Early Medical Retirement for Federal Workers: Proof and Consequence

What if you possessed a piece of unique information, but no one else could see it? What if, by all appearances, you seemed perfectly healthy, but you weren’t?  What if you struggled every day to meet the stated professional objectives and goals, but were dying inside?

The silence of a medical condition is the consequence of a duality of contradictions:  many medical conditions, including psychiatric conditions, debilitate the “inner” person, and any such explanation to third parties is met with surprise, astonishment, disbelief and denial; but concomitantly, most people don’t want to hear about the troubles of others, anyway.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, one must always distinguish between the medical condition, and proving the medical condition. That X suffers from medical condition Y, unless it is an amputated limb and is self-evident to the outside world, is known only to the sufferer, and to those whom the sufferer relates.

Proving one’s medical condition is done through the objectification of the medical condition — i.e., through a medical doctor who clinically assesses, evaluates, and concludes with a diagnosis.  From there, the proper nexus must be built between the medical condition and the ability/inability to perform one or more of the essential elements of one’s job.  Having X is one thing; proving X is another.

Knowing the distinction will make all the difference in preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Medical Conditions

In filing for Federal Disability Retirement benefits under FERS or CSRS, it is important to note that the Office of Personnel Management will often argue that the mere fact that a person suffers from a medical condition is not in and of itself a basis for granting disability retirement benefits.  So far as such a statement goes, the Office of Personnel Management is correct on the laws governing the eligibility criteria for Federal Disability Retirements (which is rare in and of itself).  Having a medical condition is not a sufficient cause in granting a Disability Retirement benefit.  As it is often argued in the world of philosophy, it is a necessary cause, but not a sufficient one.  In other words, one must indeed suffer from a medical condition (it is thus a “necessary cause”); however, suffering from a medical condition is not sufficient in and of itself to qualify for Federal Disability Retirement benefits under FERS or CSRS (it is not a “sufficient cause”).  One must, beyond having a necessary cause, prove that the medical condition is also the source and impact upon one’s inability to perform one’s job.  Thus, to the limited extent of its truth, suffering from a medical condition is indeed insufficient to obtain an approval from the Office of Personnel Management; it is not “proof enough” in and of itself.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Which Medical Conditions to List II

If you list all of the medical conditions you suffer from on the Applicant’s Statement of Disability (SF 3112A) in filing an application for Federal Disability Retirement benefits under FERS or CSRS, then you take the risk that the Office of Personnel Management may approve your disability retirement application based upon a condition which is only marginally serious (which can lead to some future problems, if OPM requests that you respond to an OPM Medical Questionnaire, inquiring about your current status and your disability).  On the other hand, if you fail to mention a medical condition, and you file your Federal Disability Retirement application, once you are assigned a CSA Number, you are precluded from amending or adding to the list of medical conditions described in your Applicant’s Statement of Disability.  Thus, discretionary decisions must be made.  You must strike a proper balance between listing the major medical conditions, and deciding which medical conditions truly impact your ability/inability to perform the essential elements of your job, and discern which conditions and symptoms are likely to remain chronic, or continue to deteriorate.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement: The Family Doctor and the Surgeon

I am often asked whether or not a medical report from the “specialist” will have a greater impact than a family doctor.  Implied in such a question, of course, is a perspective which tends to see the family doctor as somehow “less qualified”, sort of like comparing the technical deficiencies of a “country doctor” as opposed to a “real doctor” — one who works in an emergency room in a large metropolitan hospital.  Perspectives and prejudices have a way of defining judgments, and assumptions, presumptions and long-held beliefs, whether valid or not, often rule our lives. 

How can I answer such questions?  In the course of a Hearing before an Administrative Judge at the Merit Systems Protection Board, I have had family doctors testify who were unbeatable, and certainly overwhelming in his or her expertise and medical knowledge.  The years of experience in having to deal with thousands of patients, and confronting and treating medical conditions of every imaginable sort — and making decisions (including referring patients to “specialists” for concurring or confirming diagnoses and opinions) involving the “whole” patient’s medical condition and treatment — came through with such persuasive force and overwhelming confidence, that it was indeed the “family doctor” or the “country doctor” who ruled the day. 

Similarly, I have had the “specialist” testify in cases, who barely were able to coherently describe the connection between the medical condition and the essential elements of the job.  And, of course, sometimes the opposite is true — good surgeon, mediocre family doctor; mediocre specialist, great country doctor.  As in all things, in Federal Disability Retirement applications under FERS or CSRS, it is not so much that the credentials matter, as the character, experience, and “heart” of the doctor who treats the patient.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: The Lost Cause

For a lawyer, it is indeed the “lost cause” which is the most challenging of cases.  This is no less true in Federal Disability Retirement cases for Federal and Postal Employees under FERS & CSRS.  In fact, in some instances it is all-the-more-true, because there is necessarily involved a physical or psychiatric medical condition which makes the case all the more worthwhile in fighting for. 

The concept of the “lost cause” is evocative of the famous scene from Frank Capra’s classic movie, Mr. Smith Goes to Washington, of course; and no lawyer, no matter how good, should be so arrogant as to think that he or she meets with the standard of what Jimmy Stewart was fighting for.  For one thing, lawyers get paid for what they do.  Yet, it is indeed the “lost cause” cases which often spur the attorney in any area of law, with eagerness and pride. 

Whether to obtain Federal Disability retirement benefits for an individual who was wrongfully terminated for extraneous reasons; proving to the Judge that, despite post-termination medical documentation, one can and should logically extrapolate that the medical conditions existed prior to separation from Federal Service; to persuade the Office of Personnel Management that the Agency knew, or should have known, of the medical condition, and should have terminated the individual for his or her medical inability to perform one or more of the essential elements of one’s job, as opposed to the manner in which the Agency went forth; these are all microcosmic examples of “lost causes”; and it is indeed the lost cause which is the most challenging of cases for an attorney.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Approaches & Decisions (Continuation)

This is not to say that the Reconsideration Stage of the process, in the stage where there has (obviously) been an initial denial, should not retell a narrative; it is to simply point out the differences in where the emphasis should be — or, rather, where I place the different emphasis based upon the stage. 

How I approach each stage, in general terms, is as follows:  The Initial Stage (the initial application for Federal Disability Retirement benefits under FERS & CSRS) focuses upon the narrative of the applicant — the description of the medical condition; the kind of job and the essential elements thereof; the interaction and impact of one upon the other, as well as some initial legal arguments.  If it is denied, then the Reconsideration Stage has a “shift of paradigm” on what should be emphasized.  The Office of Personnel Management will often question the adequacy of the medical documentation.  In that case, one needs to respond in a two-pronged attack:  (perhaps) an updated medical report, but concurrently, an aggressive legal attack upon the legally untenable position of the denial.  This methodology sets up for the Third Stage of the process, in the event that it becomes necessary — the Merit Systems Protection Board.

Sincerely,

Robert R. McGill, Esquire