Postal and Federal Disability Retirement: The Volume-based Application

A declaration of the sheer volume of medical evidence submitted is often an indicator of the basis for which a Federal Disability Retirement application was formulated; for, in the end, if reliance of the successful outcome of a Federal Disability Retirement application is expected based upon the longevity and extent of a medical condition, the chances of an initial approval may be somewhat compromised to begin with.

Volume can never replace content; and from the perspective of the U.S. Office of Personnel Management, there is often an underlying suspicion that receipt of a thousand pages of medical documentation indicates merely that volume of treatment is being substituted for the substantive content of meeting the required legal standards.

Much of medical notation and treatment records merely reflect a particular appointment’s mechanical applications — continuation of previous treatment plan; refill of prescriptions; standard positive or negative responses to particular questions; prospective treatment modalities; and, as supportive evidence attached to a substantive medical report, they can reinforce the satisfaction of the legal criteria of establishing the necessary nexus between one’s medical condition and the inability to perform the essential elements of one’s job.  But left as a replacement for the doctor’s explicit statement confirming such a nexus, it remains a hollow voice within an expansive but empty chamber.

One should never mistake the legal distinction between “primary” evidence and “supportive” evidence.  The former is meant to establish the nexus between one’s medical condition and the essential elements of one’s job; the latter is submitted to reinforce the former.  When one utilizes the former as the substitute for the latter, it is like the self-delusion that just because you are the best player on a pick-up team in your neighborhood, you are ready to enter into the world of professional sports.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for US Government Employees: The Balance of Information

In every submission of documentary evidence for a Federal Disability Retirement application, whether under FERS or CSRS, there is the need for discretionary decision-making.

Not every piece of information is relevant or necessary; volume of attachments does not make for sufficiency of substantive content; allowing for certain information to “speak for itself” is often more effective than a long-winded explanatory addendum; and the extent of irrelevant or unimportant information attached or included may well have a decidedly negative impact upon a decision, both in terms of questions raised as to the reason for inclusion of such material, and the detracting nature of such information from the centrality and essence of the submission.

Balance of information is always a consideration.  As time is always of importance, so is maintaining the acuity of attention upon the case worker assigned to review, evaluate and decide upon a case.  Streamlining; making certain that the focus is always upon the nexus between one’s medical condition and the ability/inability to perform one or more of the essential elements of one’s job; and the editorial process of discretionary inclusion of relevant material — these should be the final steps in the formulation and compilation of a Federal Disability Retirement application just prior to submission to the U.S. Office of Personnel Management, whether under FERS or CSRS.

Balance the information — always in favor of relevance, importance, and substantive content.  Fluff is best left to descriptive articulation in a fictional genre.

Sincerely,

Robert R. McGill, Esquire

Early Medical Retirement for Disabled Federal Workers: Systematic versus Haphazard

The latter term (“haphazard”) is marked by a lack of planning, and connotes a loss of direction and depicting disorderliness.  The first term in the bifurcated title represents a purposeful and planned event; one which possesses a goal from the beginning of an initiated process, and in an ordered manner, goes about to execute that goal by taking and completing pre-planned steps in order to reach that endpoint.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, it is important to approach the completion and filing of a Federal Disability Retirement application in a systematic manner, as opposed to a haphazard one.  By “systematic” does not necessarily mean “sequential”, however — as in the sequence of the standard forms which one receives in a packet of governmental forms.

Thus, for instance, if one simply picks up the 3112 series of forms, it would not make sense to fill out and complete 3112A first, then to send out the Physician’s Statement (3112C) to the doctor (side note:  this author has widely, systematically, and for some great amount of time, counseled against using the 3112C because of the potential wider consequences of allowing for unfettered access by the agency to a Federal or Postal Worker’s medical records, so be forewarned) for completion.

Indeed, to do so would not make any sense:  why would one complete questions about one’s own medical condition prior to having, in hand, medical reports from one’s own treating doctors?  By “systematic” does not mean getting the forms and filling them out in as quick a time frame as possible.

While completion of a Federal Disability Retirement packet is certainly a goal, a far greater goal is to prepare, formulate (systematically), and then file — but not in a haphazard manner.

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

OPM Disability Retirement: OWCP Doctors, and Others, Etc.

Can a doctor with whom one has been treating, but one which was obtained through the Federal Employees’ Compensation Act, Department of Labor (FECA/DOL), Office of Workers’ Compensation Program (OWCP), be an effective advocate for one’s Disability Retirement application?  Of course.

