Medical Retirement (for US Federal Employees): Administering Treatment versus Administrative Functions

Doctors rarely have any problems with administering treatment based upon clinical encounters and subjective narratives from their patients; yet, when it comes to providing a medical report and performing similar administrative functions, the sudden pause, hesitation, and sometimes outright refusal, is rather puzzling, if not disconcerting.

Such trepidation from the doctor can obviously result in a difficult wall for purposes of preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS.

For, much of medical evaluation, diagnosis, prognosis and prescribing of treatment encompasses receipt of subjective responses from the patient:  where the pain is present; the nature and extent of the pain; the history and chronicity of manifested symptoms; even functional capacity evaluations must necessarily be an observation of the subjective actions & reactions of the participant.  Of course, there are often distinguishable “objective” factors — swelling; carcinogenic versus benign tumors; broken bones, etc.

On the other hand, even MRIs and other diagnostic tools reveal only that X exists — not that X results in symptom Y.  An example would be a bulging disc — while the abnormality itself may show up on an MRI, whether the individual experiences any pain from the abnormality may differ from subject to subject.

This is why, despite the willingness of a doctor to treat based upon most factors being “subjective” in nature, it becomes a puzzle why the same doctor shows an unwillingness to write a report stating that, because of the medical conditions for which patient M is being treated, one must necessarily conclude that he or she cannot perform essential elements X, Y and Z of his or her job.

It is the jump from treatment-to-disability-determination which is often problematic for the treating doctor.  All of a sudden, the excuses flow:  “I am not trained to make such determinations”; “There is no objective basis for your pain” (then why have you been treating me for over a decade and prescribing high levels of narcotic pain medications?); “I can’t say whether you can or cannot do your job”; and many other excuses.

The switch from administering treatment, to treating administrative matters, is one fraught with potential obstacles.  How one approaches the treating doctor will often determine whether such obstacles can be overcome — and whether one’s Federal Disability Retirement application can be successfully formulated.

Sincerely,

Robert R. McGill, Esquire

Disability Retirement for Federal Workers: From the Doctor’s Perspective

In attempting to understand others, it is important to gain a perspective from which the third party views the world.  Understanding the third party perspective is a way to formulating an effective way of persuading a change in that person, if that is the goal. Or, perhaps understanding X merely in order to accept the behavior or actions of the individual, is enough of a reason.

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, it is often important to understand the perspective of one’s treating doctor in order to obtain the necessary support and administrative initiation of the medical provider.

From the doctor’s viewpoint, it is normally counter-productive in terms of treatment and therapy to declare, ascertain and deem that the patient is “totally disabled“.  Work is therapeutic; it allows for a teleological motivation which compels continuation in recuperative and rehabilitative terms.

Further, when this “fact” is combined with the general exposure of most doctors to other forms of disability benefits — state or federal OWCP benefits; Social Security Disability benefits; private disability insurance benefits — and rarely an encounter with FERS or CSRS disability retirement issues, it becomes apparent why doctors often become reluctant and resistant to getting involved with the administrative process.  OWCP benefits require an assertion of causality-to-employment; SSDI necessitates a declaration of “total disability”; private disability policies can often lead to depositions and legal responses.

Thus, everything that is counterintuitive to a doctor’s perspective of what is therapeutically beneficial to the patient, is potentially there when presented with a request for support in a disability retirement case.

Explanation is the key to understanding; effective explanation should persuade and alter a perspective founded upon a misinformed foundation.  It is often necessary to explain the differences between FERS & CSRS disability retirement benefits and the “others” which have previously polluted the waters of a pristine stream of thought.

Sincerely,

Robert R. McGill, Esquire

Federal Disability Retirement: The Supportive Physician

Perspectives vary; varying perspectives often lead to conflict; and conflict represents the divergent paths which pursue different directions, or follow a parallel route.

Physicians who have been practicing medicine for a number of years quite often see the therapeutic benefit of employment, and the negative impact of being identified as “disabled”, with progressive physical manifestations of deterioration, and psychological destruction of futility and hopelessness.  It is not mere coincidence that the high rate of mortality is correlated to two primary life events:  birth (where the infant’s susceptibility to being exposed to an expansive and threatening environment brings with it inherent dangers), and retirement (where the propelling teleological motivation of man suddenly comes to an end).

