Tag Archives: social stigma on psychiatric medical conditions

OPM Disability Retirement: The World in Which We Live

Various social commentators have observed the contradiction that, while we live in an increasingly global economy, individuals feel a greater sense of isolation; thus, the conundrum that the world is no longer an expansive, unreachable universe, but in private lives, the uniqueness of the individual is lost and forgotten.

Whether because of the stresses of isolation, or because of the fast-paced, technologically-driven world in which we live, or some organic-based reasons, one may never know; nevertheless, the exponential explosion of psychiatric illnesses erupting in our society cannot be denied.

There was a time, perhaps a decade or so ago, when a stigma was attached to medical conditions and disabilities which were deemed “stress-related“, and which encompassed depression, anxiety, uncontrollable panic attacks, agoraphobia, etc.  One cannot mark a clear demarcation of when the approach and societal attitude, let alone the medical community’s acceptance, of the wide array of psychiatric conditions, changed.

For Federal Disability Retirement purposes, however, the level of approvals versus denials between cases involving psychiatric conditions, as opposed to purely physical medical conditions, has become indistinguishable.  The U.S. Office of Personnel Management does not review or analyze cases based upon psychiatric conditions — so long as one can tell, purely from an “outsider’s” perspective — any differently from “physical” medical conditions.

This is obviously a “good” thing, because psychiatric medical conditions are just as valid, serious, “real”, and devastating, as the most serious of “physical” medical conditions.  The world in which we live has certainly changed; OPM has evolved with the new world, and we are all the better off for it.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Concept of Psychiatric Medical Conditions

In preparing, formulating and filing for Federal Disability Retirement benefits under FERS or CSRS, and in representing Federal and Postal employees these many years to obtain the benefit of Federal Disability Retirement benefits from the Office of Personnel Management, the encounter with psychiatric medical conditions is often an involvement of greater complexity for multiple reasons:  Unlike physical conditions, the insidious nature of having an appearance of normalcy often undermines the Agency’s ability to effectively deal with the medical condition.  

While “the law” has certainly adapted itself to accept the concept of psychiatric medical conditions, such that Major Depression, Bipolar Disorder, Anxiety, panic attacks, Agoraphobia, paranoia, psychotic episodes, etc. (as well as multiple other psychiatric medical conditions not listed herein, as this is not intended to be an exhaustive list) have become “legitimate”, it is the encounter with “real” people that continues to present the problems inherent in preparing, formulating and filing a Federal Disability Retirement application.  

For, as a “paper presentation” to the Office of Personnel Management, the conceptualized presentation of a medical condition — whether physical or psychiatric — can be effectively made by the efficacy of words and concepts.  However, the reaction and treatment of “real people” in the “real world” (i.e., the Agency, coworkers, Supervisors, etc.), who deal with appearances and productivity, the problematic lack of compassionate or empathetic encounter with psychiatric medical conditions continues to abound.  

It is easy to have compassion for that which we can observe; it is far more difficult to grasp and understand the world of one’s psyche.  This is why other such medical conditions similar in their conceptual framework — Chronic Fatigue Syndrome, Fibromyalgia, etc., present difficulties for the employment community, whether in the Federal sector or the private arena.  Unless, of course, there is a “blood test” or some other diagnostic tool which one can point to, where one is able to say, “Ah, yes, so that is the problem…”  

We live in a world where we have the arrogance of believing that everything can be conceptualized and understood, and that every effect must have an understandable cause.  We are all logicians at heart; but sometimes the music of the world around us makes us pause, and astounds us to remind one that our speck of life in a vast universe should bring about a sense of humility.  

Sincerely,

Robert R. McGill, Esquire

Federal Worker Disability Retirement: Psychiatric Conditions

Sometimes, it is asked whether or not Psychiatric medical conditions are more difficult to pass through in filing a Federal Disability Retirement application.  Implicit in that question, of course, is whether there still exists an inherent stigma attached to Psychiatric conditions, as opposed to “physical” medical conditions.

Over the years, there has obviously been a cultural transformation in the legitimization, acceptance, and overall recognition that Psychiatric conditions are just as “valid” as any other medical conditions.  With such acceptance and recognition, the increase in applications for Federal Disability Retirement benefits under FERS or CSRS based upon Psychiatric medical conditions has had a parallel effect, and the short answer is that there really is no greater difficulty or distinction to be made between filing a Federal Disability Retirement application based upon Psychiatric medical conditions as opposed to, or in contradistinction to, non-psychiatric conditions.  

The legal criteria remains the same. From the wide spectrum of Major Depression, Anxiety, Post Traumatic Stress Disorder, Bipolar Disorder, Agoraphobia, Panic Disorder, various forms of Paranoia, etc., the preparation, formulation and presentation of a Federal Disability Retirement application under FERS or CSRS remains the same:  Obtaining the proper and substantiating medical documentation; forming the narrative bridge between one’s psychiatric medical conditions and the impact upon one or more of the essential elements of one’s job; and making the proper legal arguments, etc.  

