Federal and Postal Disability Retirement: Targeted Use of Collateral Evidence

Case-law from the U.S. Merit Systems Protection Board, as well as judicial opinions rendered by the U.S. Court of Appeals for the Federal Circuit, maintain the standard of acceptable proof for a Federal Disability Retirement case submitted to the U.S. Office of Personnel Management, for Federal and Postal employees under either FERS or CSRS.

The primary basis for a Federal Disability Retirement application is clear:  A medical condition which exists, which prevents the Federal or Postal employee from performing at least one, if not more, of the essential elements of one’s job; that a legally viable accommodation is not possible; that reassignment to another position at the same pay or grade is not reasonably feasible; that the medical condition will last a minimum of 12 months; and that the Federal or Postal employee must file for such benefits during the tenure of one’s employment as a Federal or Postal Employee, or within 1 year of being separated from Federal employment.

The core of one’s proof is generally based upon the treatment and opinion of one’s treating doctor.

Every now and again, however, there are “collateral” sources of proof which should be considered, and for various reasons, which must be relied upon for establishment of one’s eligibility for Federal Disability Retirement benefits.  Such proof may include: opinions rendered by Second-opinion or “referee” doctors in an OWCP case; percentage ratings provided by the Department of Veterans Affairs; SSDI approval determinations; separation from the Agency based upon one’s medical inability to perform the essential elements of one’s job; medical notes for FMLA; and even (sometimes, but rarely) a decision granting disability benefits by a private insurer; and other such collateral sources of proof.

Such proof, of course, should never replace the centrality of one’s own treating doctor, and further, should always be targeted and submitted with discretionary judgment.  Sometimes, it can be the “other evidence” which makes the difference in a case; other times, if used indiscriminately, can be an indicator of the weakness of one’s case.

Be careful; be targeted; use discretion.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement (for US Federal Employees): Administering Treatment versus Administrative Functions

Doctors rarely have any problems with administering treatment based upon clinical encounters and subjective narratives from their patients; yet, when it comes to providing a medical report and performing similar administrative functions, the sudden pause, hesitation, and sometimes outright refusal, is rather puzzling, if not disconcerting.

Such trepidation from the doctor can obviously result in a difficult wall for purposes of preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS.

For, much of medical evaluation, diagnosis, prognosis and prescribing of treatment encompasses receipt of subjective responses from the patient:  where the pain is present; the nature and extent of the pain; the history and chronicity of manifested symptoms; even functional capacity evaluations must necessarily be an observation of the subjective actions & reactions of the participant.  Of course, there are often distinguishable “objective” factors — swelling; carcinogenic versus benign tumors; broken bones, etc.

On the other hand, even MRIs and other diagnostic tools reveal only that X exists — not that X results in symptom Y.  An example would be a bulging disc — while the abnormality itself may show up on an MRI, whether the individual experiences any pain from the abnormality may differ from subject to subject.

This is why, despite the willingness of a doctor to treat based upon most factors being “subjective” in nature, it becomes a puzzle why the same doctor shows an unwillingness to write a report stating that, because of the medical conditions for which patient M is being treated, one must necessarily conclude that he or she cannot perform essential elements X, Y and Z of his or her job.

It is the jump from treatment-to-disability-determination which is often problematic for the treating doctor.  All of a sudden, the excuses flow:  “I am not trained to make such determinations”; “There is no objective basis for your pain” (then why have you been treating me for over a decade and prescribing high levels of narcotic pain medications?); “I can’t say whether you can or cannot do your job”; and many other excuses.

The switch from administering treatment, to treating administrative matters, is one fraught with potential obstacles.  How one approaches the treating doctor will often determine whether such obstacles can be overcome — and whether one’s Federal Disability Retirement application can be successfully formulated.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: The Supportive Physician

Physicians comprise a peculiar and unique breed of people; highly trained, the best physicians must be more than a technician, however, in order to effectively treat their patients.  The uniqueness of the profession itself requires a full panoply of skills, including intelligence of application; an acuity of judgment; analytical abilities in evaluating, assessing, diagnosing, and ultimately treating; a bedside manner which conveys confidence and compassion at the same time; and not least — an ability to listen and communicate.

