Disability Retirement for Federal Workers: The Unguided Doctor

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, it is important to guide the doctor into properly preparing and formulating the medical narrative report.

This is not a matter of “telling what the doctor to say”.  The treating doctor is obviously aware of the types of medical conditions that the patient — the Federal worker who is filing for Federal or Postal Disability Retirement benefits — is suffering from.  The doctor’s professional integrity, as to what his or her medical opinions are, should always be preserved and be paramount.  

Further, it is merely a factual issue as to whether the doctor will be supportive of such an endeavor, and such support can only come about by having a direct and frank discussion about the requirements of one’s positional duties and how those positional duties are impacted by one’s medical conditions.  

Rather, the issue of guiding the doctor is one of informing him or her of the particular elements which are necessary and unique in a Federal Disability Retirement application, which must be addressed in a narrative report.  For, otherwise, the unguided doctor will simply issue a narrative report with a different focus and a different end.

Guidance is merely knowing what the goal of a particular activity requires, and unless the treating doctor understands the technical requirements of what is needed (the end-goal), that doctor will merely attempt to meander by accident in a formulation which may include elements which are more harmful, than helpful, in preparing, formulating, and filing for Federal Disability Retirement benefits under either FERS or CSRS.

Sincerely, Robert R. McGill, Esquire

OPM Disability Retirement: The Simplicity of the Process

In becoming deeply involved in the morass of the bureaucratic process of preparing, formulating and filing a Federal Disability Retirement application under FERS and CSRS, it is often easy to become frustrated with the inherent complexity of the process.  

Because of the multi-faceted complexities of the administrative process (e.g., obtaining the proper format and language in a medical narrative report in order to meet the legal criteria for eligibility; creating and nexus between the essential elements of one’s position in the Federal Service with the symptomatologies of the interaction between the medical conditions and the essential elements; understanding and applying the various statutory authorities and legal precedents which have evolved over many years; of preempting — if necessary — statements by the Agency or the Supervisor; and multiple other issues to be addressed concurrently), it can be frustrating for an injured or disabled Federal or Postal employee to attempt to pull all of the intricate strings together into a singular yarn of coherency and succinct presentation of a narrative form.  

Such is the time to remind one’s self of the simplicity of the process — of the 3-part essence of a Federal Disability Retirement application which will ultimately be a paper-presentation to the Office of Personnel Management.  First, the medical narrative must be simple but concise, and must provide a proper bridge between the medical condition and why a Federal or Postal employee is unable to perform one or more of the essential elements of one’s job.  Second, one’s Applicant’s Statement of Disability must be consistent with the medical narrative reports — neither understated nor exaggerated, and guided by truth. And third, it is important to understand and apply the legal precedents, and use the law as what it is intended for — a tool for both a shield and a sword.  In life’s complexities, it is important to maintain a paradigm of simplicity.  Unfortunately, it is often the simplest forms which constitute the height of complexity.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: SF 3112C

Standard Form 3112C, the Physician’s Statement, is often an ineffective way of getting one’s treating doctor to prepare and write an effective medical report for a disability retirement application, to be submitted and reviewed by the Office of Personnel Management.  Because it is a standard form — with standard language and guidelines provided in generic form –doctor’s generally dislike taking such “instructional forms” and trying to decipher what is needed, how to properly and effectively interpret the generic instructions, and be the most effective medical advocate on behalf of a patient.

