Disability Retirement from the U.S. Office of Personnel Management: Concurrent Actions

Idioms often convey an underlying truth recognized and identified by a specific culture or population; they are statements from an experiential aggregation of similitude, based upon a shared set of values.  The phrase, “When it rains, it pours”, is easily a recognizable idiom; that when things go wrong, multiple wrong things tend to occur altogether, all at once.  It is somewhat of a tautology, as when “X is Y, X are Ys”.  But it is in the very pluralization of the outcome which makes the differentiation significant.

For Federal and Postal employees contemplating filing for Federal Disability Retirement benefits, whether the Federal or Postal employee is under FERS or CSRS, the engagement of the administrative and bureaucratic process of preparing, formulating and filing for FERS Disability Retirement benefits rarely results in a vacuum.

Often (or perhaps one is forced to begin with the prefatory clause, “All too often”), the long and complex history of harassment, complaints, formal complaints, grievances, lawsuits, EEO filings, etc., precede the filing of a Federal Disability Retirement application, thereby complicating one’s Federal Disability Retirement application with much baggage, historical aggregation of enmity and acrimony, and creating a simple set of causal facts into a convoluted compendium of complexities.  All of a sudden, the soft sounds of rain turn into a downpour of ferocious flooding.

In such cases, in formulating one’s Federal Disability Retirement application, it is important to bifurcate the compounded complexities, and to simplify, streamline and segregate.  From the viewpoint of the U.S. Office of Personnel Management, the very agency which receives and decides upon all Federal Disability Retirement applications, the mixing of concurrent actions and issues merely complicates matters.

As we all do, we would prefer to hear the soft patter of rain, and not the thunderous mess of a downpour.  Even the plants in the garden recognize that.

Sincerely,

Robert R. McGill, Esquire

 

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

Medical Retirement Benefits for US Government Employees: The Balance of Information

In every submission of documentary evidence for a Federal Disability Retirement application, whether under FERS or CSRS, there is the need for discretionary decision-making.

Not every piece of information is relevant or necessary; volume of attachments does not make for sufficiency of substantive content; allowing for certain information to “speak for itself” is often more effective than a long-winded explanatory addendum; and the extent of irrelevant or unimportant information attached or included may well have a decidedly negative impact upon a decision, both in terms of questions raised as to the reason for inclusion of such material, and the detracting nature of such information from the centrality and essence of the submission.

Balance of information is always a consideration.  As time is always of importance, so is maintaining the acuity of attention upon the case worker assigned to review, evaluate and decide upon a case.  Streamlining; making certain that the focus is always upon the nexus between one’s medical condition and the ability/inability to perform one or more of the essential elements of one’s job; and the editorial process of discretionary inclusion of relevant material — these should be the final steps in the formulation and compilation of a Federal Disability Retirement application just prior to submission to the U.S. Office of Personnel Management, whether under FERS or CSRS.

Balance the information — always in favor of relevance, importance, and substantive content.  Fluff is best left to descriptive articulation in a fictional genre.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: Quantifying Quality & Qualitative Quantity

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 make discretionary decisions concerning multiple aspects of a Federal Disability Retirement application — including the volume, extent, nature, and quality of the medical documentation to be submitted.

Because it is the Applicant (the Federal or Postal employee who is submitting the application) who has the “burden of proof” — that burden which states that by a preponderance of the evidence, one’s Federal Disability Retirement application is more likely to be so than not so — it is therefore up to the Applicant to make determinations as to the quality and quantity of the medical documentation and any other relevant attachments.

Qualitative sufficiency is often a difficult measure to determine; quantitative significance is equally difficult — as in, how much is enough? On the one hand, to submit a thousand pages of medical notes, reports, etc., would probably be “too much”.  But a case which only includes 5 pages of medical reports and notes, while seemingly “too little”, can be more than sufficient if the quality of the records and reports is indisputable and irrefutable in determining that a Federal or Postal employee is no longer able to perform one or more of the essential elements of one’s job.

