Medical Retirement Benefits for US Government Employees: The Watchmaker

Artisans are scarce in existence, these days.  With the constant drone for the economic push for profits, and the incessant pressures of everyday expenses, the village watchmaker, the goldsmith who personally fashions the engagement rings for the couple whom he saw just a moment ago playing outside his shop window as two children lost in the world of make-believe; that is a world we once read about, perhaps in a Dickens novel, of characters out of an era long lost and forgotten.

But the remnants of the characteristics evidencing quality and craftsmanship must survive, lest perfection be lost as a goal and exactitude no longer an achievement worth applauding.  Of course, there will always be cheap replicas; of digital watches manufactured en masse in factories where labor is inexpensive and the worth of human creativity barely given a moment’s glance.  That is why, when one comes upon a true craftsman, observing the care and skill being put into creating a product of worth is indeed something to behold.

And so it is in every endeavor.

For the Federal and Postal employee who must find, of necessity, that filing for Federal Disability Retirement can no longer be put off, it is well to heed the warnings of those predecessors who have experienced the nightmarish administrative procedures required in attaining the benefit.  While it need not take an artisan to put together an effective case, the approach one embraces should include the characteristics of that unique watchmaker:  care in the details; slowly building from a solid foundation; bringing together all of the variegated “parts”, including the medical documentation, legal arguments, effective factual statements, etc.

The Federal and Postal employee, whether under FERS or CSRS, needs to look at the process of preparing, formulating and filing for Federal Disability Retirement benefits as not only the presentation of the case, but the lasting impact of the finished product.  For, in the end, the true artisan creates not only a timepiece, but a timeless piece of work which should last well into a bright future.

Sincerely,

Robert R. McGill, Esquire

Postal and Federal Disability Retirement: The Volume-based Application

A declaration of the sheer volume of medical evidence submitted is often an indicator of the basis for which a Federal Disability Retirement application was formulated; for, in the end, if reliance of the successful outcome of a Federal Disability Retirement application is expected based upon the longevity and extent of a medical condition, the chances of an initial approval may be somewhat compromised to begin with.

Volume can never replace content; and from the perspective of the U.S. Office of Personnel Management, there is often an underlying suspicion that receipt of a thousand pages of medical documentation indicates merely that volume of treatment is being substituted for the substantive content of meeting the required legal standards.

Much of medical notation and treatment records merely reflect a particular appointment’s mechanical applications — continuation of previous treatment plan; refill of prescriptions; standard positive or negative responses to particular questions; prospective treatment modalities; and, as supportive evidence attached to a substantive medical report, they can reinforce the satisfaction of the legal criteria of establishing the necessary nexus between one’s medical condition and the inability to perform the essential elements of one’s job.  But left as a replacement for the doctor’s explicit statement confirming such a nexus, it remains a hollow voice within an expansive but empty chamber.

One should never mistake the legal distinction between “primary” evidence and “supportive” evidence.  The former is meant to establish the nexus between one’s medical condition and the essential elements of one’s job; the latter is submitted to reinforce the former.  When one utilizes the former as the substitute for the latter, it is like the self-delusion that just because you are the best player on a pick-up team in your neighborhood, you are ready to enter into the world of professional sports.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Foundational Paradigm

Ultimately, Federal Disability Retirement is based upon the persuasive delineation of three primary elements:  A medical condition; impact of the medical condition upon one or more of the essential elements of one’s job; and an inability on the part of the agency to accommodate the resulting impact of the medical condition upon one’s inability to perform all of the essential elements of one’s job.

How one proceeds to “prove” the case; what “kind” of evidence one needs to provide; the qualitative nature of the proof to be submitted; the quantity and volume of the type of evidentiary submissions to be included; these are determined by necessity based upon the nature of the medical condition itself.

Thus, some medical conditions may require merely a few pages; others, extensive supporting documentation, including treatment notes, diagnostic test results, explanatory clinical encounters and narratives which show a history of treatment-resistant modalities of medical applications as well as fulfillment of such extensive attempts which validate that the patient/applicant is not a “malingerer”, but rather exhibits symptoms which defy traditional approaches both for diagnoses and treatment.

It is always upon the first of the three elements identified which forms the foundational basis of a Federal Disability Retirement application; the sequential nexus of the two following almost creates itself, like the phoenix arising from the ashes, only in this case, from the debilitating medical condition from which one suffers.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: Time and Concision

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 to allocate the time properly — not from one’s own perspective, but from the viewing aspect of the Office of Personnel Management.