This is where an attorney’s guidance can be most effective and invaluable; for, ultimately, OPM’s review of eligibility for Federal Disability Retirement benefits under FERS or CSRS is not merely medical, but legal.  Because there are legal standards to be met, eligibility is ultimately determined not solely upon a medical basis, but upon a mixture of medical documentation which must satisfy a legal standard.  That is why the guidance of an attorney is crucial in a Federal Disability Retirement application under FERS & CSRS.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Termination (Part 2)

There are times when an Agency will proceed and terminate a Federal or Postal employee based upon adverse grounds — of “Failing to follow proper leave procedures”, for being AWOL, for Failure to do X, Y or Z.  Such adverse actions may be the “surface” reason for the actual, underlying reason — that of one’s medical inability to perform one or more of the essential elements of one’s job.  Once a proposed termination becomes an actual termination, then the course of action to take, of course, is to file an appeal with the Merit Systems Protection Board.  An Administrative Judge can often be of great assistance in defining and narrowing the issues, and in gently persuading and convincing the Agency to consider changing and amending the “surface” reason to the true, underlying reason of medical inability to perform the job.  The goal here, of course, is to do everything to help in “weighting” a disability retirement application in your favor, and while obtaining the Bruner Presumption in a case is not critical, in many cases, it can be helpful.  And the way to get the Administrative Judge on your side, so that the AJ will then try and persuade the Agency to consider amending a removal, is to obtain well-documented, well-written medical narrative reports from the doctors.  As is almost always the case, the underlying basis for any disability retirement application begins and ends with a well-written medical report.

Sincerely,

Robert R. McGill, Esquire

Federal & Postal Service Disability Retirement: Differing Legal Criteria

Similar benefits, at the State, Local, Private levels, and at the Federal level, each contain differing legal criteria for eligibility. Thus, for instance, Social Security Disability benefits require one set of standards of eligibility; private disability insurance policies require a different set of standards; and state disability benefits often differ from state to state.  This is of course true of Federal Disability Retirement benefits under FERS and CSRS — where the legal standard of eligibility is different from Social Security, Worker’s Comp, and State or private disability criteria.

Often, a question is asked whether a medical narrative report which is prepared for submission to the Office of Personnel Management can be used for submission for other “similar” benefits.  The short answer is, “It all depends”, but the long answer is that, in most cases, one must be very cautious.  When I represent a Federal or Postal employee under FERS or CSRS, one of the first steps in preparing a viable case is to request of the treating doctors a detailed medical narrative report.  One must understand that the treating doctor has, generally speaking, next to no idea as to the legal criteria that must be met under FERS or CSRS.  Furthermore, the treating doctor has no legal knowledge as to the differences between private disability insurance policies, State, Social Security, OWCP or FERS & CSRS.  It is the job of the Attorney to make sure and guide the treating doctors as to the criteria which must be met as to the particular and specialized field for which the medical narrative is being prepared.  This must be done with care, and with detailed guidance.

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

CSRS & FERS Disability Retirement: The Doctor

Doctors hate administrative duties.  They went to medical school, and they want to practice medicine, not law.  If they wanted to engage in vast amounts of paperwork, they would perhaps have gone to law school.  As such, paperwork, writing medical narrative reports for their patients, providing medical opinions in a report — they are part and parcel of the dreaded “paperwork” — somewhat like filling out all of the forms for medicare, medicaid, insurance, etc. to get paid. Such paperwork is often left to the “administrative staff”, and therefore doctors are only sporadically required to actually prepare any paperwork.

This presents a peculiar problem for a potential disability retirement applicant, because in order to obtain Federal Disability Retirement benefits under FERS or CSRS, an applicant must have a doctor’s narrative report which delineates certain issues, addresses certain issues, and renders certain opinions.

Thus, the crucial question becomes: How does one approach a doctor and convince him or her that preparing a proper medical report is an integral aspect of treating the patient? The answer: It must be done with diplomacy, sensitivity, caution, guidance, and understanding, all bundled into one. Above all, it begins with a relationship — a patient-doctor relationship that has been formed over many, many years. And, indeed, that is the requirement under the case-laws at the Merit Systems Protection Board governing disability retirements — that those opinions rendered by treating doctors of long duration are accorded greater credibility than single-examination doctors. And it all makes sense.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: The Lawless Supervisor

