Medical Retirement for Federal Workers: Preexisting Conditions

The concept of a “preexisting condition” necessarily entails a date before which something was in existence; thus, that condition X preexisted date-certain Y, such that X preexisted Y.  Such a condition — whatever the nature of “it” — is normally ascertainable by doctor’s notes, treatment records, etc.

The relevance of whether a certain medical condition “preexisted” a certain date, however, depends upon the issue and the forum.  For Federal OWCP cases administered under the Department of Labor, such an issue is often relevant in determining coverage, precisely because an on-the-job injury will entail causation not only regarding “how” and “where” the injury occurred, but further, encompassing whether a Federal or Postal Worker is making a claim based upon a new and heretofore unknown injury or medical condition, or is merely suffering from a condition which “preexisted” a particular date — either the date of employment, the date of claimed injury, etc.

In a Federal Disability Retirement case, whether under FERS or CSRS, filed through the U.S. Office of Personnel Management, the issue of a “preexisting medical condition” is rarely of any relevance, either on the issue of “when” or certainly not on the “how” or “where”.  OPM will often attempt to make an argument on the basis that one’s medical condition “preexisted” one’s inception date of Federal employment, but presumably the Federal or Postal employee who may have suffered from the condition was able to adequately perform the essential elements of one’s job anyway, but at some point the preexisting medical condition came to a point of progressive deterioration such that it began to impact one’s ability to perform one’s job — in which case it matters not anyway.

In a Federal Disability Retirement application, one should never be fearful of divulging the history of one’s medical condition; rather, it is the here and now which is of relevance: How the medical condition impacts one’s ability to perform the essential elements here in one’s present job, and how it now impacts such job performance.

Sincerely,

Robert R. McGill, Esquire

Federal Worker Disability Retirement: Is the Concept of “Preexisting Condition” Ever an Issue?

Sometimes, the Office of Personnel Management will refer to a medical condition which “preexisted” — and it is often confusing as to what they are referring to.  The term “preexisting medical condition” must necessarily imply the question, “Preexisting to what”?  

For health insurance coverage, the issue is obviously one of a medical condition which existed prior to the start of medical coverage, and thus the question becomes whether or not the insurance company has an obligation to pay for medical bills incurred for treatment which existed and began prior to the terms of the policy.  

For purposes of Federal Disability Retirement, however, the question of a preexisting medical condition often encapsulates an admixture of multiple issues, based upon confusing a variety of concepts.  In a denial issued by the Office of Personnel Management, some cases will be denied based upon the assertion that a particular medical condition upon which a Federal Disability Retirement application is based, preexisted the time of Federal Service, and the Federal or Postal employee — despite the existence of the medical condition — was able to perform the essential elements of the duties of the Federal or Postal position.

Thus, a person with a confirmed Veteran’s Administration rating enters into the Federal government and is able to perform the job duties as required (for example).  Such an argument (or lack thereof) by the Office of Personnel Management is thus mixing a couple of issues, and conceptually identifying it as “preexisting condition”:  that the Federal or Postal employee has a medical condition which was identified prior to entering the Federal Service; that he or she was able to successfully perform the essential elements of the job; that the same medical condition is now the basis (or at least one of them) for a Federal Disability Retirement application.  But the issue is not really one of “preexisting condition” — for, whether the medical condition existed prior to or during one’s Federal Service is really an irrelevant issue — but rather, whether or not the medical condition as such became worse such that it now prevents a Federal or Postal employee to perform one or more of the essential elements of one’s job.  

Sometimes, people get the notion that by utilizing certain language, shouting certain sophisticated-sounding catch-phrases, or referring to concepts which seem intelligible, that it actually “means” something.  The concept of “preexisting conditions” is without meaning in a Federal Disability Retirement application, precisely because the law is neutral concerning that issue.  It may sound serious, but this is not OWCP or some other legal forum which applies a criteria regarding “preexisting conditions”.

