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

Medical Retirement Benefits for US Government Employees: Succinctly Put

In a technological age where one’s attention is diverted by multiple needs, wants and necessities, the old adage that “time is money” is merely a reflection of the commodity-based approach prevalent in our society and lives at large.

One understands that in certain geographical locations, to encounter the salutation, “Hi, how are you,” is merely a formality, and is not meant to have one pause and actually provide the historical details of the past day, week or month, leaving aside any acceptable response other than a quick, “Fine, thank you,” and to walk quickly by.

In other parts of the country, foreign or domestic, such a greeting must actually be met with a personal conversation, lest one is left to be considered rude and unneighborly.  It is precisely because time is considered a valuable and threatened commodity, that one is left with attempting to devise ways in which to “maximize” the precious but ethereal substance.

In a Federal Disability Retirement application, when one approaches a medical doctor in requesting records, notes, or a rather detailed report in order to obtain support for one’s Federal Disability Retirement submission through the U.S. Office of Personnel Management, it is important to explain thoroughly; to request in detail; but at the same time, to remain succinct in order to deal with the aspect of time as a commodity.

Doctors know the value of time; they tie it to life and death decisions on a daily basis, and are keenly aware of the importance of a life’s time.  To show respect for a doctor’s time is important in the very approaching of the medical personnel.  It is simply one more thing to keep in mind in preparing, formulating and filing for Federal Disability Retirement benefits from OPM, whether under FERS or CSRS, for all Federal or Postal employees.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: Listening to the Doctor

It is amazing how unaware we often are of our very surroundings, even when the circumstances and scenario directly impact us.  Doctors see dozens of patients per day, and the administrative aspects of their medical practice rarely engender excitement; for, while being a proponent of a patient to assist in the entirety of the recuperative process, writing a medical narrative report is not the crux (for most doctors) of that process.

However, when a doctor makes statements which clearly reveal the extent of administrative support that they are willing to provide, it is time to listen.  For example, if your treating doctor says something to the effect of, “Your job is clearly killing you,” or “you shouldn’t be doing this line of work,” or sometimes even the non-subtle approach of:  “You need to medically retire” — the response for the Federal or Postal employee who is seeking to file for Federal Disability Retirement benefits should not be one of remaining silent, unaware, smiling distractedly, or even responding with, “Yes, I know, but…” with a trail of silence.

That scenario is precisely the moment to seize, and to say to the doctor, “Doctor, I think that you are right.  Will you be willing to write a medical narrative report which would support me in my quest to obtain Federal Disability Retirement benefits, which would then allow me to recuperate from my medical condition?”  Such a conversation must have the cooperative participation of both the doctor and the patient.  For, if the doctor does not bring the subject up, and the Federal or Postal employee begins the process of seeking to prepare, formulate and file for Federal Disability Retirement benefits under FERS or CSRS, the type of conversation-opener described herein will have to take place, anyway.

If the doctor brings up the subject during any clinical examination or encounter, the pursuance of such a conversation should be taken advantage of.  The old saying that the doctor knows best is certainly illustrated when one’s treating doctor has opened the door to supporting the Federal or Postal employee in the quest to obtain Federal Disability Retirement benefits from the Office of Personnel Management.

Sincerely,

Robert R. McGill
OPM Disability Attorney

 

Federal and Postal Disability Retirement: The Best Indicator

When is the right time to file for Federal Disability Retirement benefits under FERS or CSRS?  Because the process can be a rather lengthy one (6- 8 months minimum from the beginning of the process of gathering the necessary medical documentation, etc., to receipt of an approval letter from the Office of Personnel Management in Washington, D.C.), the question of when to begin the preparation, formulation, and filing of a Federal Disability Retirement application may depend upon several factors.  Obviously, a frank discussion with one’s treating doctor is a good starting point.  

As for indicators, only the Federal or Postal employee who is suffering from the particular medical condition can know — either explicitly because of something that happened in the workplace or because of a medical emergency, or implicitly/intuitively.  As for the latter, if a Federal or Postal employee is exhausting his or her Sick Leave and Annual Leave, and is taking LWOP; has filed for FMLA; has been placed on a PIP; or, as is more often the case, is using the evenings and weekends as mere “recovery times” in order to drag one’s self to work, only to continue and perpetuate the vicious cycle of work, deteriorating condition, exhaustion, sleep, work, deteriorating condition … ad nauseum and ad infinitum (or so it would appear), then such an unacceptable condition of existence may be an indicator that it is time to consider formulating, preparing, and filing a Federal Disability Retirement application under either FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: Speaking with the Doctor

Communication is the key to a successful outcome:  such a trite truism is certainly applicable in a Federal Disability Retirement application under FERS & CSRS.  The primary focus when a Federal or Postal employee has a medical condition which is impacting his or her ability to perform all of the essential elements of his or her job, is to take care of the medical condition — i.e., to have the necessary treatments, to undergo the proper prescriptive treatment modalities, including surgery, medication regimens, pain management treatments, psychotherapeutic intervention, etc.

Beyond such treatment modalities, however, there may come a point in the life of a Federal or Postal employee when it is becoming apparent that the medical condition is simply “incompatible” with the useful and efficient retention in the Federal or Postal Service.  Such a determination is best made by the Federal or Postal employee, if possible, as opposed to having the Federal Agency or the U.S. Postal Service suddenly and unceremoniously make such a determination — in the form of a proposed removal based upon one’s failure to maintain a regular work schedule; or because of taking “excessive leave“; or putting a Federal or Postal employee upon a Performance Improvement Plan.  Such a determination may best be made by the Federal or Postal employee by communicating one’s concerns to the treating doctor, and asking some incisive questions.  Another trite truism:  The only stupid question is the one not asked.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: Office Notes (Continued…)

The Office of Personnel Management has every right to establish a consistency of medical treatment and opinions rendered on the part of the doctor, the specialist, the medical facility, etc.  One of the reasons why Federal Disability Retirement benefits are (in great part) determined by the opinion of the “treating doctor”, as opposed to a determination made by a medical doctor who makes such disability determinations but is not the applicant’s “treating doctor”, is that such a determination (in the eyes of Federal Disability Retirement laws, statutes, MSPB case laws, etc.) can best be rendered by a medical specialist who has a long-standing relationship with the patient/applicant, over a long period of time, to determine the extent, severity, chronicity, etc., of the medical condition claimed.  

With this in mind, there often arises a conflict of sorts:  On the one hand, most people who are attending to their medical needs, are not thinking in terms of “getting Federal Disability Retirement benefits” during the time of treatment.  The critical point of when the line becomes drawn, where treatment & chronicity begin to conflict; or where, despite every attempt by the doctor to prescribe treatment modalities, there appears to be a medical condition which is “intractable”, is often a difficult one to determine.  In most cases, the office/treatment notes will reveal the line, which may come about gradually.  At other times, one may have a doctor who thinks that he or she can successfully treat any and all conditions, and reflects such a “positive” outlook in every office notation.  This is often not helpful, when it comes time to filing for Federal Disability Retirement benefits under FERS or CSRS.  To counter this, a frank discussion with the doctor at some point may become necessary.

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