Tag Archives: why a formal medical diagnosis doesn’t tell the whole story

The Basic Question Of “What?” during the Federal Disability Retirement Application and Process

“Why” evinces a quality of curiosity, and perhaps of disbelief; “who” indicates a need to establish an identity and source; “how” demonstrates a pragmatic approach in determining a future course of action; and “what” reveals the yearning to unravel the foundations of basic principles, as in Aristotle’s methodology in his Metaphysics.

Before the first storyteller or shaman put on a mask to enhance the mysteries of healing and divination; long before the wide-eyed children gathered with the adults around the village center where the bonfire roared with flickering shadows of unknown powers beyond the periphery of the fireflies beaming in the distant darkness of dangers beyond; and well preceding the written account of human history, where anthropology and narrative fantasy melded to provide reminiscences of prehistoric days created in the imaginations of youth, the question of “what” was uttered in innocence.

What is the meaning of X? What happened? What makes a thing become itself? What is the essence of being?  Thus for any entrance into a fresh endeavor, the human need for satisfying the “what” of a matter is the prefatory step towards progress.

For the Federal and Postal Worker who is contemplating filing for Federal Disability Retirement benefits through the U.S. Office of Personnel Management, whether under FERS or CSRS, the initial question might be: What constitutes a “disability”?  In that question is the key which often opens wide the conventional confinement which so many people are locked into.

For, in the traditional sense, the focus of the answer to such a question is contained in the definition and diagnosis of a medical condition.  For FERS and CSRS Federal Disability Retirement, however, the expansion of the answer goes well beyond the strictures of a diagnosis.  It is the nexus, or the connection, between the medical condition and symptoms, on the one hand, and the positional requirements (whether physical, mental or emotional) of one’s Federal or Postal work, which establishes the answer.

Once the Federal and Postal employee gains an understanding of this differentiating concept, then the doors open wide beyond the confinement of OWCP benefits or Social Security Disability benefits.  Thus does one approach Federal Disability Retirement with trepidation in asking, What qualifies as a disability?  For, contained within the question is the implicit and unspoken answer: such a query already implies a problem, and the problem likely is an impact already being felt upon one’s inability to perform one or more of the essential elements of one’s positional duties of one’s Federal or Postal employment.

As with the first causative rumblings deep in the consciousness of one’s soul, as a child first begins to question the complexity of the universe surrounding the inner self of the “I”, the question uttered alters the relationship between the being of “I” and the objectivity of “others” in a perplexing world of unanswered questions; but in the end, the “what” is a first step, and so it is also for the Federal and Postal employee who is considering filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether you are under FERS or CSRS.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Non-nexus

Meeting an adequacy test may constitute sufficiency for some purposes, but not for others.  Thus, it may be enough in completing an FMLA form to have a diagnosis, along with answers to other questions on WH-380-E.  But mere identification of a medical condition via a diagnosis, along with a description of symptomatologies will not be enough to meet the sufficiency test in a Federal Disability Retirement application.

People often assume that having a medical condition in and of itself sufficiently explains the severity of one’s condition, and any implied “blank spaces” can be filled in by the mere existence of such a medical condition.  But Federal Disability Retirement, whether under FERS or CSRS, filed through, reviewed by, and approved or disapproved by the U.S. Office of Personnel Management, must be proven by a preponderance of the evidence that the medical condition itself prevents the Federal or Postal employee from performing one or more of the essential elements of one’s positional duties.

As such, the identification and description of a medical condition fails to comply with the adequacy standards in proving eligibility for Federal Disability Retirement benefits.  One must establish, through the conduit of a medical professional, the “nexus” or “connection” between one’s identified medical condition and the inability to perform one or more of the essential elements of one’s job.

The weight of the proof is upon the Federal or Postal applicant.

The foundation of such evidence begins with the identified medical condition, but in and of itself, it is a non-nexus — until it is squarely placed in the context of one’s official position and the duties required by one’s duties.  Thus, the non-nexus become the nexus-point when combined with the identification and description of one’s positional duties.

It is this realization of the step-by-step sequence of proof which constitutes adequacy and sufficiency of evidence, and one of which the Federal or Postal applicant for OPM Disability Retirement benefits must be aware.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Flexibility of Language

Language is inherently a flexible tool; it is meant to communicate, and while precision in communication is the defining purpose in the use of the tool, often the essence of language must nevertheless be flexible enough to embrace other, correlative concepts. To limit the tool of language often will lead to undermining the very purpose of the use of such language.  

In filing for Federal Disability Retirement benefits under FERS or CSRS, the use of language in preparing, formulating and describing the interaction between the medical conditions and how it impacts one’s job duties, must allow for some level of flexibility.  For example, if certain chronic symptomatologies result in a mis-diagnosis of a medical condition, should a later (revised) diagnosis be allowed to be argued to the Office of Personnel Management after it has been filed?  

The answer to the question is contained in how the Applicant’s Statement of Disability on Standard Form 3112A is formulated.  If one merely lists the diagnosed medical conditions without describing the symptoms, then the language used has restricted the flexibility of post-filing inclusion.  On the other hand, if one combines the various medical diagnoses, but also includes a descriptive discussion of the symptoms, then the answer is likely, “yes”.  The use of language should be one of precision; how one utilizes the tools of language, however, should remain flexible.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Government Employees: Beyond the Diagnosis

The diagnosis of the medical condition in a Federal Disability Retirement case, either under FERS or CSRS, is merely the beginning point in preparing a case. As the Office of Personnel Management in Washington, D.C., is fond of repetitively pointing out, “The mere existence of a medical condition is not a basis for approval under Federal Disability Retirement laws.” While there may be some exceptions for certain severe medical conditions, the statement itself contains a truism which needs to be kept in mind throughout the process.  

Ultimately, in preparing a Federal Disability Retirement case, one must approach the entire process (a process, by the way, which is taking longer and longer to complete, as the backlog at the Office of Personnel Management is increasingly extending the wait-time) with a view towards bridging the two critical elements in any successful filing:  (A) the medical condition and (B) its impact upon one or more of the essential elements of one’s job.  

It is that “connective tissue” between the two which must be the focus, and that is why the symptoms which manifest themselves from the origin (the diagnosis) is what must be discussed.  For, ultimately, while the diagnosis of a medical condition provides the basis for which a medical specialist may begin treatment on a patient, it is the symptoms/symptomatologies which provide the answer to the question in all Federal Disability Retirement applications under FERS or CSRS:  In what way does one’s medical condition prevent a Federal or Postal Employee from performing the essential elements of one’s job?

That is the critical question which must be answered, in order to have a chance at having one’s Federal Disability Retirement application approved by the Office of Personnel Management.

Sincerely,

Robert R. McGill, Esquire