CSRS & FERS Medical Disability Retirement: The Treating Doctor

There is efficacy and motivational bias.  Sometimes, unintended consequences result in the coalescence of both, but where the result is unaffected by the underlying reason for acting upon an event.

In OWCP cases, the motivational bias almost always includes the intent of the Department of Labor to try and save money, and to steer the injured worker to undergo treatment (if one can call it that) and oversight with one of “the company” doctors who can quickly declare a person to be healed and ready for return to full-time duty, despite protestations of pain, discomfort and limitation of movement, all to the contrary.

It is no accident that the ever-present Worker’s Comp Nurse who infringes upon the patient-doctor relationship by imposing her presence upon each visit, agrees whole-heartedly with any such assessment of full recovery, and ignores the pleas of the patient/OWCP benefit-recipient.

By contrast, those who are filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, are encouraged to speak with their longstanding treating doctors, as opposed to merely going to a doctor whose motivational bias may stem from the source of one’s payment.

Treating doctors who have a long tenure of doctor-patient relationships have little underlying motivation to do anything but look out for the best interests of the patient.  If Disability Retirement is the best course, then that will be what the treating doctor will support.  It is ultimately the relationship that has been established over the many years, which makes for all the difference.  And that difference is worth its incalculable weight in gold.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Sufficiency of Medical Evidence

In meeting the eligibility criteria for Federal Disability Retirement benefits under FERS or CSRS, one must obtain the proper medical documentation, meeting a “preponderance of the evidence” burden of proof, such that it is more likely than not that you are entitled to Federal Disability Retirement benefits under FERS or CSRS.  

Whether a medical report and supporting documentation satisfies the eligibility criteria is based upon the subjective interpretation of the evidence presented.  By “subjective” is meant the following:  The reviewing Claims Representative at the Office of Personnel Management, while allegedly applying a 7-part legal criteria in making a determination of eligibility for each FERS or CSRS Federal Disability Retirement application, must nevertheless make an interpretive determination based upon the sufficiency of the medical evidence, and taking into account all other evidence.  

Indeed, often the interpretation of the statutory meaning which governs all Federal Disability Retirement applications is misunderstood and misinterpreted by OPM.  That being the case, how can one expect that OPM will “get it right” when reviewing and interpreting complex medical documentation?  For example, OPM will often cite as necessary that the medical evidence was not “compelling” enough; or, that the medical evidence presented did not show that it warranted the applicant’s “total exclusion from the workplace” — despite the fact that neither of these standards are required by law.  

The sufficiency of the medical documentation is the linchpin of a Federal Disability Retirement application.  As such, it must be prepared by the treating doctor by pulling together a compendium of multiple factors.  While it need not be compelling, one thing is for certain:  quantity versus quality will not meet the sufficiency test, and it is always better to have one excellent medical report, than numerous mediocre ones.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: Unequivocal Statements

Unequivocal statements can go either way:  They can either show the force of authority, or unravel a lack of knowledge.  In a Federal Disability Retirement case, where a Federal or Postal Worker is attempting to obtain Federal Disability Retirement benefits under FERS or CSRS, such statements of “unequivocal” authority can be seen at any stage of the process.  An unequivocal statement of disability can be made by a treating doctor.  An unequivocal statement of denial of a Federal Disability Retirement application can be made by an OPM Representative.  

What is the distinction and difference between the two?  For the former, the medical doctor who makes an unequivocal statement of disability is based upon the history, clinical examinations, experience, possible diagnostic testing, and other criteria applied in coming to a medical conclusion.  There accompanies it the force of the doctor’s credentials.  The latter is an opinion based upon (hopefully) a comparison of the documentation submitted by the Federal or Postal worker, and the “letter of the law”.  But that assumes that the OPM Representative understands and correctly applies the law.  Such an assumption is often erroneous, inasmuch as the OPM Representative is not a lawyer — and that is just the first of many reasons.  

Don’t be fooled by unequivocal statements; authority of such statements must have a force of rational basis and credentials, and not just because a person “says so”.

Sincerely,

Robert R. McGill, Esquire