Often, however, there is a complaint that the “OWCP doctor” is not very responsive to a Federal or Postal employee’s attempt to approach the question of filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS.  As FERS & CSRS Disability Retirement is based upon proving by a preponderance of the evidence one’s medical inability to perform one or more of the essential elements of one’s job, it is crucial that the Federal or Postal employee contemplating filing for Federal Disability Retirement benefits have a supportive doctor.

While the Merit Systems Protection Board’s expanding case-law holdings continue to reinforce the idea that the most effective advocate in a Federal Disability Retirement case is a “treating doctor”, as such, medical reports obtained through 2nd opinion or “referee” consultations, or via filing for Social Security Disability benefits, may have some limitations on their usage; nevertheless, the weapons of arguing that an “independent” source of medical review also found that one could not perform one or more of the essential elements of one’s job, can be an effective substantive argument.

As for the OWCP-treating doctor, sometimes those forms completed by such a doctor will be enough to meet the eligibility requirements for OPM Disability Retirement — but that is an individual assessment based upon the uniqueness of each case.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: Quantifying Quality & Qualitative Quantity

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, it is important to make discretionary decisions concerning multiple aspects of a Federal Disability Retirement application — including the volume, extent, nature, and quality of the medical documentation to be submitted.

Because it is the Applicant (the Federal or Postal employee who is submitting the application) who has the “burden of proof” — that burden which states that by a preponderance of the evidence, one’s Federal Disability Retirement application is more likely to be so than not so — it is therefore up to the Applicant to make determinations as to the quality and quantity of the medical documentation and any other relevant attachments.

Qualitative sufficiency is often a difficult measure to determine; quantitative significance is equally difficult — as in, how much is enough? On the one hand, to submit a thousand pages of medical notes, reports, etc., would probably be “too much”.  But a case which only includes 5 pages of medical reports and notes, while seemingly “too little”, can be more than sufficient if the quality of the records and reports is indisputable and irrefutable in determining that a Federal or Postal employee is no longer able to perform one or more of the essential elements of one’s job.

Ultimately, the discretionary decision will come down to a matter of experience — for it is based upon prior experience that one can make better decisions for the future.  To that extent, to be inrepresented in attempting to obtain Federal Disability Retirement benefits is obviously a disadvantage, because an unexperienced Applicant is merely entering into the arena of Federal Disability Retirement law based upon a “hit or miss” history of inexperience.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: The Proper Balance

Meeting and arriving at the “proper balance” in any endeavor is an Aristotelian concept found in his Nichomachean Ethics, of achieving a median between any two extremes.  In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, it is important to ascertain, then apply, this concept of a “middle” balance between providing too much information (which then includes much superfluous content and documentation which merely provides volume, but not qualitative evidence of one’s Federal Disability Retirement eligibility), and not enough to meet the legal criteria.

By appearance alone (and here, of course, the philosophical outlook and distinction between that which is merely “appearance” as opposed to “substance” applies beautifully), it is sometimes necessary to provide a certain level of volume of medical records in order to satisfy OPM that there is indeed “substance” to one’s medical claim.

It is an unfortunate anomaly that, while on the one hand OPM is looking for “relevant” information, and much of the office and treatment notes of a doctor merely contain passing and quick notations on treatment modalities, medication regimens prescribed, etc.; nevertheless, the appearance of office notes, regardless of their irrelevant nature and lack of substantive content, accompanying a qualitatively significant medical narrative report, often satisfies OPM’s request for “documentation” of a medical condition.  On the other hand, too great a volume of immaterial medical documentation which tends to show nothing, should be streamlined, if possible.  Meeting that Aristotelian “median” between providing too much and too little is something which is discretionary, but important to attain.

It is normally through experience of having handled a volume of cases that one can gain a sense of what the “proper balance” means, but for the particular Federal or Postal employee who is preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, such an endeavor is, and should be, the one and only time that such an encounter would be engaged in.

That, in and of itself, is a conundrum which can only be resolved by consulting someone who is knowledgeable in the area of Federal Disability Retirement law, and as knowledge of first principles is also an Aristotelian mandate, so consultation with those who are familiar with such first principles (or any principle which applies to OPM’s arbitrary approach, for that matter) should be a must for the Federal or Postal employee considering a Federal Disability Retirement application.

Sincerely,

Robert R. McGill, Esquire

Postal and Federal Disability Retirement: Providing Information

In every area of law, in most facets of life, and certainly in the administrative procedures of preparing, formulating and filing for Federal Disability Retirement benefits either under FERS or CSRS with the Office of Personnel Management, one must determine the extent, scope and substance of the information which will be provided to the requesting entity.  