Ultimately, one must approach Psychiatric medical conditions in the same manner as non-psychiatric, physical conditions:  by preparing, formulating and filing an excellent narrative presentation of a Federal Disability Retirement application under either FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for Federal & Postal Employees: How to Handle those “Second-Class” Medical Conditions

Attitudes toward various medical conditions change over time.  This has certainly been the case with psychiatric medical conditions:  Major Depression, Anxiety, panic attacks, Bipolar Disorder, Agoraphobia, PTSD, OCD, etc.  At one time in our society, the heavy stigma placed upon such medical conditions essentially made them unacceptable.  Over time, however, as greater numbers of such conditions came to the forefront, and greater success at treatment of such conditions became evident, the validity and acceptance of such conditions have resulted in other medical conditions taking their place.

Thus, certain conditions such as Fibromyalgia, Chronic Fatigue Syndrome, Chronic Pain, Chemical Sensitivity cases, etc., have become the psychiatric conditions of a prior age.  Perhaps it is because the medical profession treats such conditions as afterthoughts — where, through a process of elimination of saying that the medical condition is not X, Y or Z, therefore it is A.

Whatever the reasons, in a Federal Disability Retirement application under FERS, a Federal or Postal employee who is applying for such benefits who is suffering from any of the Second-Class medical conditions must formulate and compile his or her case in a thoughtful, deliberate and forceful manner.  Such a FERS Disability Application must include adequate medical support; a clear and concise bridge between the symptomatologies experienced and the type of job which one must perform; and legal arguments which support the basis for an approval.

To some extent, this approach is no different than with any other medical condition; it is merely a reminder that one must cross all “T’s” and dot all “I’s” with that much more care.

Sincerely,

Robert R. McGill, Esquire
FERS Disability Retirement Attorney

 

OPM Disability Retirement: Do Psychiatric Disabilities Still Carry a Stigma?

Do Psychiatric Conditions still carry a stigma?  Does the Office of Personnel Management, or the Merit Systems Protection Board, treat Psychiatric medical conditions any differently than, say, bulging discs, degenerative disc disease, or carpal tunnel syndrome, etc.?  Is there a greater need to explain the symptoms of psychiatric conditions, in preparing an Applicant’s Statement of Disability, than conditions which can be “verified” by diagnostic testing?  Obviously, the answer should be: There is no difference of review of the medical condition by OPM or the MSPB. 

Certainly, this should be the case in light of Vanieken-Ryals v. OPM.  Neither OPM nor an MSPB Judge should be able to impose a requirement in disability retirement cases involving psychiatric disabilities, that there needs to be “objective medical evidence,” precisely because there is no statute or regulation governing disability retirement which imposes such a requirement that “objective” medical evidence is required to prove disability.  As I stated in previous articles, as long as the treating doctor of the disability retirement applicant utilizes “established diagnostic criteria” and applies modalities of treatment which are “consistent with generally accepted professional standards,” the evidence presented concerning psychiatric disabilities should not be treated any differently than that of physical disabilities.  As the Court in Vanieken-Ryals stated, OPM’s adherence to a rule which systematically demands medical evidence of an “objective” nature and refuses to consider “subjective” medical evidence, is “arbitrary, capricious, and contrary to law.”  Yet, when preparing the Applicant’s Statement of Disability, it is always wise to utilize greater descriptive terms.  For, when dealing with medical conditions such as Bipolar disorder, Major Depression, panic attacks, anxiety, etc., one must use appropriate adjectives and “triggering”, emotional terms — if only to help the OPM representative or the Administrative Judge understand the human side of the story.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Are Psychiatric Disabilities Denied More Readily?

I am often asked whether or not it is more difficult to get disability retirement benefits under FERS or CSRS based upon a psychiatric medical condition (e.g., PTSD, Major Depression, Anxiety, panic attacks, Bipolar Disorder, etc.).  Does the Office of Personnel Management deny a disability retirement application which is based solely upon a psychiatric condition?   Should a FERS or CSRS disability retirement application always include a physical condition? The short and simple answer is an unequivocal “No”. 

Let me provide a slightly more expanded answer:  (1)  In my experience, psychiatric disabilities present no greater obstacles than physical disabilities.  So long as we can prove, by a preponderance of the evidence, that the medical condition — physical or psychiatric — prevents one from performing the essential elements of one’s job, there really is no difference between the two.  (2)  Do not “add” a physical disability because you think that a psychiatric disability is “not enough”.  This would be a foolish approach.  Focus upon the primary medical conditions, whether physical or psychiatric, in proving your case.  (3)  Remember that disability retirement often has other complex factors which come into play — accommodation issues; certain jobs are more easily shown to be “incompatible” with a psychiatric disability (for instance, Law Enforcement Personnel who have psychiatric disabilities obviously must have the mental acuity to perform the inherently dangerous aspects of the position); and remember that psychotropic medications, prescribed and necessary for daily functioning, often have side-effects which impact one’s ability to perform one’s job.  The point in all of this is that there really is no substantive difference between psychiatric disabilities and physical ones, anymore; the societal stigma of “psychiatric medical conditions” has largely disappeared, and the Office of Personnel Management — in my experience — treats both psychiatric disabilities and physical disabilities on an equal par.

Sincerely,

Robert R. McGill, Esquire