Federal Employee Medical Retirement: Keeping it Simple

In almost all instances, stating the obvious when filing for Federal Disability Retirement benefits under FERS & CSRS is the rule to follow.  Another simple rule to follow:  Keep it Simple.  Except in special circumstances (e.g., where there is a nebulous diagnosis and one must interweave multiple symptmatologies in order to bypass the possibility that you may be later precluded from “adding” a “new” medical condition, etc.), it is best to stick to a paradigm of a 1-to-1 ratio or correspondence of medical conditions, symptoms, impact upon work, etc.  

Such a template can be dangerous to follow, however, because any Applicant’s Statement of one’s disability should never appear mechanical or stilted in its tone and tenor.  Emotionalism should not be stripped from an applicant’s statement of one’s disability in a Federal Disability Retirement application and, indeed, sterility should not be a goal to be sought.  

That goal should be from the treating doctor, where technical medical terms present a sense of diagnostic objectivity and scientific validity.  But such simple rules as presenting the correspondence between specific physical conditions with the physical requirements of one’s job, and similarly, between specific psychiatric symptoms with the cognitive requirements of one’s job, is an important “rule” to follow.  Remember, however, that filing a Federal Disability Retirement application under FERS or CSRS is not a “perfect science”; in fact, it is not a science at all, but a mix between law, personal input, and medical facts, with the creative force of persuasion.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement Benefits for Federal & Postal Employees: The Developing Medical Issue

There is a legitimate concern in preparing a Federal Disability Retirement application, that if an Applicant’s Statement (Standard Form 3112A both for FERS & CSRS employees) is not prepared properly, there may be some unforeseen repercussions down the road, including being barred from “adding” to the list of diagnosed medical conditions, to being found “disabled” based upon a minor, peripheral medical condition which may become “cured” within a short timeperiod.  This is true also of a “developing” medical condition — where symptoms abound, but the doctor is unsure of the specific diagnosis to ascribe to the patient.  That is why much of preparing a Federal Disability Retirement application under FERS or CSRS is more of an art form than a strict application of “the law” .  Yes, it is important to understand and apply the law.  Yes, it is important to extract prior experiences and weave the essential elements, both of the law, of facts, of medical descriptions, etc., into a meaningful narrative in bridging the two essential fields of evidentiary substance:  the medical evidence and the type of job which is impacted.  But more than that, one must know how to interconnect all of the necessary elements — the law, the facts, the medical basis, the essential elements of one’s job — into a coherent whole.  As for any developing medical issues, the same methodology can be applied — in an artful way, such that an unnamed diagnosis will have been “covered” by a description of the symptoms.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: The Tailored Approach

By a “tailored” approach, it does not mean that it must be narrow and without flexibility.  Flexibility is important in a Federal Disability Retirement Applicant’s Statement of Disability (Standard Form 3112A).  For, if you tailor an Applicant’s Statement of Disability too narrowly, there are multiple unintended consequences which can occur — from being pigeonholed into a narrow disability (which can become problematic later on if you get a Medical Questionnaire for updated medical information); to being unable to provide supplemental medical documentation to prove your case because the additional medical documentation does not apply directly to an identified medical condition on the SF 3112A; to multiple other potentially problematic areas.  Thus, always make the distinction between a formally diagnosed medical condition from the symptoms which may be delineated.  Further, there does not have to be a 1-to-1 correspondence between diagnosis and symptom; rather, the symptomatology can interweave between the formal diagnosis and the experiential pain, discomfort or cognitive dysfunctions (especially for psychiatric disabilities).  By allowing for some flexibility, one leaves enough “wiggle room” without sacrificing a clear and concise tailoring of descriptive delineation.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: Listing Specific Medical Conditions

Because the essence of an OPM Disability Retirement Application under FERS or CSRS goes to the symptomatologies and their impact upon one’s ability or inability to perform one or more of the essential elements of one’s job, it is therefore important to weave throughout the narrative of one’s Statement of Disability the symptoms, the impact, the descriptive events, which impact one’s ability/inability to perform the job.  Thus, while listing specific diagnosed medical conditions shoulder certainly be a part of any such application, the narrative itself should include the description of multiple symptoms resulting from the diagnosis.  Further, while the applicant is disallowed from “adding” any new medical conditions once it has been received by the Office of Personnel Management and assigned a CSA number, nevertheless, the applicant is not a medical doctor, and if a medical condition which later develops or becomes clarified during the process of review needs to be supplemented with an additional medical report or results of a diagnostic test, if the medical condition can be reasonably related to a described symptomatology or description in the original statement of disability, then in all likelihood, it will be allowed in for review.

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: 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

CSRS & FERS Disability Retirement: Diagnosis v. Symptoms

Is an official diagnosis important?  It certainly makes for a “clean” Federal Disability Retirement application under FERS & CSRS, and indeed, sometimes the Office of Personnel Management will question the validity of a Federal Disability Retirement application if a treating doctor equivocates on ascribing a clean, clear-cut diagnosis.  But, as they say in philosophy, and specifically in symbolic logic, while a medical diagnosis may be necessary, it is not sufficient.  That is, while a medical diagnosis is often necessary in order to easily identify the medical condition, it is not sufficient to get a Federal or Postal worker an approved Federal Disability Retirement claim.  This is because, beyond an official diagnosis of a medical condition, it is important to describe the manifestation of symptoms, and how those symptoms impact one’s ability to perform the essential elements of one’s job.  To that extent, it is analogous to the story of a primitive tribesman who feared having his picture taken, because to have one’s image captured was to circumscribe the essence of an individual.  Similarly, while a medical diagnosis identifies the “what” of a condition, it fails to show the endless “hows” of that condition — as in, how does it impact one’s job, one’s personal life, one’s sense of well-being, self-image, etc.

Sincerely,

Robert R. McGill, Esquire