For the Federal or Postal worker who is contemplating preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, a physician who is supportive of the potential applicant’s endeavor is crucial to the successful outcome of the entire administrative process.  By “support” cannot merely be characterized by a smile and a pat on the back; it requires that the physician be willing to make the connection between one’s medical conditions (which the treating doctor should have a thorough knowledge and understanding of) and the essential elements of one’s job (of which the Federal or Postal employee should have a deep and detailed awareness).

Thus, as the partnership for healing comes together in the creation and fostering of a doctor-patient relationship, so the fruition of a successful Federal Disability Retirement application begins with the coalescent cooperation between the medical professional and the Federal or Postal employee who is preparing, formulating, and filing for Federal Disability Retirement benefits.  How that cooperation comes together, of course, makes all the difference, and the tell-tale sign is the willingness to provide a detailed narrative medical report.

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

Postal and Federal Disability Retirement: Supporting the Concept

In preparing, formulating and filing a FERS or CSRS Federal Disability Retirement application, the important first step in the “preparation” phase — or, one might even term it conceptually as the “pre-preparation phase” — is to engage the treating doctor with the conceptual framework of what Federal Disability Retirement entails and encompasses.  

As has been repeated many times previously in other blogs, doctors are not administrators, and ultimately detest the need to annotate, narrate, write reports, etc.  The legal system has forced doctors to keep records, if only for their self-protection in the event of a question of malpractice, and the requirement of keeping office records and notes has had the positive corollary effect of forcing doctors to “think through” the procedural steps of what it is that they are “doing”.  

Requesting the treating doctor to support a Federal Disability Retirement application has the identical positive result of forcing the doctor into an admission that one’s medical condition has come to a crossroads:  prior treatment modalities have not proven to be effective; the chronic and progressively deteriorating nature of the physical or psychiatric condition has shown to be “treatment-resistant”; the time has come to acknowledge that a different mind-set must be embraced — one which includes a period of rest, restorative time, and a stage of recuperation away from the activities which the Federal or Postal employee spends on average 40 – 50% of the time at:  one’s job.  

Speaking to the doctor about his or her support and role in preparing a Federal Disability Retirement application is the first, necessary, and vital step in the preparation, formulation and filing of a Federal Disability Retirement application under either FERS or CSRS.  How best to approach the doctor, the timing, the words and concepts to use, etc., are all part of that preparation.  

If it is time for the Federal or Postal worker to recognize that one’s medical conditions are preventing the Federal or Postal worker from performing one or more of the essential elements of one’s job, it is time to think about pre-preparing the treating doctor.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Obtaining the Doctor’s Support

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, it is important to garner the support of the treating doctor. 

Such needed support is obvious; it is, after all, a paper presentation to the Office of Personnel Management (despite the move to a “paperless” society, the conceptual application is still relevant; for, whether paperless or not, some mode of presentation must still be forwarded to the Office of Personnel Management).  As such, one should be prepared to discuss with one’s treating doctor the “medical” benefits of filing for Federal Disability Retirement — and not just focus upon the administrative and legal efforts which must be engaged. 

Thus, for example, one should inform the doctor that obtaining OPM Disability Retirement benefits under FERS or CSRS does not prevent one from seeking other, alternate employment — one which will not medically exacerbate the conditions which one is suffering from.  As such, going out on Federal Disability Retirement has a therapeutic impact, inasmuch as it (1) allows one to recover by ceasing the type of current work and (2) as work is often considered good therapy, it allows for productivity in another, separate area.  

Remember that a treating doctor’s concern is focused upon the medical health of the patient; persuading a doctor to support one’s Federal Disability Retirement application should thus focus upon the concerns of the doctor.  Persuasion must always take into account the “other’s” concerns.  That is the key to effective persuasion.

Sincerely,

Robert R. McGill, Esquire

 

Federal Employee Medical Retirement: The Family Doctor

One characteristic that people normally do not observe in medical doctors, is one of lack of confidence.  For, confidence, knowledge, direction, advice and assertiveness — those are the “bedside manners” which we expect from a medical doctor to whom we approach for treatment of our maladies.  

Yet, in preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, often the “Family Doctor”, or otherwise identified as the Primary Care Physician or General Practitioner, will declare that he or she cannot make a disability determination because of being either ill-equipped, or because they do not possess the “speciality” of knowledge in making such a determination.  

