In fighting to prove one’s eligibility for Federal Disability Retirement benefits, a recurring argument which the Office of Personnel Management often alleges is that an applicant failed to follow the treatment recommendations of the treating doctor.
Such an argument can prove to be fatal to an applicant’s case, but it is good to know the parameters of what it means to “fail to follow” reasonable medical treatment. For instance, non-compliance with a medication regimen can be fatal to a case. Thus, OPM will successfully argue that an individual who has failed to follow the medication regimen of the treating doctor has thus failed to show that the individual could have returned to work precisely because non-compliance with a medication regimen would logically undermine the potential efficacy of the medical treatment.
On the other hand, invasive surgery is normally not required, and the Merit Systems Protection Board has stated that an “estimated probability of success of future surgery is speculative, just as a prediction as to the worsening of a condition may be, and will not necessarily provide a basis for denial of a disability annuity.”
These are two light-posts on the spectrum of what is deemed “reasonable treatment”. Most issues concerning reasonable medical treatment fall somewhere between these two extremes, and the best course of action (obviously) is never to self-treat, or make medical decisions without the input of your treating doctor. Indeed, to not follow the medication regimen of your doctor is a manner of self-treatment; on the other hand, to elect not to have surgery because of the speculative success/failure rate is a reasonable decision which the Merit Systems Protection Board will not second-guess. What falls in-between these two extremes should always be with the guidance of “reasonableness”, in close consultation with your treating doctor.
Sincerely,
Robert R. McGill, Esquire
Filed under: Federal Disability Judge-Made Decisions Quoted, Reasonable Medical Treatment and Compliance Issues | Tagged: avoid giving the opm an excuse or "basis" for denial, civil service disability, disability retirement consequences of self-treatment, disability retirement opm, federal employee disability doctor, if your medical treatment is "reasonable" or not, importance of following up medical disability treatment, invasive surgery, medical and surgical treatments in opm disability decisions, medical condition(s), medication treatment on federal disability retirement cases, Merit Systems Protection Board and OPM disability, minimally invasive spine surgery, misinterpretation or misapplication of OPM disability law, mistakes that can cost you an opm disability denial, OPM disability appeal to the MSPB, OPM disability application tips and strategies, OPM medical retirement, OPM's methodology, OWCP medical treatment, physician's statements in an OPM disability case, Postal disability retirement, pragmatic methodology, prescribed medication regimen and opm disability, reasonable medical determination, statutory requirements in OPM disability law, Terry Davis v. the Office of Personnel Management, what's reasonable treatment, why is so important to take all your drugs in opm disability?, your treating doctors | 1 Comment »