Disability Retirement for Federal Workers: The Unguided Doctor

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, it is important to guide the doctor into properly preparing and formulating the medical narrative report.

This is not a matter of “telling what the doctor to say”.  The treating doctor is obviously aware of the types of medical conditions that the patient — the Federal worker who is filing for Federal or Postal Disability Retirement benefits — is suffering from.  The doctor’s professional integrity, as to what his or her medical opinions are, should always be preserved and be paramount.  

Further, it is merely a factual issue as to whether the doctor will be supportive of such an endeavor, and such support can only come about by having a direct and frank discussion about the requirements of one’s positional duties and how those positional duties are impacted by one’s medical conditions.  

Rather, the issue of guiding the doctor is one of informing him or her of the particular elements which are necessary and unique in a Federal Disability Retirement application, which must be addressed in a narrative report.  For, otherwise, the unguided doctor will simply issue a narrative report with a different focus and a different end.

Guidance is merely knowing what the goal of a particular activity requires, and unless the treating doctor understands the technical requirements of what is needed (the end-goal), that doctor will merely attempt to meander by accident in a formulation which may include elements which are more harmful, than helpful, in preparing, formulating, and filing for Federal Disability Retirement benefits under either FERS or CSRS.

Sincerely, Robert R. McGill, Esquire

Postal and Federal Disability Retirement: Supporting the Concept

In preparing, formulating and filing a FERS or CSRS Federal Disability Retirement application, the important first step in the “preparation” phase — or, one might even term it conceptually as the “pre-preparation phase” — is to engage the treating doctor with the conceptual framework of what Federal Disability Retirement entails and encompasses.  

As has been repeated many times previously in other blogs, doctors are not administrators, and ultimately detest the need to annotate, narrate, write reports, etc.  The legal system has forced doctors to keep records, if only for their self-protection in the event of a question of malpractice, and the requirement of keeping office records and notes has had the positive corollary effect of forcing doctors to “think through” the procedural steps of what it is that they are “doing”.  

Requesting the treating doctor to support a Federal Disability Retirement application has the identical positive result of forcing the doctor into an admission that one’s medical condition has come to a crossroads:  prior treatment modalities have not proven to be effective; the chronic and progressively deteriorating nature of the physical or psychiatric condition has shown to be “treatment-resistant”; the time has come to acknowledge that a different mind-set must be embraced — one which includes a period of rest, restorative time, and a stage of recuperation away from the activities which the Federal or Postal employee spends on average 40 – 50% of the time at:  one’s job.  

Speaking to the doctor about his or her support and role in preparing a Federal Disability Retirement application is the first, necessary, and vital step in the preparation, formulation and filing of a Federal Disability Retirement application under either FERS or CSRS.  How best to approach the doctor, the timing, the words and concepts to use, etc., are all part of that preparation.  

If it is time for the Federal or Postal worker to recognize that one’s medical conditions are preventing the Federal or Postal worker from performing one or more of the essential elements of one’s job, it is time to think about pre-preparing the treating doctor.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Is the Doctor in, Please?

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, the support of one’s treating doctor is essential in putting together an effective presentation to the Office of Personnel Management.  Sometimes, even doctors have to be reminded of his or her “obligation” to a patient.  When, how, and in what manner of approaching the doctor, is a discretionary element of the process best left up to the patient.  

The reason why the “treating doctor”, as delineated by cases and opinions rendered by Administrative Judges at the Merit Systems Protection Board and by Judges at the U.S. Court of Appeals for the Federal Circuit, is the best one to provide a clinical assessment and evaluation of one’s ability or inability, and the extent thereof, of performing one or more of the essential elements of one’s job, is that the long-term relationship that has been (or should have been) established over these many years of treatment, is a foundational basis of being able to ascertain the abilities, capabilities, and limitations of the patient’s physical, emotional and mental condition. 

If a treating doctor hides behind the excuse of saying that he or she is not “equipped” to make a disability determination, or that there are doctors “out there” who specialize in disability determinations, and he/she is not one of them, an explanatory discussion should be engaged in with the doctor, which should include at least the following three (3) elements:  (1)  A reminder of the history of the doctor-patient relationship, (2) that your particular doctor is the one who knows the intimate details of your medical conditions and the history of treatment engaged in, and (3) that such administrative headaches resulting in obtaining Federal Disability Retirement benefits from the Office of Personnel Management is a vital part of the long and recuperative process that the doctor has been trying to attain.  