Often, the doctor will rely upon a Functional Capacity Evaluation, and will insist that such an evaluation be performed prior to rendering his or her medical opinion on the matter of one’s capability, capacity, and ability to perform all of the essential elements of one’s job in preparing and formulating a medical narrative report for a Federal Disability Retirement application.  This, despite the obvious advantages already obtained in the course of many years of treatment of the Federal or Postal employee, the most important of which:  an intimate knowledge, gained through clinical examination and contact over the years, of the medical conditions of the patient, including the extent, severity and chronicity of the medical condition(s); as well as the consistency of complaints and review of radiological reports, the direct clinical contact with the patient, etc.  

Often, such lack of confidence is merely one of not understanding what a FERS or CSRS Disability Retirement application requires — and it is the job of either the patient or, if represented, with the assistance of the federal attorney, to clearly and concisely explain the process, the requirements, and why the family doctor is best qualified to provide a detailed medical narrative report explaining why the Federal or Postal employee is unable to perform one or more of the essential elements of one’s job.  

Marcus Welby, M.D. aside, the general practitioner is still the best source of information and proof in meeting the legal criteria in preparing, formulating and filing a Federal Disability Retirement application under either FERS or CSRS (and if you failed to understand the reference, you are much younger than the writer of this blog).

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Is the Doctor in, Please?

In preparing, formulating and filing an OPM Disability Retirement application under Federal employee retirement system (FERS), the support of one’s treating doctor is essential in putting together an effective presentation to the Office of Personnel Management.  Sometimes, even doctors have to be reminded of his or her “obligation” to a patient.  When, how, and in what manner of approaching the doctor, is a discretionary element of the process best left up to the patient.  

The reason why the “treating doctor”, as delineated by cases and opinions rendered by Administrative Judges at the Merit Systems Protection Board and by Judges at the U.S. Court of Appeals for the Federal Circuit, is the best one to provide a clinical assessment and evaluation of one’s ability or inability, and the extent thereof, of performing one or more of the essential elements of one’s job, is that the long-term relationship that has been (or should have been) established over these many years of treatment, is a foundational basis of being able to ascertain the abilities, capabilities, and limitations of the patient’s physical, emotional and mental condition. 

If a treating doctor hides behind the excuse of saying that he or she is not “equipped” to make a disability determination, or that there are doctors “out there” who specialize in disability determinations, and he/she is not one of them, an explanatory discussion should be engaged in with the doctor, which should include at least the following three (3) elements:  (1)  A reminder of the history of the doctor-patient relationship, (2) that your particular doctor is the one who knows the intimate details of your medical conditions and the history of treatment engaged in, and (3) that such administrative headaches resulting in obtaining Federal Disability Retirement benefits from the Office of Personnel Management is a vital part of the long and recuperative process that the doctor has been trying to attain.  

Ultimately, it is the treating doctor who is the best one to render an opinion as to whether a Federal or Postal employee whom the doctor is treating, can continue to perform all of the essential elements of one’s particular job.  The question then is, Is the doctor in?  Meaning:  Is the doctor still going to “be there” when it really counts?

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

Disability Retirement for Federal Government Employees: Confirming the Relationship

After undergoing all of the those diagnostic tests; after allowing the doctor to clinically examine, prescribe multiple medications based merely upon the say-so of the doctor; after allowing for invasive surgery; sending you to physical therapy; if the time then comes to prepare and file a Federal Disability Retirement application under FERS or CSRS, it is important to confirm the real strength of that “patient-doctor” relationship that has apparently been ongoing and fostered for those many months, years, and sometimes, decades.

It is not enough to get a nebulous “pat-on-the-back-sure-I’ll-support-you” sort of response, and with that, you receive a thick packet from the medical office, you open it, and inside is merely a copy of your medical records.  No — “support” must be concrete and definitive. It must mean, specifically, that the doctor is willing to write an excellent medical report outlining his or her opinion in connecting your medical condition with you inability to perform one or more of the essential elements of your job.  If it is time to file for Federal Disability Retirement benefits, it is time to have a heart-to-heart talk with the treating doctor, and see how committed he or she really was and is to this “patient-doctor” relationship.

Sincerely, Robert R. McGill, Esquire