Tag Archives: when the federal employee’s physician is ready to support a disability claim

Federal Employee Medical Retirement: Back to Fundamentals

In any endeavor, concern or current focus of attention, one can become embroiled in the morass of complexities which comprise the peripheral penumbras of the issue, and disregard the fundamental essence of the matter.  In proverbial terms, it is to overlook the individual trees while viewing the generality of the forest.  So, back to basics.

In a Federal Disability Retirement application, a person who is under FERS (Federal Employees Retirement System — normally those who entered into the Federal Workforce sometime after 1985, and who have a Thrift Savings Plan and contribute to Social Security) or under CSRS (Civil Service Retirement System — pre-1985, with no TSP) may become eligible for Federal Disability Retirement benefits, but must have the following minimum eligibility criteria met: under FERS, you must have at least 18 months of creditable service; under CSRS, you must have at least 5 years of creditable service.

There is a hybrid status applicable for some, called CSRS-Offset, also.  Once that eligibility criteria is met, then the Federal or Postal Worker can take the next step in determining whether one may want to proceed, by asking the following questions: Do I have a medical condition? Does that medical condition prevent me from performing one, if not more, of the essential elements of my position? What are some of the essential elements of my position which I cannot perform? Do I have a treating doctor who will be supportive of my case (remember, this is a medical disability retirement; as such, one must be able to establish through proof of medical documentation, that the medical condition impacts one or more of the essential elements of one’s job)?

These are some of the preliminary, basic questions which should be asked and answered, in order to begin the process of determining whether Federal Disability Retirement is the best pathway for the Federal or Postal employee suffering from a medical condition, in order to manage and maneuver one’s way through the thick forest of a bureaucracy known as the U.S. Office of Personnel Management, which is the agency which ultimately receives and reviews all Federal Disability Retirement applications, whether you are under FERS, CSRS, or CSRS-Offset.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Process Mentality

The importance of understanding that filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, as a “process”, is critical in reaching the mental preparedness necessary to endure the potentiality of the lengthy encounter.

The analogy of the approach should be likened to the difference between WWI and WWII — of trench warfare as opposed to a blitzkrieg.  It is the former which must be prepared for, and not the latter.

For, at each step of the way — from waiting for the proper medical reports to be prepared by the treating doctors, to formulating the narrative of one’s statement of disability; to waiting for the agency to complete the processing of their potion (i.e., the Supervisor’s Statement and the Agency’s Certification of Reassignment and Accommodation efforts); to the intake processing unit of OPM at Boyers, PA, then down to Washington D.C. where assignment of the case will take some time; to final assignment of the case, and potential routing for review by a contract doctor — this is all merely at the First Stage of the process.

If it is denied at the First Stage, then one must fight the process through the Reconsideration Stage, and possibly beyond.

Thus is the mental preparation at the outset required in order to survive the multiplicity of bumps and turns within the process itself.  It is best to know the trials in order to survive the process, and to prepare for it as best one can.

Sincerely,

Robert R. McGill, Esquire

Federal Employee Medical Retirement: The Supportive Physician

Physicians comprise a peculiar and unique breed of people; highly trained, the best physicians must be more than a technician, however, in order to effectively treat their patients.  The uniqueness of the profession itself requires a full panoply of skills, including intelligence of application; an acuity of judgment; analytical abilities in evaluating, assessing, diagnosing, and ultimately treating; a bedside manner which conveys confidence and compassion at the same time; and not least — an ability to listen and communicate.

For the Federal or Postal worker who is contemplating preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, a physician who is supportive of the potential applicant’s endeavor is crucial to the successful outcome of the entire administrative process.  By “support” cannot merely be characterized by a smile and a pat on the back; it requires that the physician be willing to make the connection between one’s medical conditions (which the treating doctor should have a thorough knowledge and understanding of) and the essential elements of one’s job (of which the Federal or Postal employee should have a deep and detailed awareness).

