Doctor Office Notes

The Office of Personnel Management, in reviewing a FERS Disability Retirement application, will often request to see the doctor’s office/progress notes, detailing the history of treatment for the previous 18 months.

Such scrutiny of clinical notations made by the treating doctor is meant to verify and validate the statements made by the doctor in his or her medical narrative report, to see if there are internal contradictions between the clinical notes and the narrative report prepared for purposes of obtaining Federal Disability Retirement benefits.  Such a review of clinical notes can be an unfair process, precisely because they are being reviewed with a paradigmatic purpose in mind: to “find” any inherently contradictory remarks or evidence which conflicts with statements made in the primary medical report.

Thus, reviewing the medical notes in a vacuum, outside of the context of the entirety of treatment, and with the intention and motive of seeking out any “discrepancies”, will sometimes result in a denial based upon selective interpretation of the office/progress notes.  Statements such as, “medications are helping”, “patient notes feeling better”, “Is sleeping much better”, can provide a false picture of the actual progress of the Federal Disability Retirement applicant.  Indeed, such a skewed picture will often come up in the denial letter issued by the Office of Personnel Management, where the denial letter will selectively quote from the progress notes.

This reminds one of a particular case where the Office of Personnel Management quoted from clinical notes, statements made by the applicant: “Feeling much better”; “Making great progress”; “overall doing very well.”  The problem, however, is that the applicant was permanently in a wheelchair, and the job was that of a Law Enforcement Officer. It was denied at the Initial Stage; at Reconsideration, when the pertinent facts were pointed out to OPM, it was quickly approved.

Sincerely,

Robert R. McGill, Esquire
FERS Disability Retirement Lawyer

FERS Disability Retirement is a benefit available to Federal Civil Service employees and U.S. Postal workers who meet certain medical and legal requirements.  To find out if you’d qualify for Federal Disability Retirement, please contact Attorney Robert R. McGill for a personal assessment of your case.

Getting Legal Advice and Guidance

The worth of advice is unique in that it is valued based up multiple facets of judgments: the source of such advice; the reputation and historical successes of that source; the soundness of the advisory statement, based upon all information available; and, ultimately, the receptiveness of such advice on the part of the person who seeks it.  When advice falls upon deaf ears, of course, then the very value and effectiveness of such advice has been lost forever.

In the legal arena, there is an added component — that the attorney is unable to, for obvious ethical reasons, to render advice unless there has been established an attorney-client relationship.  The “obvious reasons” have to do with the fact that proffering advice in particular circumstances can only come about if and when an attorney has received the confidential and specific information pertaining to a “client”.  Guidance of a general nature, without reference to individualized details, can be given in a generic sense.

In Federal Disability Retirement law, where each case is unique because of fact-specific medical conditions, position descriptions which are impacted by the particularized medical conditions of the individual case, and the nexus which must arise with the interaction between the two — because of this, legal advice must be tailored within a context of an attorney-client relationship.

General guidance can be given; but the Federal or Postal employee seeking help in preparing, formulating and filing for FERS Disability Retirement benefits from the U.S. Office of Personnel Management should understand that the importance of getting good legal advice is dependent upon the value and worth the Federal or Postal employee places upon his or her unique and individualized case.

Sincerely,

Robert R. McGill, Esquire
Federal & Postal Disability Lawyer

Attorney Robert R. McGill specializes in FERS Disability Employment Law, helping Federal and Postal employees across the nation secure their Federal Disability Retirement benefits.  You may contact him over the phone to receive a free and confidential 30 minute initial case evaluation.

Apparent Normalcy

One can venture and maneuver through this world with a semblance of normalcy, where from all outside perspectives, a person is untroubled and unencumbered.

There are multiple complexities inherent in such a perspective, of course: what constitutes “normal”; to what extent do individuals have a responsibility in assessing and evaluating a person’s private world; as well as the problem of infringing upon the privacy of others, and the desire of the other to allow for any intrusion, whether consciously or subconsciously.

For, each person constructs multiple layers of privacy zones — from the proverbial picket fence, to one’s own private bedroom; to the gates of a home; but always, the foundation begins within the walls of the skull of one’s brain. For, the gatekeeper is always maintained by the individual, as to what is allowed in, and what is manifested for others to observe.

For the Federal and Postal Worker who is beset with a medical condition, such that he or she must contemplate filing for Federal Disability Retirement benefits, whether under FERS or CSRS, with the U.S. Office of Personnel Management, it is often the preparation of the actual forms which is the first manifested evidence of an impacting medical condition.