Sincerely,

Robert R. McGill, Esquire

Federal and Postal Disability Retirement: A Hostile Work Environment

Unfortunately, reality often outperforms and upstages any attempt at fictional characterization of the workplace.  Often, the meanness and temperamental behavior of a supervisor in the “real” workplace can never be properly represented by an actor’s attempt in a sitcom or a drama; the persistent, irrational, capricious and outright cruel behavior and acts of “the boss” or one of his/her underlings can never be accurately depicted in fiction.  Further, the reality of the consequences of such behavior can be devastating.  Workplace stress resulting from demeaning behavior, intentional acts to undermine, cruel and arbitrary acts against a specific employee, can all result in serious medical consequences.  

It is all well and good to talk about internal procedures — of filing an EEOC Complaint; filing a grievance; filing a complaint based upon discrimination, etc.  But beyond such agency procedures to protect one’s self, there is the problem of the eruption of a medical condition, be it Major Depression, Anxiety, panic attacks, physical symptoms of IBS, chronic pain, headaches —  some or all of which may result from such stresses in the workplace.  There is no diagnostic tool to establish the link between the medical condition and the workplace stress.  

For Federal and Postal employees thinking about filing for Federal Disability Retirement benefits under FERS or CSRS, there is the context of harassment & stress in the workplace, and then the medical condition which prevents one from performing one or more of the essential elements of one’s job. Sometimes, it is difficult to bifurcate the two.  That which is difficult, however, must sometimes be accomplished in order to be successful.  The origin of the medical condition may have to be set aside, because it “complicates” the proving of a Federal Disability Retirement application.  If one is contemplating filing for Federal Disability Retirement benefits, the story — however real — of the workplace harassment, may have to be left behind.

Sincerely, Robert R. McGill, Esquire

Disability Retirement for Federal Government Employees: The Origin of Psychiatric Disabilities

When preparing the Applicant’s Statement of Disability (Standard Form 3112A) in preparing to file for Federal Disability Retirement benefits from the Office of Personnel Management, it is important to keep the essence of the statement “on topic”.  By this, is meant that the primary focus of the applicant’s statement should be repetitively twofold:  First, what the medical conditions and their symptomatologies & manifestation of symptoms are, and Second, how those medical conditions and symptoms impact one’s ability/inability to perform one or more of the essential elements of one’s job.  

While history and origin of a medical condition may be somewhat relevant (unlike in an OWCP case, where causality and date of injury and where/how it happened are important elements in establishing that a medical condition was somehow job related), normally in Federal Disability Retirement cases the origin of a medical condition should not be emphasized, if only because OPM does not care about it.  If the origin of one’s psychiatric medical conditions (e.g., Major Depression, anxiety, panic attacks, etc.) find their source from conflicts within a job, such a history may be a red flag which can lead the Office of Personnel Management to conclude that the medical condition constitutes a “situational disability“.  In a final determination as to whether a medical condition can be characterized as “situational”, while it must be looked at in its full context, nevertheless, it is the origin of a psychiatric medical conditions which is the first point of reference in making such a determination.  

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Medical Disability Retirement: Psychiatric Disabilities — Origin versus Situational (Continued…)

The “origin” of a medical disability, from the perspective of a Claims Representative at the Office of Personnel Management, may be relevant for purposes of adjudicating a Federal Disability Retirement application under FERS or CSRS.  Note that physical disabilities rarely become an issue in the context of the origination of the medical disability, precisely because it is irrelevant whether or not a medical disability occurred on the job or not.

The origin of a psychiatric disability, however, is potentially relevant from OPM’s perspective, because it may give rise to the argument that it is a “situational” disability — one that is contained, limited, and ultimately circumscribed within the situation of the particular office of the specific agency in which the Federal or Postal Worker works.  