This is often a difficult point to consider, and indeed, more difficult to acknowledge and recognize.  For, the applicant who is preparing and formulating a Federal Disability Retirement application often views the substantive content of a Federal Disability Retirement packet as an opportunity to spew out all of the facts and circumstances which coalesced and accumulated in the course of the past few years, which resulted in the present need to file for Federal Disability Retirement benefits in the first place.

Thus, the compendium of assertions often includes medical facts, opinions, etc.; allegations concerning hostile work environment; mistreatment by coworkers and supervisors; the bathtub (and the baby) encapsulating every conceivable medical diagnosis and symptoms; allegations against one’s agency; and multiple other compilation of facts, opinions, statements and propositions.  But a Federal Disability Retirement application is neither the place, the time, nor the proper forum for all such aggregations of such information.

Concision and narrow, focused pinpointing of facts, statements, and references to medical conditions; their impact upon one’s inability to perform the essential elements of one’s job — that is the key to an effective Federal Disability Retirement application.

Time is a valuable commodity — for everyone, including the Case Worker at OPM.  Moreover, a focused approach — one guided by a concise and time-sensitive criteria — will be the one which OPM will recognize as one worthy of consideration, if not for the simple fact that it is an “easier read” than that one in the corner with a 36-inch stack of medical records.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Quality & Quantity of Medical Report

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, it is often asked as to the quantitative sufficiency of the medical documentation to be submitted.

Qualitative sufficiency for Federal Disability Retirement applications, at least on a generic level, is an easy one to answer — the substance of the medical documentation must meet the legal standard of proof.  If the Office of Personnel Management or the Merit Systems Protection Board approves the Federal or Postal employee’s Federal Disability Retirement application under FERS or CSRS, then obviously both the quality and quantity of medical documentation met the standard of proof.  

But an answer based upon “after the fact” circumstances is rarely useful; the generic answer of, “Submit medical evidence such that it meets the legal burden of proof, of Preponderance of the Evidence”, might be well and good, but what does that mean?  

Ultimately, the reason why such questions as to sufficiency of medical documentary submission cannot be answered in a generic manner, is that each particular case is unique, and any imposition of a general rule is dangerous because, the moment the general rule is followed and violated (with a denial from the Office of Personnel Management), then the rule becomes obsolete and irrelevant.  

The quality of the medical documentation to be submitted must ultimately show to OPM that each of the legal criteria are met, and that there is a nexus between one’s medical conditions and the type of work that one performs.  

Quantity of medical documentation is ultimately determined by the quality of the medical narrative.  While generic in scope, the general approach is that one should submit only the extent of medical documentation sufficient to prove one’s case; and in each particular case, what that proof must consist of, is unique, particularized, and ultimately personalized to the individual Federal or Postal Worker who is preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Workers: The Quantitative Approach

The problem with submitting a Federal Disability Retirement application under FERS or CSRS based upon the “quantitative approach” (submitting a voluminous medical file which, by the sheer weight, extent and thickness of the file, reveals the severity of the multiple medical conditions) is that it often fails to provide the proper bridge between the particular medical condition a Federal or Postal employee suffers from, and the impact upon the essential elements of one’s job.

Certainly, medical records, notes, diagnostic test results, etc., can provide a narrative delineation of one’s continuing medical conditions — but the question becomes, a narrative to what end?  The Office of Personnel Management will often review a large stack of medical documentation and simply conclude that there has been insufficient medical documentation, and further, that the medical documentation submitted fails to show that such conditions are severe enough to prevent one from perform one or more of the essential elements of one’s job. That is because the mere existence of a medical condition — no matter how extensive such medical conditions have required in terms of hospitalizations, testing, surgical or other procedures, etc. — is not enough to satisfy, by a preponderance of the evidence, the criteria applicable for eligibility for Federal Disability Retirement benefits under FERS or CSRS.