All throughout the previous many years, the apparent normalcy has been closely protected; great performance ratings, minimal leave taken, and daily smiles and platitudinous greetings; until the Federal or Postal worker arrives at a crisis point.

This is the apparent face and semblance of normalcy — the surprise of others, of the regretful and remorseful comment, “I just never would have realized.” Or, perhaps it is the indicia of the busy world in which we all live, which allows us to lack any compassion to notice.

Sincerely,

Robert R. McGill, Esquire
Federal Disability Retirement Lawyer

Robert R. McGill is a FERS Disability Retirement attorney, that is, a lawyer who specializes in helping Federal and Postal employees secure their FERS Disability Retirement benefits, a practice area he dedicates 100% of his time.  For more information about his legal services, publications and forum, please visit one of his legal websites and blogs available through the Internet.

The Subjective Experience of Pain

Pain by definition is “subjective”, if by it one means that the experiential verification of the condition is uniquely possessed by the “I”, or the subject of the experience. By contrast, that which is deemed “objective” is presumably validated by more than the possessor of the experiential condition — i.e., by third parties; by testing for the validity and verification of an event through means other than the personal narrative of a singular subject. Yet, if verification of an experience is accepted merely by sheer volume of a collective consensus, then most scientific revolutions in advanced discoveries would never have survived.

In Federal Disability Retirement law, it is often the argument of the U.S. Office of Personnel Management that the Federal or Postal applicant has failed to provide “objective” medical evidence in presenting his or her case. The narrative of having a condition of “chronic pain”, or “severe pain” — being “subjective” by definition — is not deemed “objective“, and therefore cannot be the valid basis alone for a FERS Disability Retirement case (or so the argument by OPM is often presented). Even the results of an MRI will not necessarily satisfy the scrutiny of OPM; for, ultimately, an MRI can only reveal an observable abnormality — not that a person experiences “pain”.

Fortunately, there are a number of cases in law which rebut OPM in their attempt to bifurcate between “objective” and “subjective”, and such legal tools should always be cited and applied in any Federal or Postal Disability Retirement application.

While pain may indeed be subjective by definition, the objectivity of a Federal Disability Retirement application should never be based upon what OPM deems as sufficient; rather, it is the law and the long history of legal guidance by the courts which should mandate how OPM acts. Indeed, if we let OPM’s subjective determinations rule the day, we would all be left in an existential state of pain — one which would then result in a collective consensus which may be deemed objective in nature.

Sincerely,

Robert R. McGill
Federal Disability Attorney

This article and others in this blog may or may not have been previously published in the author’s other websites such as the Federal Disability Attorney blog, the FERS Disability Retirement website, or the Postal Service Disability Retirement blog.

Stress and Other Medical Conditions

Often, the generic designation of “stress” is the underlying medical condition; other medical conditions can exist, and perhaps are exacerbated by the underlying condition of “stress” — or, at least that is the suspicion, both by the Federal or Postal worker who is suffering from such conditions, and (hopefully) understood by the treating medical doctor.

While failing to have direct causal linkage, the situation often arises where the chronic medical condition may have periods of remission, followed by severe episodes of unrelenting exacerbations.  The problem with such medical conditions in preparing, formulating and filing a FERS Disability Retirement application, is that the medical condition must prevent one from performing one or more of the essential elements of one’s job, and such a condition must last for a period of 12 months or more.

Medical conditions which “wax and wane” (OPM’s favorite description of Fibromyalgia) and are “not severe enough to preclude an individual from the workplace altogether” (another of OPM’s favorite descriptive rationalizations for denying a Federal Disability Retirement application — which is legally inconsequential and a mis-statement of the laws governing Federal Disability Retirement) — present a special challenge in preparing, formulating and filing a Federal Disability Retirement application.  However, even a challenge such as “stress” and a secondary medical condition which is exacerbated for episodic periods, is one which can be overcome, and successfully overcome.

The fact is that the focus is often misplaced.  Instead of asking the doctor to focus upon each individual medical condition, it is the wiser route to have the doctor discuss all medical conditions in their totality, and show that the complex interaction of the primary and secondary medical conditions together prevent the Federal or Postal employee from performing one or more of the essential elements of one’s job.

Sincerely,

Robert R. McGill, Esquire
FERS Disability Retirement Lawyer

Please notice that this and other articles may or may not have been previously published in the author’s other websites such as the Federal Disability Attorney blog, the FERS Disability Retirement website, or the Postal Service Disability Retirement blog.