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

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

Federal Employee Medical Retirement: Preexisting Conditions

The Office of Personnel Management will sometimes make the following fallacious argument:  “Because your medical condition appears to have preexisted the time of your Federal Service, and you have been able to perform your job, you are not entitled to Federal Disability Retirement benefits.”  

This argument may take on various forms, with embellishments on the language used, but the argument as quoted represents the essence of what OPM will often state.  While the argument itself makes one scratch one’s head, there are implicit sub-arguments which, if extracted, extrapolated and projected/assumed, may bring one to a better understanding of what OPM is trying to say, and thereby be able to rebut and address such an argument.  The expanded version of the argument goes as follows:  “You had a diagnosed medical condition X prior to beginning your career with the Federal Service (often evidenced by a VA disability rating, or an MRI showing such).  You were placed in job Y, which you were able to do all of these many years.  From the time of your Federal Service to the present, there has been no defining moment or event which reveals that your condition worsened; only that you now state that you cannot perform your job.”  

This expanded version is what OPM is often attempting to argue.  Inasmuch as “pre-existing conditions” are not supposed to be a factor in Federal Disability Retirement cases (as opposed to being one in FECA cases), how does one address it?  By pointing out to the progressively deteriorating nature of the medical condition; by having a discussion with the treating doctor that, over time, a chronic condition can progressively deteriorate the human body, through fatigue, longevity, and chronicity of pain (or a chronic nature of Major Depression, Anxiety, stress, etc.), and such progressive deterioration often arrives at a critical point where, once passed, there is a sudden decline in the ability of a Federal or Postal worker to continue to perform a certain type of work.  

The key to an argument is to reframe the argument, so that one may understand and address it.  Only upon understanding the argument, can one begin to address it.

Sincerely,

Robert R. McGill, Esquire