Remember, always use the golden rule:  quality over quantity.  And in a Federal Disability Retirement application under FERS or CSRS, quality means the bridging of that conceptual gap between the medical condition, and the essential elements of one’s job.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Proper Approach

Some believe that, when formulating and compiling a disability retirement application, that quantity of supporting documentation will win the day — all medical reports, records, statements from friends, family, co-workers, etc.  Sometimes, however, it is better to refrain from providing everything all at once; for, if a determination is made that there is sufficient documentation to prevail in a disability retirement application, it is sometimes the wiser course to restrain the natural inclination to bombard the Office of Personnel Management with all of the available documentation.  This is merely a strategic bit of advice; yet, in practical terms, inasmuch as every disability retirement case has the potential to be denied at the First Stage, and OPM would in that event be requesting additional supporting documentation, it is often a good idea to “withhold” and “keep back” a secondary source of supporting documentation — but only if the primary source of supporting documentation is confidently adequate to win at the first stage.  It is a discretionary method of approaching the compiling of data and documentation at the first stage — a decision which should be made with wise counsel.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Quality versus Quantity

While most Federal Disability Retirement applicants whom I represent, and have represented, retain me at the initial stage of the application, a good many of my clients come to me at the Second (Reconsideration) and Third (Merit Systems Protection Board) Stages of the process.  I find that the vast majority of the individuals who attempted to put his or her disability retirement packet together, and got it denied at the first level, attempted to simply overpower the Office of Personnel Management with a voluminous compendium of medical records.  Wrong move.  Always place quality over quantity.  Streamlining a case is often the key to winning a disability retirement case. 

This is just as true for cases involving Fibromyalgia, Chronic Fatigue, Multiple Chemical Sensitivity, etc.  Because such medical conditions are often thought of as “not quite” legitimate conditions, applicants often make the mistake of thinking that by overloading the Office of Personnel Management with a thick, unwieldy file of medical records, that the sheer weight of the records will convince OPM that it is a “legitimate” case.  Wrong move.  Don’t be defensive.  Such conditions as Fibromyalgia, Chronic Fatigue, Multiple Chemical Sensitivity, Bi-polar Disorder, panic attacks, Generalized Anxiety Disorder — they are all legitimate basis for disability retirement.  Such medical conditions need not be apologized for.  Such conditions need not be “defensively” or “apologetically” submitted.  They are legitimate conditions to file; they just need to be submitted in the proper manner — by having a strong, streamlined, and cohesive medical narrative, properly prepared by the doctor, under the guidance of a Federal Disability Retirement attorney.

Sincerely,

Robert R. McGill, Esquire

Common Mistakes in Filing for CSRS & FERS Disability Retirement III

Words are peculiar animals; they are meant to convey meanings through stringing together, creating conceptual models, images, descriptive thoughts. Thus, one would think that the greater quantity of words would lead to a greater level of thoughts conveyed, images created, etc. However, what often happens (a commond mistake found in unrepresented applicants who file for disability retirement under FERS & CSRS) is that there is a ‘fatigue factor’ by the reader: in this case, the reviewing person at the Office of Personnel Management. People often either overstate his or her medical disability, or tend to think that pages and pages of a stream-of-consciousness narrative about one’s medical conditions will persuade the reviewer of the seriousness of the medical condition. Neither are necessary. Let the medical condition itself speak to the seriousness. The applicant does not need to overstate it; and a voluminous narrative only points out and emphasizes a suspicion that there is some underlying reason as to why you feel the need to explain yourself so much. Use of words is a ‘balancing act’ — using the right words; explaining the right amount; creating the right string of thoughts and images. An effective disability retirement application must find the right balance of all of these elements.

Sincerely,

Robert R. McGill, Esquire

Common Mistakes in Filing for CSRS & FERS Disability Retirement II

Always emphasize quality over quantity of medical records & reports. A common mistake often made by unrepresented individuals is that he or she will ship off to the Office of Personnel Management a large packet of medical records, bills, appointment sheets, raw blood test results, etc. A potential applicant is always wise to try and look at it from OPM’s viewpoint: if you were a reviewer at OPM, which disability retirement application that is assigned to you would you look at on a Monday morning — the one that is 6-inches thick, or the one that is 1/2 inch thick? Further, untranslated raw test results rarely effectuate a positive response. Raw data that merely conveys numbers, unless interpreted by a physician as to the medical significance of such raw data, will not impress anyone at the Office of Personnel Management. It is the job of an attorney to use the tools of an attorney: effective and descriptive words, and to help the applicant to find the proper descriptive words to convey the serious medical conditions that he or she suffers from.

Sincerely, Robert R. McGill, Esquire