Tag Archives: Helping your doctor to write the FERS disability medical report

Doctor Office Notes

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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.

The Doctor’s Perspective

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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, 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 Disability Retirement issues, it becomes apparent why doctors often become reluctant and resistant to getting involved with the administrative process.  Federal 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 FERS 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 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 Attorney

Disclaimer: While every effort has been made to confirm the accuracy of this article, it is not intended to provide legal advice as individual situations will differ and should be discussed with a lawyer expert in the field of Federal Disability Retirement law.  For specific technical or legal advice on the information provided and related topics, please contact the author.

OWCP Determinations

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The key to effectively using collateral sources of disability determinations in a FERS Disability Retirement application is to tailor its relevance in each individual circumstance.

Thus, for example, because the focus upon percentages of disability, or the issue of causal connection to the workplace, is a focal point of importance in an OWCP/Department of Labor case, but not in cases of Federal Employee Disability Retirement.  Such issues should be left alone.  However, the fact that there may be an “independent medical examination” by a Second-Opinion doctor, or a referee doctor in a Worker’s Comp case, can be used to one’s advantage.

Often, a person who has been under the agonizing scrutiny and torture of the Worker’s Comp process will miss the point, and complain that the OWCP-appointed doctor “didn’t even exam me for 2 minutes”, or “didn’t listen to a thing I said,” but all the while missing the key ingredients in the doctor’s report:

(1) That the doctor can be effectively characterized as “independent” — not from an OWCP standpoint, but certainly from a FERS Disability Retirement standpoint, because that particular doctor has no self-interest from OPM’s viewpoint.

(2) If the doctor’s opinion is that, while the causal connection (for example) may not have been established, does he nevertheless express a medical opinion that the Federal or Postal employee is unable to return to perform the essential functions of his or her job?

Often, the emotional uproar in an OWCP case, or in other similar cases (SSDI & Veteran’s Department disability determinations) causes the Federal or Postal employee to miss the primary point of the process: to use the tools effectively in getting a Federal Disability Retirement application under FERS approved.  With that goal in mind, an experienced FERS Disability Retirement Attorney can help you to evaluate your medical records to identify which ones you should use as supporting documentation for your Federal Disability Retirement claim.

Sincerely,

Robert R. McGill, Esquire
FERS Disability Retirement Lawyer

The law office of Attorney Robert R. McGill, P.C., has intended to convey general information by the information contained in this blog. The information contained in this website should in no way be construed as legal advice or opinion. The intent of this website is a source for general information about Federal Disability Retirement law only.

Stress and Other Medical Conditions

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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.