Federal Employee Medical Retirement: Back to Fundamentals

In any endeavor, concern or current focus of attention, one can become embroiled in the morass of complexities which comprise the peripheral penumbras of the issue, and disregard the fundamental essence of the matter.  In proverbial terms, it is to overlook the individual trees while viewing the generality of the forest.  So, back to basics.

In a Federal Disability Retirement application, a person who is under FERS (Federal Employees Retirement System — normally those who entered into the Federal Workforce sometime after 1985, and who have a Thrift Savings Plan and contribute to Social Security) or under CSRS (Civil Service Retirement System — pre-1985, with no TSP) may become eligible for Federal Disability Retirement benefits, but must have the following minimum eligibility criteria met: under FERS, you must have at least 18 months of creditable service; under CSRS, you must have at least 5 years of creditable service.

There is a hybrid status applicable for some, called CSRS-Offset, also.  Once that eligibility criteria is met, then the Federal or Postal Worker can take the next step in determining whether one may want to proceed, by asking the following questions: Do I have a medical condition? Does that medical condition prevent me from performing one, if not more, of the essential elements of my position? What are some of the essential elements of my position which I cannot perform? Do I have a treating doctor who will be supportive of my case (remember, this is a medical disability retirement; as such, one must be able to establish through proof of medical documentation, that the medical condition impacts one or more of the essential elements of one’s job)?

These are some of the preliminary, basic questions which should be asked and answered, in order to begin the process of determining whether Federal Disability Retirement is the best pathway for the Federal or Postal employee suffering from a medical condition, in order to manage and maneuver one’s way through the thick forest of a bureaucracy known as the U.S. Office of Personnel Management, which is the agency which ultimately receives and reviews all Federal Disability Retirement applications, whether you are under FERS, CSRS, or CSRS-Offset.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Pre-Conditional Preparatory Steps

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether a Federal or Postal employee is under FERS or CSRS, there are steps to be taken — not only at each “stage” of the administrative process, but moreover, in the weeks and months prior to the actual formulation, compilation and submission of the Standard Forms, documentary support, writing of the Applicant’s Statement, etc.

As a “process”, one may bifurcate the necessary steps into the following:  the pre-conditional stage; the preparatory stage; the time of formulation & actualization; finally, the submission of the disability retirement packet.

In the “pre-conditional” time period, one should focus upon the single most important aspect of a Federal Disability Retirement case — that of garnering, concretizing and establishing the necessary physician-patient relationship, such that there is a clear understanding of what is required of the physician; what the physician expects of the patient; and, wherever and whenever possible, a continuing mutual respect and understanding between the doctor and the patient-applicant.

This is why the Merit Systems Protection Board has explicitly, through case after case, opined upon the preference for “treating” doctors of longstanding tenure.  For, in such a relationship of long-term doctor-patient relationships, a greater ability to assess and evaluate the capabilities and limitations of the patient’s physical, emotional and psychological capacities can best be achieved.

In every “rule”, of course, there are exceptions, and sometimes more “distant” methods of evaluations can be obtained — through OWCP doctors, referee opinions, independent examinations (indeed, one can make the argument that because it is “independent”, therefore it carries greater weight), functional capacity evaluations, etc.

For the most part, however, the cultivation of an excellent physician-patient relationship will be the key to a successful Federal Disability Retirement claim, and as such, the pre-conditional stage to the entire process should be focused upon establishing that solid foundation.

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

Disability Retirement for Federal Workers: The “Nice” Doctor

In preparing, formulating and filing a Federal Disability Retirement application under FERS or CSRS, it is first and foremost important to have the support of one’s treating doctor.  By “support” is meant that the treating doctor must be willing to spend the time and effort needed to prepare and present a medical narrative which will not only narrate and delineate the diagnoses and symptoms — but beyond that, to take the time to explain the “why” of the nexus between the patient’s medical conditions and the essential elements of one’s job.  

To this extent, of course, the Federal or Postal Worker’s attorney should be of the utmost assistance — to guide the doctor in order to meet the legal criteria for qualifying for Federal Disability Retirement benefits under FERS or CSRS.  It is never an issue of telling the doctor “what to say” — the integrity of the medical opinion of the doctor should never be violated.  Rather, it is an issue of explaining the elements and legal criteria which need to be addressed.  

In ascertaining the level of support which a doctor is willing to provide, it is simply not enough to establish the factual foundation that the doctor is very “nice”.  Nice doctors aside — whether in conversation, table manners or a general sense that he or she is genuinely an all-around nice person — the question is, Will the doctor spend the time and effort (and yes, it is proper for the doctor to be reasonably compensated for his time and effort) in preparing a narrative report which addresses the legal elements in order to present a case of medical disability to the Office of Personnel Management?  

It is nice to have a nice doctor; it is even nicer to have a nice doctor who will support one’s Federal Disability Retirement application under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: What Ifs

“What Ifs” are hypotheticals which can paralyze a process.  Often, such imaginary road blocks are pragmatic irrelevancies, and are better left alone.  Others, one should affirmatively confront.  

Thus:  “What if my Supervisor says…”  There are things in one’s control, and those which are not.  A Federal Disability Retirement application contains an implicit concept which must not be forgotten:  It is actually a Federal Medical Disability Retirement application. What the Supervisor says or doesn’t say is not ultimately relevant. Can the Supervisor’s Statement have an influence or impact?  Obviously.  But it is not one of those things which should be worried about, because it is beyond anyone’s control — for the most part.  

“What if my doctor won’t support my case?”  This is a hypothetical which one has control over, in filing for Federal Medical Disability Retirement benefits.  As such, one should make an appointment with the doctor before starting the process, or even contemplating starting the process, and have a frank discussion with the doctor.  Bifurcate those issues which one has control over, from those which one does not.  In filing for Federal Disability Retirement benefits under FERS or CSRS, one needs to confront the reality of today, in preparation for tomorrow’s future.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: The Necessary Doctor

Ultimately, the doctor who is necessary is the one who will be supportive.  Whenever the question is asked of me whether it is “necessary” to have the support of this or that doctor, my answer is generic in nature:  It is better to have one excellent narrative report in support of one’s Disability Retirement Application, than to have 5 mediocre or lukewarm reports.  Excellence in a Federal Disability Retirement application is encapsulated by the level of passion and support by the treating doctor.  The character and texture of a medical report is not just a set of factual listings of medical conditions and a dry statement of an opinion; rather, the underlying sense of a doctor’s firm and passionate belief in a patient is often evident in the intangible underpinnings of a good report.  There are simply some reports written by a doctor where one knows that it is improbable that the Office of Personnel Management will want to entangle themselves in; the unequivocal voice, tone and tenor of such a report can make the difference between getting an initial approval of an Application for Federal Disability Retirement under FERS or CSRS, or a denial, resulting in the necessity of going to another stage of the process.

Sincerely,

Robert R. McGill, Esquire