Federal Employee Medical Retirement: Back to Fundamentals

In any endeavor, concern or current focus of attention, one can become embroiled in the morass of complexities which comprise the peripheral penumbras of the issue, and disregard the fundamental essence of the matter.  In proverbial terms, it is to overlook the individual trees while viewing the generality of the forest.  So, back to basics.

In a Federal Disability Retirement application, a person who is under FERS (Federal Employees Retirement System — normally those who entered into the Federal Workforce sometime after 1985, and who have a Thrift Savings Plan and contribute to Social Security) or under CSRS (Civil Service Retirement System — pre-1985, with no TSP) may become eligible for Federal Disability Retirement benefits, but must have the following minimum eligibility criteria met: under FERS, you must have at least 18 months of creditable service; under CSRS, you must have at least 5 years of creditable service.

There is a hybrid status applicable for some, called CSRS-Offset, also.  Once that eligibility criteria is met, then the Federal or Postal Worker can take the next step in determining whether one may want to proceed, by asking the following questions: Do I have a medical condition? Does that medical condition prevent me from performing one, if not more, of the essential elements of my position? What are some of the essential elements of my position which I cannot perform? Do I have a treating doctor who will be supportive of my case (remember, this is a medical disability retirement; as such, one must be able to establish through proof of medical documentation, that the medical condition impacts one or more of the essential elements of one’s job)?

These are some of the preliminary, basic questions which should be asked and answered, in order to begin the process of determining whether Federal Disability Retirement is the best pathway for the Federal or Postal employee suffering from a medical condition, in order to manage and maneuver one’s way through the thick forest of a bureaucracy known as the U.S. Office of Personnel Management, which is the agency which ultimately receives and reviews all Federal Disability Retirement applications, whether you are under FERS, CSRS, or CSRS-Offset.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Medical Support, Belief, Documentation and the Diagnosis

Ultimately, in preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, one must always remind one’s self that this is a “paper presentation” (regardless of the prevailing and inevitable march towards a paperless society) to the U.S. Office of Personnel Management (OPM).  As such, there are certain inextricable components in the presentation itself, which must be reviewed, evaluated, and decided upon before proceeding.

As a “presentation” which is meant to be persuasive — i.e., proving by a preponderance of the evidence that one is entitled to the Federal Disability Retirement benefit, whether under FERS or CSRS — it must obviously have the essence of the proof itself:  Medical Support.  Without the medical support, one need not consider moving forward at all.

Once the Federal or Postal employee has ascertained that he or she has the medical support to proceed, then the question is one of obtaining the documentation which confirms such support.  For, a pat on the back and a wonderful smile from the doctor will not be persuasive to OPM; the doctor must be willing to document, in detailed format, the support which is expressed.

Next, in sequential order, the medical documentation must reveal, convey, and persuasively reflect, a level of belief which will be tested in the event that the Federal Disability Retirement application is denied at the First Stage of the Process, and further tested if it is denied at the Second, or Reconsideration Stage, of the process.  Thus, in short, the treating or supporting doctor must possess a level of belief in one’s case, and be willing to support that belief throughout the entire administrative process.

Finally, the doctor must be able to make a diagnosis, but more than that, to support the diagnosis, and be willing to make the “nexus” between the diagnosis, the patient’s physical, emotional and cognitive capabilities, and to relate them to one’s positional duties of one’s job.  It is through this process of connecting the dots, where the end-goal is achieved:  of obtaining one’s Federal Disability Retirement benefits.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: Preparation in Anticipation of the Process

Preparation in anticipation of a process, as opposed to filing the proper paperwork to receive an entitlement, constitutes a different mindset and approach.

In preparing, formulating and filing a Federal Disability Retirement application under CSRS or FERS, where the Federal or Postal employee may be subject to undergoing the process of the initial stage of the application, then potentially the Request for Reconsideration stage; if denied at the Request for Reconsideration Stage, then the process involves an appeal to the Merit Systems Protection Board; then, if denied at the MSPB, a Petition for Full Review, and an appeal to the U.S. Court of Appeals for the Federal Circuit. Because the entire process may involve multiple forums, the extent of support requested from the outset should be understood to potentially involve such extensive time frames and stages.

Filing for FERS Disability Retirement benefits must be understood as potentially involving the entirety of the process, and not just a single-event occurrence.

Now, as to whether to inform the treating doctor at the outset the details of such potential support needed, is another matter. Such a full disclosure may, if presented wrongly, indicate such a daunting process that no one in his right mind would want to undergo such a process. Most doctors, however, already have an inkling of what an administrative process might involve, through contact with Social Security, which is the benefit most medical doctors have been involved with.  In any event, it is important to secure the support of the treating doctor and to have the comfort of knowing that he or she will continue such support through the entirety of the process, and not abandon you halfway through it.

That is why the mindset of understanding that preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS is important to obtain from the outset, that it is a process, and not an entitlement.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: The Reluctant Doctor II

Dealing with the Reluctant Doctor — one who presumably has been treating the potential applicant for Federal Disability Retirement benefits for at least several months, but often for several years — is a rather “touchy” subject.  

On the one hand, the build-up of confidence, confidentiality, and security developed over many years of having a doctor-patient relationship is at stake; on the other hand, the Federal or Postal employee has come to a critical point in his or her future, career and professional life, where the support of the treating doctor in the preparation, formulation and filing of a Federal Disability Retirement application has become necessary.  

Doctors, by nature dislike the administrative aspects of preparing lengthy medical narrative reports.  Yet, most doctors recognize the necessity of that aspect of their practice, and are willing to perform the service as part of their duty to their patients.  A diplomatic, sensitive balance must be struck, but one that is honest and placed within the appropriate context of one’s health and future well-being.  

