OPM Disability Retirement: Treatment, Surgery and Medication Regimens

In contemplating preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, one needs to always bifurcate issues which are “legal”, “employment-related”, and “medical”, etc.  Of course, issues can easily cross over between neatly-construed, artificial boundaries, such that certain issues contains multiple areas.

For example, there is the question of compliance with medical treatment.  First and foremost, whether it concerns or impacts a Federal or Postal employee — or any employee of any organization — the question of whether an individual is complying with the treatment recommendations of a doctor is one which is, and should be, first and foremost a medical one.

In preparing a Federal Disability Retirement application, however, that same question can indeed cross over into becoming a legal issue concurrently, because non-compliance with certain types of treatment regimens can be a basis for a denial of a Federal Disability Retirement application by the Office of Personnel Management.

As to “which” treatment modalities would be a basis for a denial, in general terms, those treatment modalities which one might construe as “minimal” in nature, certainly qualify.  Thus, compliance with a medication regimen is certainly a basis for a denial in a Federal Disability Retirement application; refusing to undergo a prescribed course of physical therapy may be another.  On the other hand, deciding to forego surgery is normally not a basis for a denial of a Federal Disability Retirement application, if only because of the percentages of success even with surgery are tenuous at best, and even with surgery, there is always the question of whether the Federal or Postal employee would be able to perform all of the essential elements of the job anyway.

Questions of medical treatment compliance should first and always be considered a medical question, and only in a secondary sense, a legal question.  One’s health should be the penultimate concern; the legal consequences, an afterthought.

Keeping one’s priorities in order is always the best approach, whether contemplating filing for Federal Disability Retirement under FERS or CSRS, or not.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: Agency Actions prior to Separation

The question is often asked as to whether there is an adverse or detrimental impact upon a Federal Disability Retirement application if the Agency or the U.S. Postal Service initiates an adverse action, places an individual on AWOL, or administers a similar type of administrative sanction, action, etc.

The general answer is that such agency actions will not prevent or influence the prevention of a Federal Disability Retirement application from the U.S. Office of Personnel Management, whether under FERS or CSRS, but such a generalized answer contains within the “details” certain implicit assumptions — the primary one being, that the medical support which would accompany such a medical retirement will be strong enough to withstand and effectively refute such an adverse action.

By “supporting medical documentation” is meant, at a minimum, two issues which the treating doctor of the applicant must address:  That, prior to separation from Federal Service, the Federal or Postal employee could no longer perform one or more of the essential elements of one’s job, and further, that the medical condition is expected to last for at least 12 months.

Additionally, a third element would also be helpful — that the medical condition or disability began before the adverse action, or conversely, that the behavior or acts of the Federal or Postal Disability Retirement applicant which precipitated the adverse response of the Federal Agency or the U.S. Postal Service occurred after the origination point of the medical condition, and such an origination point can be ascertained.

This is because OPM will sometimes argue that the underlying motivation and purpose of the Federal or Postal applicant filing for Federal Disability Retirement benefits was based not upon the medical condition, but because of the adverse action.  Further, the Merit Systems Protection Board has stated that such circumstantial evidence of underlying motive or intent can indeed be reviewed.  Rebuttal of such implied intent can best be proven by a doctor’s assertion.

Motives are a peculiar thing, but the casting of such underlying motives are often difficult to refute, unless a timeline of facts can counter them.  Motives are found only in the depths of one’s consciousness; and like the air we breath, the fact that we assert its existence does not necessarily prove otherwise, especially if the doubter is receptive to the poisonous whispers of finger-pointing.

Sincerely,

Robert R. McGill, Esquire