Thus, from this argument, the logical extrapolation is that while the Federal or Postal worker is unable to work in the specific office or location, he or she is nevertheless able to perform all of the essential elements of the particular job — but in another agency, another office, another location, etc.  Thus, the concept of “situational disability” arises, with the consequential argument that one is in fact NOT prevented from performing one or more of the essential elements of one’s job — but rather, it is the “situation” which is at fault. This is why the citation of correlative EEOC complaints, hostile work environment accusations, etc., are dangerous to make in the context of filing for Federal Disability Retirement benefits under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for U.S. Federal Government Employees: Context, Sequence & Connections

Often, a potential applicant for Federal Disability Retirement will insist that the origin of the medical condition or injury is important to annotate, for one reason or another.  Unlike OWCP issues, origin and causation is usually of little or no significance in a Federal Disability Retirement application, whether under FERS or CSRS.  Thus, for OWCP Disability, it may be of importance to show that X injury was caused by occupational hazard Y; or that, while on the job on a certain date, the applicant slipped and fell, etc.  In proving OWCP Disability, such “incident-specific” facts are important in establishing causation, in order to determine eligibility and entitlement to OWCP Disability benefits.

For purposes of OPM Disability, however, the Federal or Postal worker who is seeking Federal Disability Retirement benefits from the Office of Personnel Management, does not have to establish such incident-specific facts.  Rather, the focus shifts upon the medical condition, the symptoms, and the impact upon those medical medical conditions and symptoms upon one’s inability to perform one or more of the essential elements of one’s job, within the last year.  While it may be that some factual context is significant by way of showing a sequence of events from the past, in order to show how the medical condition worsened over time, OPM normally does not care about such historical facts.  While the history of X is interesting, what occurs in the recent-to-present timeframe is what interests OPM.

Sincerely,

Robert R. McGill, Esquire

Medical Retirement Benefits for Federal & Postal Employees: Situational Disability, Revisited

Remember that there is nothing wrong with issues and events in the workplace being the originating factor which instigates or otherwise propels a medical condition — often (though not necessarily always) a psychiatric condition.  The characterization of a “situational disability” (one of the basis upon which the Office of Personnel Management may attempt to deny a Federal Disability Retirement application) only becomes a problem if and when a psychiatric condition prevents a person from performing one or more of the essential elements of his or her job with a particular office, agency or department. 

If the Federal or Postal employee is unable to perform in a particular job in an office or agency, but is able to perform the same basic set of essential elements with another agency, or in the private sector, then it becomes a case of “situational disability”.  However, if the medical condition pervades other aspects of the Federal or Postal employee’s life — personal life; relationships with family & friends; impacts his or her ability to be employable in other sectors; then the medical condition is no longer one of “situational disability” — despite its origins having been formulated in the workplace.  Thus, the issue is not “where the condition came from”, but rather, “where is it now”?  The Office of Personnel Management will often attempt to blur the boundaries between the two questions, and try and characterize the medical disability as not only originating with an agency, but being limited to that particular agency.  And, indeed, the Federal or Postal employee who files a Federal Disability Retirement application under FERS or CSRS does not help matters when he or she wants to persist in focusing upon the events in the workplace which may have contributed to the medical condition.  Beware not to fall into OPM’s trap.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Workplace (Part 2)

In filing for FERS or CSRS Federal Disability Retirement benefits with the Office of Personnel Management, it is important to stay away from issues which may explicitly or implicitly characterize the particular medical condition as being “situational” in nature.  However, this does not mean that the medical condition cannot have originated from, or been exacerbated by, the workplace environment.  Remember that OPM disability retirement is not like OWCP/Worker’s Comp — the issue of causality, or whether the medical condition occurred as a result of your occupation, is not important to prove. 

However, sometimes, it is simply an indisputable fact that the medical condition originated from the workplace, or was exacerbated by conditions in the workplace.  Such origination or exacerbations, once it takes on a “life of its own” and becomes chronic and pervasive such that the medical condition impacts a person both at the workplace as well as outside the workplace, then it has transformed into a medical condition beyond being merely “situational”.  Thus, that which originated as a “situational” medical condition may well no longer be a situational one.  In such cases — and that is normally the case in almost all medical conditions which begin as a situational disability — there would be no problem with filing for OPM disability retirement benefits.

Sincerely,

Robert R. McGill, Esquire