In essence, the doctor must be asked about his or her support in preparing a Federal Disability Retirement application under FERS or CSRS, but in the context of a larger discussion concerning one’s health, treatment modalities, permanency and chronicity of disabling medical conditions, and future treatment.  In essence, the “reluctant doctor” must be persuaded to disrobe his or her reluctance, for the sake of the patient’s health.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: Speaking with the Doctor

Communication is the key to a successful outcome:  such a trite truism is certainly applicable in a Federal Disability Retirement application under FERS & CSRS.  The primary focus when a Federal or Postal employee has a medical condition which is impacting his or her ability to perform all of the essential elements of his or her job, is to take care of the medical condition — i.e., to have the necessary treatments, to undergo the proper prescriptive treatment modalities, including surgery, medication regimens, pain management treatments, psychotherapeutic intervention, etc.

Beyond such treatment modalities, however, there may come a point in the life of a Federal or Postal employee when it is becoming apparent that the medical condition is simply “incompatible” with the useful and efficient retention in the Federal or Postal Service.  Such a determination is best made by the Federal or Postal employee, if possible, as opposed to having the Federal Agency or the U.S. Postal Service suddenly and unceremoniously make such a determination — in the form of a proposed removal based upon one’s failure to maintain a regular work schedule; or because of taking “excessive leave“; or putting a Federal or Postal employee upon a Performance Improvement Plan.  Such a determination may best be made by the Federal or Postal employee by communicating one’s concerns to the treating doctor, and asking some incisive questions.  Another trite truism:  The only stupid question is the one not asked.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: Exaggerated Focus

Often, in preparing and filing a Federal Disability Retirement application, the distractions of collateral issues can be heightened to a level of exaggerated focus, such that it formulates and creates a perception which is beyond the proper perspective which it should be accorded.

Thus, for instance, the issue of whether or not a Supervisor’s support in a Federal Disability Retirement application is important, and to what extent. The issue of whether the Agency can undermine or subvert the Federal Disability Retirement application, etc. — these can be mere distractions which, if allowed to expand in an exaggerated vacuum, can derail a Federal Disability Retirement application unnecessarily.

On the other hand, certain issues and obstacles can indeed be exaggerated, and still maintain a perspective of “reality” — such as the support and importance of one’s treating doctor.

It is important to make the conceptual distinction between the core essentials which make up a Federal Disability Retirement application, and those which are secondary, and further, those which are peripheral to the process.

The ultimate goal is to formulate an approach, prepare an effective presentation to the Office of Personnel Management, and not get distracted from the multiple obstacles and seeming-obstacles which can divert one’s attention, and maintain a reasoned perspective throughout.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: Don’t Assume

We are all familiar with the acronym-like adage which can be extracted from the word “assume”.  In preparing a Federal Disability Retirement application under FERS or CSRS, the first question that one must ask of one’s self is:  “Do I have a supportive doctor?”  If the answer is an unequivocal “No”, then entertaining even the thought of proceeding forward with the process is a virtual act of futility.  

Now, to all unqualified statements, there are exceptions to the rule.  There are, indeed, medical conditions where the mere treatment records, office notes, etc., reveal irrefutably of a medical condition of such severity that there is no question as to its impact upon one’s ability/inability to perform the essential elements of one’s job.  But that is rare.  If the answer to the original question is:  “He may be…”  “I assume he is supportive…”  “He seems supportive because…”   While these are niceties in one’s figment of one’s imagination, and foster a sense of security and a warmth for a doctor-patient relationship, such answers all have an undercurrent of an assumption.  Don’t assume, if you are planning to go forward with a Federal Disability Retirement application.  Instead, make an appointment with your doctor and have a frank and open discussion.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement Benefits for Federal & Postal Employees: Knowing your own Case

In preparing and submitting an application for Federal Disability Retirement benefits under FERS & CSRS, it is important to know your own case.  This will often take some time and effort, but it is worthwhile, for many reasons:  Knowing and understanding the extent to which your doctor will support you; understanding fully the medical terminology which your doctor has used; knowing that what you say in your Applicant’s Statement of Disability (SF 3112A) does not contradict or otherwise invalidate what your doctor states in his or her medical report — these are all important aspects of a Federal Disability Retirement case.

Often, doctors use medical terminology which, read in the context in which it is written, can be misunderstood and mininterpreted.  Such misreading then leads to a misstatement by the applicant in his or her Applicant’s Statement of Disability, thinking that it is supported by the medical documentation which is submitted. Even if it is an honest error, such a self-contained contradiction can harm a case, as when the Office of Personnel Management is able to point to a doctor’s report and is able to state:  While you claim X, your own doctor states Y…

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: The Necessary Doctor

Ultimately, the doctor who is necessary is the one who will be supportive.  Whenever the question is asked of me whether it is “necessary” to have the support of this or that doctor, my answer is generic in nature:  It is better to have one excellent narrative report in support of one’s Disability Retirement Application, than to have 5 mediocre or lukewarm reports.  Excellence in a Federal Disability Retirement application is encapsulated by the level of passion and support by the treating doctor.  The character and texture of a medical report is not just a set of factual listings of medical conditions and a dry statement of an opinion; rather, the underlying sense of a doctor’s firm and passionate belief in a patient is often evident in the intangible underpinnings of a good report.  There are simply some reports written by a doctor where one knows that it is improbable that the Office of Personnel Management will want to entangle themselves in; the unequivocal voice, tone and tenor of such a report can make the difference between getting an initial approval of an Application for Federal Disability Retirement under FERS or CSRS, or a denial, resulting in the necessity of going to another stage of the process.

Sincerely,

Robert R. McGill, Esquire