Every now and then (or perhaps more often than we like to think) a Supervisor will fill out the SF 3112B (Supervisor’s Statement) with such venom and innuendo and half-truths, as to make the disability retirement applicant out to be John Gotti’s half-brother and reincarnate of the conceptual paradigm of the greatest incompetent the Federal Government has ever seen (next to the Supervisor himself, of course). Or, it will state that the applicant has been “under investigation”, or that he/she has “mislead” the Agency, or other such half-truth, unsubstantiated allegation. The problem in addressing such a Supervisor’s Statement with the Office of Personnel Management (if, in fact, one has the opportunity to address the issue before it gets to OPM or, as is more often the case, if the disability retirement application is denied, and the Supervisor’s Statement is referenced in the initial decision of denial), is the following: If you address it too forcefully, or emphasize it, then you are in danger of focusing the “fight” on the truth or falsity of what the Supervisor has said. In other words, you have essentially allowed the Supervisor to win the fight by shifting your focus upon the venom of the Supervisor. It is more likely the wiser course of action to grant minimal attention to the Supervisor’s Statement; give it the due response it deserves, addressing the falsity of the statement, and how it is entirely unsubstantiated; and, sometimes, express outrage that OPM would have even considered such scandalous charges when it has been unverified; then focus most of the attention upon the validity and force of the Medical Narrative Report that accompanies the disability retirement application. For, after all, always remember that this is a “Medical Disability Retirement Application” — with the emphasis upon “medical”, and not “Supervisor”.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Process & Time

Time is also part of the entire process of filing for Federal Disability Retirement; time factors involve multiple issues from multiple aspects and perspectives:  The Statute of Limitations of filing a Federal Disability Retirement within one (1) year of being separated from federal service; the fact that the 1-year mark begins from the date of actual separation, not from the date of disability, or the date of one’s inability to perform one’s job (although those dates may, on occasion, coincide); the fact that the medical condition must last for at least 1 year (while, at the same time, recognizing that one normally should not wait for the year to pass before filing for Federal Disability Retirement, because most doctors can provide an opinion, within reasonable medical certainty, that the medical condition impacting one’s inability to perform the essential elements of one’s job will last for at least a year, normally quite early on in the process); the time it takes for the doctor to prepare a proper medical narrative report; the time it takes for the Agency to prepare and attach to the disability retirement packets its required forms; the time it takes for Boyers, PA to process the case and assign a CSA Number to it (which begins with a “4” for CSRS employees, and an “8” for FERS employees); the time it takes to get the case assigned once it is sent down to Washington, D.C.; the time it takes, once assigned, for an Initial Approval or Denial.  And, of course, all the while, during this entire “process” of time, issues as to whether the applicant should, could, or will continue to work, either at the Agency, in some light duty capacity, or in some other job.  These are all “time/process” issues which an attorney can guide and assist a client with, in the complex “process” of filing for Federal Disability Retirement under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: The Process

The importance of the “process” cannot be overstated in the filing of Federal Disability Retirement benefits.  It is the “coordination” of all of the various elements involved:  the Medical Narrative Report; the proper legal citations to refer to; the relevance of which medical documents to use; streamlining the documentation; the orderly listing of the medical conditions; how the medical conditions should be described; the narrative description of the impact and nexus between the medical condition and the job description; how to deal with accommodation issues; how to preemptively minimize any adverse impact from an “unfriendly” Supervisor’s Statement; preparing for the “long haul” — the potential denial, the denial at the Reconsideration Stage, and onward to the Merit Systems Protection Board — thus, preparing the case not only for the First Stage, but for any future stages of the process; how to deal properly and intelligently with specific medical conditions which may require a different “tweaking” of the application (i.e., medical conditions such as Fibromyalgia, Chronic Fatigue Syndrome, Bipolar Disorder, panic attacks, Multiple Chemical Sensitivity cases, etc.); the “do’s and don’t’s” of describing certain medical conditions.  These are only some of the issues which must be dealt with, coordinated, and thoughtfully constructed in preparing for a Federal Disability Retirement case.  

Sincerely,

Robert R. McGill, Esquire