Tag Archives: relevance over quantity on disability medical documentation

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

 

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

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

Federal and Postal Disability Retirement: The Proper Balance

Meeting and arriving at the “proper balance” in any endeavor is an Aristotelian concept found in his Nichomachean Ethics, of achieving a median between any two extremes.  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 ascertain, then apply, this concept of a “middle” balance between providing too much information (which then includes much superfluous content and documentation which merely provides volume, but not qualitative evidence of one’s Federal Disability Retirement eligibility), and not enough to meet the legal criteria.

By appearance alone (and here, of course, the philosophical outlook and distinction between that which is merely “appearance” as opposed to “substance” applies beautifully), it is sometimes necessary to provide a certain level of volume of medical records in order to satisfy OPM that there is indeed “substance” to one’s medical claim.

It is an unfortunate anomaly that, while on the one hand OPM is looking for “relevant” information, and much of the office and treatment notes of a doctor merely contain passing and quick notations on treatment modalities, medication regimens prescribed, etc.; nevertheless, the appearance of office notes, regardless of their irrelevant nature and lack of substantive content, accompanying a qualitatively significant medical narrative report, often satisfies OPM’s request for “documentation” of a medical condition.  On the other hand, too great a volume of immaterial medical documentation which tends to show nothing, should be streamlined, if possible.  Meeting that Aristotelian “median” between providing too much and too little is something which is discretionary, but important to attain.

It is normally through experience of having handled a volume of cases that one can gain a sense of what the “proper balance” means, but for the particular Federal or Postal employee who is preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, such an endeavor is, and should be, the one and only time that such an encounter would be engaged in.

That, in and of itself, is a conundrum which can only be resolved by consulting someone who is knowledgeable in the area of Federal Disability Retirement law, and as knowledge of first principles is also an Aristotelian mandate, so consultation with those who are familiar with such first principles (or any principle which applies to OPM’s arbitrary approach, for that matter) should be a must for the Federal or Postal employee considering a Federal Disability Retirement application.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: The Relevant Medical Condition

In preparing, formulating and filing for Federal Disability Retirement benefits under FERS or CSRS, make sure that the medical condition which the Federal or Postal employee is listing, describing and delineating, including the symptoms and impact, etc., is “relevant” to one’s Federal Disability Retirement application under either FERS or CSRS.

Let me clarify with the following (outlandish) hypothetical:  A Federal employee has the job and positional duty of pushing a button with his right index finger once every 2 hours.  He suffers a horrendous injury to his left shoulder, left arm, left leg and left side of his body. Use of the left side of his body is nowhere described or required in his position description, and the Agency has never requested that he use the left arm, shoulder or leg, or any part of the left side of his body, in performing the essential elements of his job.  He prepares and formulates his Federal Disability Retirement application, describing the extent of his medical limitation of the left side of his body.  Result:  he is denied by the Office of Personnel Management because the relevance of his medical condition has not been established with respect to the essential elements of his job.

“Relevance” of a medical condition is essential to establish in a Federal Disability Retirement application. Now, had the Federal or Postal worker gone on to describe how the chronic and radiating pain from the left-sided injuries (taking the hypothetical one step further) impacted his ability to use his right index finger, and this was established through the medical opinion of his treating doctor, the case would have had merit and a basis for an appeal, argumentation, etc., would have been established.

But in preparing, formulating and filing for Federal Disability Retirement benefits under FERS or CSRS, it is important to understand and apply the basic principle in the Federal Disability Retirement case:  It is not just the medical condition which is at issue; it must encompass the relevance of the medical condition to the essential elements of one’s job.

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

Federal Employee Medical Retirement: Too Much Information

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, brevity and succinctness should be the guiding rule.  Often, over-explaining and overstating a particular issue, while intending to be helpful and fully descriptive, can result in greater confusion and muddling of the issues.

This is found not only in the Applicant’s Statement of Disability, but also in an Agency’s responsive completion of forms — both the Supervisor’s Statement as well as the Agency’s efforts for Reassignment and Accommodation.  Previously, much has been written concerning (for example) the Agency’s attempt to explain how the Federal or Postal employee was “accommodated” in various ways.

Such explanations, while legally untenable precisely because the efforts engaged in did not in fact constitute an accommodation as the term is defined in Federal Disability Retirement laws, nevertheless confuse the issue with the Office of Personnel Management because (A) they often provide an appearance of having accommodated the Federal or Postal employee and (B) the Claims Representative at the Office of Personnel Management himself/herself neither understands the laws governing accommodation, nor applies it properly.

The same is often true in a long narrative of the Applicant’s Statement of Disability — where causation, harassment, the history of the medical condition, the problems at the agency, the history of how one’s work could not be performed, collateral legal forums filed with, etc. are all extensively discussed.

Remember that an answer to a question should always be guided by the question itself.  Don’t create your own question and answer the question you composed. Rather, re-read the question, and answer only the question asked.

Sincerely,

Robert R. McGill, Esquire

Postal and Federal Disability Retirement: Details

Ultimately, it is not the “devil” which is in the details; rather, the details of a Federal Disability Retirement application often determine the success or failure of a case.

Attention to the details — of coordinating the Applicant’s Statement of Disability with the submitted medical reports and the legal/analytical arguments to be made; of distinguishing between “facts” and “arguments”; of anticipating any issues which an Agency might bring up; of making the determination as to which anticipated issues should be focused upon and preempted (if at all); of whether to utilize collateral sources of documentation, whether they be statements from a denied SSDI application or the ascription and allocation of a Veterans Administration disability rating; whether, if a concurrent OWCP case has generated a Second Opinion or Referee Medical Report; which medical reports to request and submit; which legal and analytical arguments to engage in at the outset; whether or not additional, non-medical but (potentially) supportive documentation should be attached — these are the details which make up for a devilish time.

In preparing, formulating, and filing a Federal Disability Retirement application under FERS or CSRS, it is not a question of whether the details make any difference; for the most part, they constitute all the difference.

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