In preparing, formulating and filing for Federal Disability Retirement benefits from the U.S. Office of Personnel Management, whether under FERS or CSRS, it is obvious that one must have supportive medical documentation in order to prove, by a preponderance of the evidence, that the Federal or Postal employee is eligible for Federal Disability Retirement benefits.  Part of that medical evidence should include a narrative report from one’s treating doctor, or a doctor who can properly and thoroughly assess, evaluate, and conclude that the Federal or Postal employee  can no longer perform one or more of the essential elements of one’s job.

What constitutes “support”, however, can sometimes lead to divergent paths.  Doctors are trained to treat patients, not to perform administrative duties.  The divergence which potentially leads to conflict often involves the differing perspective of what will “help” the patient.  Federal Disability Retirement is a benefits which allows the Federal or Postal employee to remain productive in the workforce, by encouraging the Federal or Postal employee to seek outside employment.  This is the key component and concept which often lends persuasive effect upon a suspicious and cautious medical practitioner.

Explaining the process will hopefully allow for parallel paths, and not a route which results in different directions.

Sincerely,

Robert R. McGill, Esquire

FERS & CSRS Disability Retirement for Federal and USPS Workers: Arming the Doctor after Disarming

It is one thing to provide an explanation of the process of filing for Federal Disability Retirement benefits under FERS or CSRS to the treating doctor; that is simply not enough.  Providing an explanation “disarms” the health professional.  While such explanation and helping the doctor to understand the process is certainly helpful, ultimately the treating doctor needs more than information; he or she needs guidance in order to “arm” one’s self with the tools necessary to help the patient. 

Fortunately, most doctors are professional, compassionate, and eager to help.  Writing medical reports are an administrative aspect of the practice of medicine which is not only a headache, but takes the doctor away from the valuable and limited time for actually treating the patient.  It is therefore important for the Federal or Postal employee who is applying for Federal Disability Retirement benefits under FERS or CSRS to “arm” the doctor with the necessary tools needed in order to successfully prepare, formulate and construct a sufficient and effective narrative report in order to “pass muster” with the Office of Personnel Management.  The first and primary rule in helping to prepare the doctor is to always protect and maintain the integrity of the doctor.  Truth in every endeavor, and especially in filing for Federal Disability Retirement benefits under FERS or CSRS, should be the ultimate guiding light.  How that truth is stated, however, is where the guidance, tooling and “arming” comes into play.

Sincerely,

Robert R. McGill, Esquire

CSRS & FERS Disability Retirement: The Doctor's Opinion

As an attorney who represents Federal and Postal employees to “obtain” Federal Disability Retirement benefits, it is important to make distinctions within the process of securing the Federal benefit:  while it is important to solicit and secure the medical opinion of the treating doctor, the resistance from such doctors — if in fact there is any resistance at all — most often comes about because the doctor doesn’t understand the “process”. 

Doctors are medical providers.  They are in the practice of medicine because they believe in applying the science of medicine to help their patients get better.  Helping someone obtain Federal Disability Retirement benefits under FERS or CSRS is not part of “practicing medicine”.  Yet, in many ways, it is.  It is part of practicing medicine because, to allow the patient to continue to work in a job which he or she cannot perform, will only exacerbate and worsen the medical condition. 

Further, doctors never like to “disable” their patients.  To counter this medical opinion, it is important to clearly inform the doctor what the process of Federal disability retirement is and is not.  It is the job of the attorney hired to represent a Federal or Postal worker to obtain disability retirement benefits, to clearly and cogently explain the entire process to the treating doctor.  That is what I do, at the very start, in representing my clients.

Sincerely,

Robert R. McGill, Esquire

OPM Disability Retirement: The Doctor II

Work is good for a person — being productive, being useful, being a contributing member of a team, an agency, an organization; it provides a sense of self-worth, dignity, and therapy. On the one side, that is why a Federal or Postal worker takes such a long, careful and hesitant step before deciding to file for Federal Disability Retirement. On the other side, the treating doctor knows the medical, therapeutic and healing value of work.

That is often why doctors are reluctant to agree to support a Federal or Postal worker’s decision to file for disability retirement under FERS & CSRS. Such reluctance, however, is mostly due to an unfamiliarity with the legal standards required to obtain disability retirement. Most doctors are familiar with the Social Security process of filing for disability benefits; and, further, many doctors are familiar with State Worker’s Compensation benefits and process; and, to a lesser extent, Federal Worker’s Compensation programs. Very few doctors are familiar with Federal Disability retirement benefits under FERS & CSRS. That is why it is important to clearly, concisely, and thoroughly inform the treating doctor of the process — and, often, it is wise to have an attorney who can clearly explain and delineate the process.

Sincerely,

Robert R. McGill, Esquire