Federal and Postal Disability Retirement: Is the Doctor in, Please?

In preparing, formulating and filing an OPM Disability Retirement application under Federal employee retirement system (FERS), the support of one’s treating doctor is essential in putting together an effective presentation to the Office of Personnel Management.  Sometimes, even doctors have to be reminded of his or her “obligation” to a patient.  When, how, and in what manner of approaching the doctor, is a discretionary element of the process best left up to the patient.  

The reason why the “treating doctor”, as delineated by cases and opinions rendered by Administrative Judges at the Merit Systems Protection Board and by Judges at the U.S. Court of Appeals for the Federal Circuit, is the best one to provide a clinical assessment and evaluation of one’s ability or inability, and the extent thereof, of performing one or more of the essential elements of one’s job, is that the long-term relationship that has been (or should have been) established over these many years of treatment, is a foundational basis of being able to ascertain the abilities, capabilities, and limitations of the patient’s physical, emotional and mental condition. 

If a treating doctor hides behind the excuse of saying that he or she is not “equipped” to make a disability determination, or that there are doctors “out there” who specialize in disability determinations, and he/she is not one of them, an explanatory discussion should be engaged in with the doctor, which should include at least the following three (3) elements:  (1)  A reminder of the history of the doctor-patient relationship, (2) that your particular doctor is the one who knows the intimate details of your medical conditions and the history of treatment engaged in, and (3) that such administrative headaches resulting in obtaining Federal Disability Retirement benefits from the Office of Personnel Management is a vital part of the long and recuperative process that the doctor has been trying to attain.  

Ultimately, it is the treating doctor who is the best one to render an opinion as to whether a Federal or Postal employee whom the doctor is treating, can continue to perform all of the essential elements of one’s particular job.  The question then is, Is the doctor in?  Meaning:  Is the doctor still going to “be there” when it really counts?

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Office Notes (Continued…)

The Office of Personnel Management has every right to establish a consistency of medical treatment and opinions rendered on the part of the doctor, the specialist, the medical facility, etc.  One of the reasons why Federal Disability Retirement benefits are (in great part) determined by the opinion of the “treating doctor”, as opposed to a determination made by a medical doctor who makes such disability determinations but is not the applicant’s “treating doctor”, is that such a determination (in the eyes of Federal Disability Retirement laws, statutes, MSPB case laws, etc.) can best be rendered by a medical specialist who has a long-standing relationship with the patient/applicant, over a long period of time, to determine the extent, severity, chronicity, etc., of the medical condition claimed.  

With this in mind, there often arises a conflict of sorts:  On the one hand, most people who are attending to their medical needs, are not thinking in terms of “getting Federal Disability Retirement benefits” during the time of treatment.  The critical point of when the line becomes drawn, where treatment & chronicity begin to conflict; or where, despite every attempt by the doctor to prescribe treatment modalities, there appears to be a medical condition which is “intractable”, is often a difficult one to determine.  In most cases, the office/treatment notes will reveal the line, which may come about gradually.  At other times, one may have a doctor who thinks that he or she can successfully treat any and all conditions, and reflects such a “positive” outlook in every office notation.  This is often not helpful, when it comes time to filing for Federal Disability Retirement benefits under FERS or CSRS.  To counter this, a frank discussion with the doctor at some point may become necessary.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for Federal & Postal Employees: The Treating Doctor

In a Federal Disability Retirement application under FERS & CSRS, what distinguishes the entire process of proving, by a preponderance of the evidence, that a Federal or Postal employee is unable to perform one or more of the essential elements of one’s job — from other processes, such as Social Security and OWCP — is that the evidentiary weight is placed upon a treating doctor.  There are “other” types of doctors other than treating doctors:  specialists who are referred to for consultative purposes; doctors who specialize in determining functional capacity & evaluate the functional limits of an individual; occupational specialists, etc.  Why a “treating” doctor?  Because we are talking about workers who, over time, find that he or she is no longer able to perform the essential elements of a job and, over that same time, it makes sense that a doctor would be treating that individual.  Disability Retirement is not normally filed as a result of a traumatic accident (although that can happen, also); rather, a Federal or Postal employee normally files a Federal Disability Retirement application because of a condition which develops over time.  That is why the “treating” doctor would be the best source of knowledge and information:  because, through clinical examinations, long-term doctor-patient relationship, the treating doctor can make a long-term assessment based upon all of the facts and circumstances of the patient.

Sincerely,

Robert R. McGill, Esquire

OPM SF 3112 Schedule C Form: The Doctor’s Statements

The lack of cooperation from a treating doctor, who is asked to provide a medical narrative report for a Federal Disability Retirement application under FERS or CSRS, may be based upon one of several factors.

It may be that the doctor merely refuses to engage in any type of administrative support for his patients; it may be that the doctor has private suspicions that, to openly admit that his/her patient must file for Federal Disability Retirement means that his/her treatments have failed, and thus, the patient/disability retirement applicant is considering filing a malpractice action, and asking him/her to write a supportive medical narrative is merely a ploy to set the groundwork for a later malpractice action; it may just be bad bedside manners; or it may be that the doctor does not understand the Federal Disability Retirement process, and how it differs for Social Security Disability, or Worker’s Comp.

If it is the latter reason, then it is the job of the attorney to make sure and explain, delineate, and inform the doctor of the nature, extent, and context of Federal Disability Retirement — and to show how an approval for disability retirement benefits will be the best thing for his/her patient.  This is where an attorney representing an applicant for Federal Disability Retirement benefits under FERS or CSRS becomes a crucial component in the preparation of such an application.

Sincerely,

Robert R. McGill, Esquire

 

CSRS & FERS Disability Retirement: The Doctor & the Applicant

Before a client hires an attorney to obtain Federal Disability Retirement Benefits under FERS or CSRS, it is important that he or she has an initial commitment from the treating doctor, that a medical narrative report discussing and addressing the specific issues surrounding Federal disability retirement will be prepared. While medical reports are always helpful, and sometimes a disability retirement application can be successfully prepared, submitted and approved with the supporting documentation being comprised entirely from treatment and diagnostic records, such an application can only be compiled with the assistance of an experienced attorney.

The properly prepared medical narrative is crucial to the success of a Federal disability retirement application, generally speaking. Further, the compendium of case-laws issued by the Merit Systems Protection Board over the past decade (and longer) clearly reveal that greater weight will be given to a medical disability retirement narrative prepared by a treating doctor of long-standing tenure having a doctor/patient relationship, as opposed to a single-examination doctor for purposes of disability determination. The key? Form that bond with the treating doctor — such that the treating doctor is truly your “treating physician”.

Sincerely,

Robert R. McGill, Esquire