Most of the time, the extent of information is pre-determined by the requirements which must be satisfied.  Similarly, the scope of the information to be submitted must meet certain criteria, but additionally, it will depend upon the question asked.  More importantly, the substance of the information one needs to provide, will be determined by the question asked, the criteria to be addressed, and the statutory and regulatory guidelines which must be met — in the case of Federal Disability Retirement under FERS or CSRS, that which would meet the legal standard of “preponderance of the evidence.”  

In venturing and maneuvering through the administrative process of applying for Federal Disability Retirement benefits, however, there will be times when either the Agency or the Office of Personnel Management may request “additional” information, indicating that they are not satisfied with what has been submitted.  

An appraisal of what information is being asked; whether the question is properly formulated as posed, or whether it can be reformulated and still satisfied; and the harm or good in responding fully or partially to the request — these are all determinations which are best guided by the advice and counsel of an attorney who understands the laws governing the legal criteria in Federal Disability Retirement cases.  

Not every question deserves a full answer.  Sometimes, the question itself must be re-formulated and answered in the re-formulated format.  Agencies are not gods; they are not omnipotent, and certainly not omniscient.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Workers: SSDI Impact

In preparing, formulating and filing a Federal Disability Retirement application under FERS (CSRS individuals are exempted for this particular issue), the Federal or Postal employee who is contemplating filing for the benefit must at some point in the process file for Social Security Disability benefits (SSDI).  This is because the law is set up for an off-setting feature between the two “pockets” of benefits — where, in the first year, there is a 100% offset between FERS & SSDI, and a 60% offset every year thereafter.  

In some rare instances, Social Security will approve a person’s disability application before the Office of Personnel Management has approved a FERS Disability Retirement application.  In that instance, one can use the SSDI approval as “persuasive” evidence to the Office of Personnel Management.  It is not determinative evidence, but there are legal arguments to be made which essentially state that, since a person has been found to be “totally disabled” by the Social Security Administration, based upon the same or identical medical evidence and documentation, that the Office of Personnel Management should grant a FERS Disability Retirement application based upon the same or identical medical evidence.  

Is the reverse true?  If a FERS Disability Retirement application is approved, can such an approval be used as evidence — persuasive or determinative — for an SSDI application?  That would be a weaker argument, precisely because OPM Disability Retirement does not make a determination of total disability, but rather, a decision that the Federal or Postal employee cannot perform one or more of the essential elements of one’s particular kind of job.  Moreover, the Social Security Administration might also argue that inasmuch as SSDI does allow for some earned income (about $1,000 per month) from a job, such allowance shows that approval of a FERS Disability Retirement, which recognizes that one is merely disabled from performing one or more of the essential elements of one’s particular kind of job, should not be determinative of a Social Security criteria which requires a higher standard of disability.

Knowing what impact each aspect or element of a process will have upon another is an important step in preparing, formulating and filing a Federal Disability Retirement application. As knowledge is the source of success, utilization of such knowledge is the pathway to an approval in a Federal Disability Retirement application under FERS and CSRS.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Disability Retirement: Discretionary Decisions

In preparing, formulating and filing for Federal Disability Retirement benefits under FERS or CSRS, there are obviously the “basics” which one must submit, in order to meet the legal standard of proof of preponderance of the evidence.  

Thus, submitting “adequate” medical documentation which formulates a nexus between the medical condition upon which the Federal Disability Retirement application is based, and the essential elements of one’s job; writing the descriptive narrative to complete the Applicant’s Statement of Disability (SF 3112A), and filling out the other standard forms in order to meet the minimum requirements, are deemed “non-discretionary”, in that one does not have the choice of filing such paperwork  — it is a requirement.  

However, certain other documentation can be designated and categorized as “discretionary” —  whether to include certain medical conditions, and therefore medical documentation which bears upon the particular medical condition; whether to include paperwork from one’s OWCP, Department of Labor filing; Veteran’s Administration ratings, findings, medical documentation; Social Security Disability paperwork; additional statements from co-workers; Private Disability Insurance paperwork, etc.  

“Discretion” implies freedom to act or not act, but the problem will often arise, “In what context”?  Discretion is a wonderful, liberating position to be in; acting effectively in a discretionary manner requires research, and knowing the relevant criteria to apply in making a proper decision; and an understanding of the laws governing Federal Disability Retirement in making the “right” discretionary decision.  

Using discretion in making discretionary decisions is the key to obtaining a positive discretionary determination from the Office of Personnel Management.

Sincerely,

Robert R. McGill, Esquire