Medical Retirement Benefits for US Government Employees: Physicians

Physicians are peculiar animals.  They are here to help; and from their perspective, success is measured in terms of how rarely a patient returns for further care.  The ultimate sentence of failure is to conclude that nothing further can be done for an individual, and one must therefore declare that the patient is permanently disabled.

For the Federal or Postal employee contemplating filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, such a perspective on the part of the physician is important before approaching the treating doctor with a request for a medical report.  That is why the SF 3112C is such an ineffective vehicle of communication.

Consider this:  SF 3112C is a government-prepared form; it is formulated by Federal bureaucrats; the language merely proposes generic guidelines concerning what is required — without any amendments or consideration of case-law refinements which have been promulgated over the evolution of Federal Disability Retirement laws over these many years.

Perhaps more importantly, however, is the lack of bedside manners in handing to a physician a standard form.  While many physicians themselves lack adequate bedside manners, it is the epitome of bad form to thrust a pre-printed form (no pun intended) under the nose of a physician who is supposed to be treating and taking care of you, and to declaratively order, “Fill this out”.  Even an addendum of “please” will not adequately modify such an affront.

The physician-patient relationship is one based upon communication, knowledge, personal sharing, and a good bit of explaining.  Taking the time to prepare a physician is the least one should do in preparing for an effective Federal Disability Retirement application.

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

Medical Retirement Benefits for US Government Employees: Case Development

Federal Disability Retirement is one of those areas of law where countervailing forces are always at play, and the tug-of-war against time, resistance of individuals to respond, all within a context of a hectic-pace of life, create for a havoc of systems and regularity.

Because the underlying basis of filing for Federal Disability Retirement benefits often involves a chronic, progressively deteriorating medical condition, it is often seen from the perspective of the Federal or Postal employee to be an emergency; from the viewpoint of the medical doctor whose support for the case is critical, because the opinion of the doctor is essential to formulating the foundation of a Federal Disability Retirement application, it is often seen as another administrative burden; from the Agency’s vantage point, the alleged patience over the years which it has shown in “dealing” with loss of time, less-than-stellar performance, etc., often results in a reactionary adversity of being entirely unsympathetic to the plight of the Federal or Postal employee; and, together, all of the strands of these multiple countervailing forces places an undue pressure upon the entire process.  Yet, once it gets to the Office of Personnel Management, the file sits…and sits.

The long-term perspective on every Federal Disability Retirement application must always be to accept the fact that case development is the most important point to ponder.  Quickly filing a Federal Disability Retirement application, whether under FERS or CSRS, may in the end prove to be pound-foolish, especially in a retrospective, Monday-night quarterbacking sense, if OPM denies the case anyway.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Workers: From the Doctor’s Perspective

In attempting to understand others, it is important to gain a perspective from which the third party views the world.  Understanding the third party perspective is a way to formulating an effective way of persuading a change in that person, if that is the goal. Or, perhaps understanding X merely in order to accept the behavior or actions of the individual, is enough of a reason.

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 often important to understand the perspective of one’s treating doctor in order to obtain the necessary support and administrative initiation of the medical provider.

From the doctor’s viewpoint, it is normally counter-productive in terms of treatment and therapy to declare, ascertain and deem that the patient is “totally disabled“.  Work is therapeutic; it allows for a teleological motivation which compels continuation in recuperative and rehabilitative terms.

Further, when this “fact” is combined with the general exposure of most doctors to other forms of disability benefits — state or federal OWCP benefits; Social Security Disability benefits; private disability insurance benefits — and rarely an encounter with FERS or CSRS disability retirement issues, it becomes apparent why doctors often become reluctant and resistant to getting involved with the administrative process.  OWCP benefits require an assertion of causality-to-employment; SSDI necessitates a declaration of “total disability”; private disability policies can often lead to depositions and legal responses.

Thus, everything that is counterintuitive to a doctor’s perspective of what is therapeutically beneficial to the patient, is potentially there when presented with a request for support in a disability retirement case.

Explanation is the key to understanding; effective explanation should persuade and alter a perspective founded upon a misinformed foundation.  It is often necessary to explain the differences between FERS & CSRS disability retirement benefits and the “others” which have previously polluted the waters of a pristine stream of thought.

Sincerely,

Robert R. McGill, Esquire