Ultimately, it is the treating doctor who is the best one to render an opinion as to whether a Federal or Postal employee whom the doctor is treating, can continue to perform all of the essential elements of one’s particular job.  The question then is, Is the doctor in?  Meaning:  Is the doctor still going to “be there” when it really counts?

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: The Reluctant Doctor II

Dealing with the Reluctant Doctor — one who presumably has been treating the potential applicant for Federal Disability Retirement benefits for at least several months, but often for several years — is a rather “touchy” subject.  

On the one hand, the build-up of confidence, confidentiality, and security developed over many years of having a doctor-patient relationship is at stake; on the other hand, the Federal or Postal employee has come to a critical point in his or her future, career and professional life, where the support of the treating doctor in the preparation, formulation and filing of a Federal Disability Retirement application has become necessary.  

Doctors, by nature dislike the administrative aspects of preparing lengthy medical narrative reports.  Yet, most doctors recognize the necessity of that aspect of their practice, and are willing to perform the service as part of their duty to their patients.  A diplomatic, sensitive balance must be struck, but one that is honest and placed within the appropriate context of one’s health and future well-being.  

In essence, the doctor must be asked about his or her support in preparing a Federal Disability Retirement application under FERS or CSRS, but in the context of a larger discussion concerning one’s health, treatment modalities, permanency and chronicity of disabling medical conditions, and future treatment.  In essence, the “reluctant doctor” must be persuaded to disrobe his or her reluctance, for the sake of the patient’s health.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: The Reluctant Doctor

In preparing, formulating, and filing a Federal Disability Retirement application under FERS or CSRS, the linchpin (sometimes spelled “lynchpin”) is comprised of a supportive doctor who is willing to provide substantive medical evidence, by a preponderance of the evidence, that a Federal or Postal employee is no longer able to perform one or more of the essential elements of one’s job, and that the medical condition will last a minimum of 12 months.  

Originally, a linchpin referred to a metal fastener which prevented a wheel from becoming separated or dislodged from the axle.  Similar to the conceptual analogy of the “weakest link” in a chain, the idea of viewing a Federal Disability Retirement application in such terms and perspective is to recognize the centrality of a foundation, and how everything else is supported by that foundation.  If the foundation itself is weak, then the chain may snap, and the wheel may fall off the wagon, and everything which is supported by the foundation may come tumbling down.

Such a weak linchpin may be characterized by “The Reluctant Doctor.”   For, ultimately, it will be the treating doctor’s opinion which will provide the primary basis of a Federal Disability Retirement application under FERS or CSRS.  To presume the support of one’s treating doctor may reveal an unfounded sense of confidence.  To declare that, “Of course my doctor will support me.  He’s been my doctor for X number of years,” is to be naive about the psychology of doctors.

Doctors enjoy engaging in the practice of medicine; they abhor the administrative necessities of supporting their patients in preparing a Federal Disability Retirement application.  The Reluctant Doctor is fairly widespread; it is up to the potential applicant, or his/her attorney, to explain the process, beginning with a simple request for an assurance of support from the patient — the applicant who will be filing for Federal Disability Retirement benefits under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: Don’t Assume

We are all familiar with the acronym-like adage which can be extracted from the word “assume”.  In preparing a Federal Disability Retirement application under FERS or CSRS, the first question that one must ask of one’s self is:  “Do I have a supportive doctor?”  If the answer is an unequivocal “No”, then entertaining even the thought of proceeding forward with the process is a virtual act of futility.  

Now, to all unqualified statements, there are exceptions to the rule.  There are, indeed, medical conditions where the mere treatment records, office notes, etc., reveal irrefutably of a medical condition of such severity that there is no question as to its impact upon one’s ability/inability to perform the essential elements of one’s job.  But that is rare.  If the answer to the original question is:  “He may be…”  “I assume he is supportive…”  “He seems supportive because…”   While these are niceties in one’s figment of one’s imagination, and foster a sense of security and a warmth for a doctor-patient relationship, such answers all have an undercurrent of an assumption.  Don’t assume, if you are planning to go forward with a Federal Disability Retirement application.  Instead, make an appointment with your doctor and have a frank and open discussion.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: Forms

In preparing, formulating & filing a Federal Disability Retirement application under FERS or CSRS, one must fill out the various “forms“:  SF 3107 with schedules A, B & C under FERS (for CSRS, SF 2801 with schedules A, B & C); as well as SF 3112 A – D.  These forms are necessary in filing a Federal Disability Retirement application (as well as some which are not listed here). Along with these Standard Forms (thus, the “SF”), one must attach supporting documentation to be eligible for Federal Disability Retirement benefits.  However, all applicants must be fully aware that the Standard Forms neither explain, nor necessarily “follow”, the expansive laws which govern Federal Disability Retirement.  

