Esqire

Federal Worker Disability Retirement: Is the Concept of “Preexisting Condition” Ever an Issue?

Sometimes, the Office of Personnel Management will refer to a medical condition which “preexisted” — and it is often confusing as to what they are referring to.  The term “preexisting medical condition” must necessarily imply the question, “Preexisting to what”?  

For health insurance coverage, the issue is obviously one of a medical condition which existed prior to the start of medical coverage, and thus the question becomes whether or not the insurance company has an obligation to pay for medical bills incurred for treatment which existed and began prior to the terms of the policy.  

For purposes of Federal Disability Retirement, however, the question of a preexisting medical condition often encapsulates an admixture of multiple issues, based upon confusing a variety of concepts.  In a denial issued by the Office of Personnel Management, some cases will be denied based upon the assertion that a particular medical condition upon which a Federal Disability Retirement application is based, preexisted the time of Federal Service, and the Federal or Postal employee — despite the existence of the medical condition — was able to perform the essential elements of the duties of the Federal or Postal position.

Thus, a person with a confirmed Veteran’s Administration rating enters into the Federal government and is able to perform the job duties as required (for example).  Such an argument (or lack thereof) by the Office of Personnel Management is thus mixing a couple of issues, and conceptually identifying it as “preexisting condition”:  that the Federal or Postal employee has a medical condition which was identified prior to entering the Federal Service; that he or she was able to successfully perform the essential elements of the job; that the same medical condition is now the basis (or at least one of them) for a Federal Disability Retirement application.  But the issue is not really one of “preexisting condition” — for, whether the medical condition existed prior to or during one’s Federal Service is really an irrelevant issue — but rather, whether or not the medical condition as such became worse such that it now prevents a Federal or Postal employee to perform one or more of the essential elements of one’s job.  

Sometimes, people get the notion that by utilizing certain language, shouting certain sophisticated-sounding catch-phrases, or referring to concepts which seem intelligible, that it actually “means” something.  The concept of “preexisting conditions” is without meaning in a Federal Disability Retirement application, precisely because the law is neutral concerning that issue.  It may sound serious, but this is not OWCP or some other legal forum which applies a criteria regarding “preexisting conditions”.

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

OPM Disability Retirement: Plantar Fasciitis, Rotator Cuff, Extremity Injuries, etc.

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, it is often the case that Federal and Postal workers (and the general population) tend to “pigeonhole” medical conditions, injuries and disabilities.  Certain medical conditions are considered “causally related” to certain types of jobs, and this type of relational categorization is often true in Worker’s Compensation claims, or other benefits sought in other areas of law. 

Thus, Plantar Fasciitis is often closely associated with Postal Workers who must remain on their feet throughout the day; Rotator Cuff injuries are often associated with the repetitive physical use of upper extremities; Shoulder Impingement Syndrome, Cervical, Lumbar & Thoracic pain, degenerative disc disease, etc., are all categorized and pigeonholed into physical types of jobs.  Yet, chronic pain of one’s extremities, joints, musculature, etc. can often severely impact more sedentary types of jobs, precisely because of the high distractability of such chronicity of pain.  Additionally, one often overlooks the excessive amount of repetitive “micro-movements” one engages in while on a computer — of the thousands of dexterous manipulations of the fingers and the concomitant engagement of the shoulder muscles, etc., in the very act of typing on a keyboard. 

Pigeonholing a medical condition to a specific type of job is a dangerous endeavor of dismissing a viable Federal Disability Retirement application under FERS and CSRS.  Careful thought and consideration should be given for each medical condition, especially when attempting to ignore the impediment it is causing in performing the essential elements of one’s job does not make the pain go away.  “Out of sight” does not mean “out of mind”, especially when dealing with pain and the underlying medical condition.

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: The Decision

I have often spoken about the “process” of filing, but that mostly concerns the administrative ordeal of filing:  of preparing, of gathering the medical documentation, of writing up the proper applicant’s statement, of putting together the legal arguments in support thereof, etc.  Then, of course, I have spoken about the “human” side of things — of the difficult human ordeal of going through the process.  There is the initial psychological barrier — of starting the administrative process, which is somewhat of an implicit acknowledgment that a person is indeed “disabled”, as if that concept or label has some sort of a “stigma” attached thereto. 

One would think that in the 21st Century, all such stigmas would have been extinguished and extinct; and, indeed, most such stigmas are merely self-imposed.  Often, we are our own worst enemy; there is the barrier of ourselves in the process, of actually starting the process.  This is often why an attorney is the best person to handle a Federal Disability Retirement application — because it allows for the process to begin, without it being so intimately and personal a matter to the applicant.

Sincerely,

Robert R. McGill, Esquire

Federal & Postal Disability Retirement: The Futility of Waiting for an Agency

In Federal Disability Retirements, the general rule is as follows:  waiting for your agency to act in some way that may prove to be beneficial to your case, is an act of futility.  Whether it is to wait for a performance appraisal; whether to see if the Agency will accommodate you, or not; whether you are waiting for a response from your Supervisor to see if he or she will support your Federal Disability Retirement application, etc. — in the end, a disability retirement application under FERS or CSRS is a medical issue.  It is not an “Agency Application for Disability Retirement”; it is not a “Supervisor’s Application for Disability Retirement”.  It is a medical disability retirement, inseparable from the Federal or Postal employee who is filing for the benefit.  As such, the proper focus should be placed upon the sufficient and substantiating medical documentation.  If the medical documentation, combined with the applicant’s statement of disability, are persuasive with respect to the correlative force of being unable to perform one or more of the essential elements of one’s job, then such a combined force makes all other issues essentially moot and irrelevant.  Don’t wait upon an agency to act; to act affirmatively without depending upon the agency is always the best route to follow.

Sincerely,

Robert R. McGill, Esquire