Diagnosed medical conditions v. symptoms

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, the medical reports and treatment notes, office notes, etc., will often bifurcate and conceptually distinguish between a “diagnosis” of a medical condition, and the description of “symptoms” which the patient experiences.

Thus, as a simplified example, on a physical level, one might have the diagnosis of “Shoulder Impingement Syndrome” or “Rotator Cuff Tendonitis” in a specific category in a medical report under “Diagnosis”, but in a narrative paragraph discussing the history of the symptoms manifested by the individual, there may be a reference to “chronic pain”, or “radiating pain”.  Similarly, in psychiatric cases, one might be diagnosed with “Major Depressive Disorder” or “Generalized Anxiety Disorder“, without being officially diagnosed with “Panic Disorder” or “Agoraphobia”, but in a discussion concerning the Federal Employee’s symptomatologies, there may be a reference to having “panic attacks” or being fearful of leaving the house or going out into the public.

The conceptual bifurcation between “diagnosis” and “symptoms”, however, may (and perhaps should) be carefully brought together in completing the Applicant’s Statement of Disability.  Thus, while “pain”, “chronic pain”, “radiating pain”, etc., may not officially qualify as the officially diagnosed medical condition in a medical report, in preparing and formulating an Application for Federal Disability Retirement benefits, it is important to interweave such symptoms if they are a prominent part of one’s medical conditions.  Similarly, “Panic Attacks”, even if merely described as a symptom, may be an important part — if not the “essence” of a psychiatric condition — of one’s medical condition, and it is important to include it as part of the diagnosis.  For, when an approval is granted from the Office of Personnel Management, the identified medical diagnosis should, if at all possible, include the most debilitating of medical conditions.

That which is conceptually distinguished on a medical report need not necessarily dictate what is described and delineated on one’s Application for Disability Retirement.  Just some thoughts.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Distinguishing between Diagnoses and Symptomatologies

In preparing, formulating and filing a Federal Disability Retirement application with the Office of Personnel Management, whether under FERS (Federal Employee’s Retirement System) or CSRS (Civil Service Retirement System), in preparing and formulating the Applicant’s Statement of Disability on Standard Form 3112A, it is important to distinguish between the medical conditions which are diagnosed, from the symptoms which are experienced by the Federal or Postal employee.  The focus is often upon the latter (the symptoms) as opposed to the former (the officially diagnosed medical conditions), as it should be because of the nature of the requirements in proving a Federal Disability Retirement case with the Office of Personnel Management.

By that is meant the following: Because one must prove by a preponderance of the evidence that one is eligible and entitled to Federal Disability Retirement benefits from OPM, by exhibiting a nexus between one’s medical conditions and one’s medical inability to perform one or more of the essential elements of one’s job, the descriptive analysis of such bridging between one’s medical condition and the impact upon one’s ability/inability to perform the essential elements of one’s particular job, is quite naturally focused upon the symptomatologies which one experiences.

The blurring of the lines between the “official” medical condition as itemized in a list of diagnoses, as opposed to the descriptive delineation of the exhibited symptoms, or the symptoms which are subjectively experienced and (often) correlated by objective radiological reports, is a natural occurrence. Often, the two are (and should be) deliberately intermingled in the narrative description of the Applicant’s Statement of Disability. However, one should always write the narrative portion of the SF 3112A with the view towards the future potential issues which may arise: that of being “disabled” for a specifically-identified medical condition.

Sometimes the OPM Representative will specifically identify a medical condition; sometimes, no such identification will occur. Then, there are times when the lines between “diagnosis” and “symptoms” naturally crosses — as in, “Chronic Pain Syndrome” as distinguished from “chronic pain”. Blurring the lines in a discussion is expected and should be applied in formulating one’s Applicant’s Statement of Disability; but such blurring should occur with deliberation and purpose, and not just because one does not recognize the distinction between the two.

As with everything in life, the consequences of doing something by accident are quite different from that which results from a purposive and deliberate action.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Workers: The “Mixed Case”

The “Grab-bag” approach of annotating every medical condition on an Application for Federal Disability Retirement should be distinguished and differentiated from a “Mixed-Case” approach.  The former contains some unintended consequences (i.e., of being approved for a minor medical condition), while the latter is a formulation of multiple medical conditions, any one of which may be a basis for a Federal Disability Retirement application, but the combination of which will strengthen the case as a whole. 

By “Mixed-Case” does not necessarily include a mixture of psychiatric and physical conditions (although it might); rather, the conceptual term which is used here is meant to be a compendium of the primary medical conditions from which a Federal or Postal worker suffers, along with a descriptive narrative of the symptoms which are manifested. 

By preparing, formulating and completing an Applicant’s Statement of Disability (SF 3112A) in this manner, it satisfies the concerns which lead to the “Grab-bag” approach, but prevents the danger of having a Federal Disability Retirement application approved based upon a “minor” medical condition, by conceptually differentiating between diagnosed medical conditions v. symptoms, while at the same time including all of the medical conditions relevant to one’s Federal Disability Retirement application under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Flexibility of Language

Language is inherently a flexible tool; it is meant to communicate, and while precision in communication is the defining purpose in the use of the tool, often the essence of language must nevertheless be flexible enough to embrace other, correlative concepts. To limit the tool of language often will lead to undermining the very purpose of the use of such language.  

In filing for Federal Disability Retirement benefits under FERS or CSRS, the use of language in preparing, formulating and describing the interaction between the medical conditions and how it impacts one’s job duties, must allow for some level of flexibility.  For example, if certain chronic symptomatologies result in a mis-diagnosis of a medical condition, should a later (revised) diagnosis be allowed to be argued to the Office of Personnel Management after it has been filed?  

The answer to the question is contained in how the Applicant’s Statement of Disability on Standard Form 3112A is formulated.  If one merely lists the diagnosed medical conditions without describing the symptoms, then the language used has restricted the flexibility of post-filing inclusion.  On the other hand, if one combines the various medical diagnoses, but also includes a descriptive discussion of the symptoms, then the answer is likely, “yes”.  The use of language should be one of precision; how one utilizes the tools of language, however, should remain flexible.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Government Employees: Beyond the Diagnosis

The diagnosis of the medical condition in a Federal Disability Retirement case, either under FERS or CSRS, is merely the beginning point in preparing a case. As the Office of Personnel Management in Washington, D.C., is fond of repetitively pointing out, “The mere existence of a medical condition is not a basis for approval under Federal Disability Retirement laws.” While there may be some exceptions for certain severe medical conditions, the statement itself contains a truism which needs to be kept in mind throughout the process.  

Ultimately, in preparing a Federal Disability Retirement case, one must approach the entire process (a process, by the way, which is taking longer and longer to complete, as the backlog at the Office of Personnel Management is increasingly extending the wait-time) with a view towards bridging the two critical elements in any successful filing:  (A) the medical condition and (B) its impact upon one or more of the essential elements of one’s job.  

It is that “connective tissue” between the two which must be the focus, and that is why the symptoms which manifest themselves from the origin (the diagnosis) is what must be discussed.  For, ultimately, while the diagnosis of a medical condition provides the basis for which a medical specialist may begin treatment on a patient, it is the symptoms/symptomatologies which provide the answer to the question in all Federal Disability Retirement applications under FERS or CSRS:  In what way does one’s medical condition prevent a Federal or Postal Employee from performing the essential elements of one’s job?

That is the critical question which must be answered, in order to have a chance at having one’s Federal Disability Retirement application approved by the Office of Personnel Management.

Sincerely,

Robert R. McGill, Esquire