Forms are created and published by bureaucrats who are neither aware of, nor are informed about, statutes, regulations or cases which define, refine or otherwise expand upon the complex laws which govern Federal Disability Retirement law.  As such, they are the “bare bones”, skeletal requirements.  In filling out such forms, therefore, one does so without any guidance or knowledge by the mere reading of the “instructions” on the forms.  As such, one should “beware” in trying to complete any of the Standard Forms when preparing a Federal Disability Retirement application under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Arming the Doctor after Disarming

It is one thing to provide an explanation of the process of filing for Federal Disability Retirement benefits under FERS or CSRS to the treating doctor; that is simply not enough.  Providing an explanation “disarms” the health professional.  While such explanation and helping the doctor to understand the process is certainly helpful, ultimately the treating doctor needs more than information; he or she needs guidance in order to “arm” one’s self with the tools necessary to help the patient. 

Fortunately, most doctors are professional, compassionate, and eager to help.  Writing medical reports are an administrative aspect of the practice of medicine which is not only a headache, but takes the doctor away from the valuable and limited time for actually treating the patient.  It is therefore important for the Federal or Postal employee who is applying for Federal Disability Retirement benefits under FERS or CSRS to “arm” the doctor with the necessary tools needed in order to successfully prepare, formulate and construct a sufficient and effective narrative report in order to “pass muster” with the Office of Personnel Management.  The first and primary rule in helping to prepare the doctor is to always protect and maintain the integrity of the doctor.  Truth in every endeavor, and especially in filing for Federal Disability Retirement benefits under FERS or CSRS, should be the ultimate guiding light.  How that truth is stated, however, is where the guidance, tooling and “arming” comes into play.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Disarming the Doctor

To some extent, there is indeed a “difference” and a “distinction” between an Administrative process of law, and a “legal” or “courtroom” (i.e., “adversarial”) process of law.  Doctors are, by either personal & professional direct experience, or from hearing or reading about others, keenly aware of the horrors of the “legal” process.  Malpractice lawsuits, personal injury lawsuits, subpoenas, depositions, being cross-examined by a defense attorney (or the Plaintiff’s attorney, whichever may be the case) on the stand — these are all intimidating factors that are deliberately avoided. 

Because of such negative experiences, perspectives, memories or viewpoints about the legal process, it is often an unfortunate fact that doctors “run for cover” whenever there is even a hint that one is being asked to involve him or herself in such a “legal process”.  Doctors will outright refuse to write a medical report; one may be dropped as a patient suddenly and without warning; there may be considerable delays and obfuscation in responding to a request for a written narrative report.  These are merely some of the underlying reasons why an SF 3112C should never be used — because it does not properly explain what it means to “get involved” in the administrative process.  To this extent, it is important to have an attorney who will carefully, and with great tact, explain the process of obtaining Federal Disability Retirement benefits — and thereby “disarm” the doctor from being intimidated.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: The Doctor

Out of all of the elements comprising a Federal Disability Retirement application — the various aspects, including medical, personal, impact-statement, statement of disability, Supervisor’s Statement, etc. —  the essence of it all must be coordinated around the core of the case:  the medical narrative report

That alone has multiple, inherently complicating factors:  Why won’t the surgeon write the report?  Why is it that the Pain Management doctor, or the Internal Medicine doctor, or the Family Physician is the one often most cooperative and willingIs the Chiropractor’s opinion sufficient?  Is it helpful?  How detailed must the report be?  How long must you be a patient in order to establish the threshold of having a “longstanding doctor-patient relationship“?  Are medical records in and of themselves sometimes sufficient to obtain Federal Disability Retirement benefitsIs it sufficient to get a Therapist to do the report, without the Psychiatrist?  Can a therapist alone win a case? Must I undergo a Functional Capacity Evaluation?  Can I use reports from an OWCP Second Opinion doctor?  If my Psychiatrist only sees me for five minutes each time and prescribes the medication, is it necessary for him/her to write a report?  How detailed must the report be?  Is the doctor going to understand, let alone actually read, the SF 3112C?  These are just some of the questions which one is immediately confronted with, in beginning the process of putting together a Federal Disability Retirement application under FERS or CSRS.  It is a complex, overwhelming process.

Sincerely,

Robert R. McGill, Esquire