Thus, as the partnership for healing comes together in the creation and fostering of a doctor-patient relationship, so the fruition of a successful Federal Disability Retirement application begins with the coalescent cooperation between the medical professional and the Federal or Postal employee who is preparing, formulating, and filing for Federal Disability Retirement benefits.  How that cooperation comes together, of course, makes all the difference, and the tell-tale sign is the willingness to provide a detailed narrative medical report.

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

Postal and Federal Disability Retirement: Supporting the Concept

In preparing, formulating and filing a FERS or CSRS Federal Disability Retirement application, the important first step in the “preparation” phase — or, one might even term it conceptually as the “pre-preparation phase” — is to engage the treating doctor with the conceptual framework of what Federal Disability Retirement entails and encompasses.  

As has been repeated many times previously in other blogs, doctors are not administrators, and ultimately detest the need to annotate, narrate, write reports, etc.  The legal system has forced doctors to keep records, if only for their self-protection in the event of a question of malpractice, and the requirement of keeping office records and notes has had the positive corollary effect of forcing doctors to “think through” the procedural steps of what it is that they are “doing”.  

Requesting the treating doctor to support a Federal Disability Retirement application has the identical positive result of forcing the doctor into an admission that one’s medical condition has come to a crossroads:  prior treatment modalities have not proven to be effective; the chronic and progressively deteriorating nature of the physical or psychiatric condition has shown to be “treatment-resistant”; the time has come to acknowledge that a different mind-set must be embraced — one which includes a period of rest, restorative time, and a stage of recuperation away from the activities which the Federal or Postal employee spends on average 40 – 50% of the time at:  one’s job.  

Speaking to the doctor about his or her support and role in preparing a Federal Disability Retirement application is the first, necessary, and vital step in the preparation, formulation and filing of a Federal Disability Retirement application under either FERS or CSRS.  How best to approach the doctor, the timing, the words and concepts to use, etc., are all part of that preparation.  

If it is time for the Federal or Postal worker to recognize that one’s medical conditions are preventing the Federal or Postal worker from performing one or more of the essential elements of one’s job, it is time to think about pre-preparing the treating doctor.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Government Employees: Confirming the Relationship

After undergoing all of the those diagnostic tests; after allowing the doctor to clinically examine, prescribe multiple medications based merely upon the say-so of the doctor; after allowing for invasive surgery; sending you to physical therapy; if the time then comes to prepare and file a Federal Disability Retirement application under FERS or CSRS, it is important to confirm the real strength of that “patient-doctor” relationship that has apparently been ongoing and fostered for those many months, years, and sometimes, decades.

It is not enough to get a nebulous “pat-on-the-back-sure-I’ll-support-you” sort of response, and with that, you receive a thick packet from the medical office, you open it, and inside is merely a copy of your medical records.  No — “support” must be concrete and definitive. It must mean, specifically, that the doctor is willing to write an excellent medical report outlining his or her opinion in connecting your medical condition with you inability to perform one or more of the essential elements of your job.  If it is time to file for Federal Disability Retirement benefits, it is time to have a heart-to-heart talk with the treating doctor, and see how committed he or she really was and is to this “patient-doctor” relationship.

Sincerely, Robert R. McGill, Esquire

OPM Disability Retirement: The Right Timing

Timing the preparation and submission, and ultimate separation/retirement from Federal Service in getting Federal Disability Retirement benefits under FERS or CSRS is rarely a method of precision; it is closer to art than it is to science.  That is because there is the “human” element involved — of when does the medical condition reach its critical point where one cannot withstand the daily and chronic pain; is the doctor ready to support the Federal Disability Retirement application; is the Agency sympathetic or suspicious; can the reduced finances be worked out for a livable standard of living; will the future allow for all of the elements to coalesce? 

There are many, many such human elements which must come into play.  All too often, however, the “right time” for contemplating filing for Federal Disability Retirement benefits is simply determined by external circumstances, such as reaching a critical point in one’s medical condition such that there is simply no other choice left, as opposed to being able to rationally and calmly make an affirmative decision for one’s future.  Whatever may be the particular and peculiar circumstances of a given Federal or Postal employee, the time to consider preparing a Federal disability retirement application must be a decision made by each individual, based upon that individual’s unique circumstances.

Sincerely,

Robert R. McGill, Esquire