Ultimately, the discretionary decision will come down to a matter of experience — for it is based upon prior experience that one can make better decisions for the future.  To that extent, to be inrepresented in attempting to obtain Federal Disability Retirement benefits is obviously a disadvantage, because an unexperienced Applicant is merely entering into the arena of Federal Disability Retirement law based upon a “hit or miss” history of inexperience.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Additional Supporting Evidence

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management under FERS, there is nothing to preclude one from attaching multiple supporting documentation in proving one’s eligibility for Federal Medical Retirement benefits.

In doing so, however, it is appropriate to keep in mind that the conceptual paradigm of “supporting” should be just that — it must be to assist, help, or otherwise enhance such evidence which constitutes the central component of one’s Federal or Postal Disability Retirement application.

Thus, “supporting” should not be the primary basis of one’s evidence, but rather, that which further enlightens and advances the primary documentary evidence.  For example, statements from co-workers, photographs, and similar supporting evidence can be provided to OPM, but only if –and as — it enhances the primary documentation, which should be comprised of medical documentation from treating doctors, specialists, referral consultative medical providers, etc.  Even ancillary supporting documentation — SSDI approvals, VA assignation of disability ratings, OWCP acceptance, OWCP second-opinion doctor’s reports, etc — should be viewed as “supporting”.

It is important, as an aside, to recognize that the OPM Case Worker does not, and will not, expend hours upon hours reviewing every piece of document one submits, and therefore it is important to streamline and provide an efficient, effective paper presentation.

Think about it this way as a guiding principle:  If you approach a file which is an inch thick, or one which is 8 inches thick, which do you tackle on a Friday afternoon?

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

OPM Disability Retirement: “The Grab-bag”, “Volume” and the “Last Minute” Case

Procrastination leads to filing a Federal Disability Retirement application under FERS or CSRS at the last minute, which leads one to simply attach a volume of medical documentation and list a grab-bag of medical conditions. 

Sometimes, such an approach is thought to be the only way of preparing, formulating, and filing a Federal Disability Retirement application, especially when there is little or no time left in which to meet the statutory deadline for filing (a Federal or Postal employee must file within 1 year of being separated from Federal Service).  It may well be the only way to file, given that a Federal or Postal employee has only days left to submit the Federal Disability Retirement application. 

The fact is, one can only argue the merits of a case if, and only if, one has met the Statute of Limitations; if one fails to file in a timely manner, then there is simply no opportunity at all to argue the substantive basis for the Federal Disability Retirement application.  Yet, even in “Last Minute” cases, it is important to pause and attempt to streamline a case.  Why?  Because once a case has been filed, and the Statute of Limitations has passed, a Federal or Postal employee is unable to change or otherwise amend the stated and identified medical conditions, as listed on Standard Form 3112A. 

As such, even at the last minute, the grab-bag volume case should be — and can be — prepared and formulated with some thought.  In the end, it will serve the Federal or Postal employee who is filing for OPM Disability Retirement benefits under FERS or CSRS, well.

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

Disability Retirement for Federal Government Employees: The Medical Records

Federal Disability Retirement under FERS & CSRS is essentially “connecting the dots” between one’s medical conditions (whether singular or multiple) and the impact of the medical condition(s) upon one’s ability to perform all of the essential elements of one’s job.  The treatment records, also, are helpful in the matter of connecting the dots, as the Office of Personnel Management will often request a copy of the medical records — evidence of treatment over the years — in order to ascertain the extent of the medical conditions claimed.  

This can sometimes present a problem, when a Federal or Postal employee has switched doctors, has quietly endured the pain of the medical condition with little or no treatment over the years, or where the doctor fails to annotate any legible or detailed notes in his or her treatment notes.  Normally, however, there is a consistency of evidence between treatment/office notes and the medical narrative which the doctor prepared; or, between the diagnostic results and the clinical findings and conclusions of the treating doctor.  Where there is a lack of medical records “backing up” the narrative report of the doctor, often a Functional Capacity Evaluation or an “independent medical evaluation” by a referral doctor will help a case.  As always, there are ways to counter the problems which arise, in order to meet the eligibility criteria as proposed by the Office of Personnel Management in a Federal Disability Retirement case.

Sincerely,

Robert R. McGill, Esquire