Tag Archives: medical reports in the OPM disability retirement applic

OPM Disability Retirement: Reconsideration Decisions

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Types of reconsideration decisions denying an applicant his or her Federal Disability Retirement benefits under FERS or CSRS can and do span the entire spectrum, depending upon the OPM representative who writes up the decision:  from half a page (barely giving a passing, respectful review to a packet which took multiple hours to put together) to over 3 pages long (in the “Discussion Section”); from merely listing general principles of law and generalized, template-like denials to apparent detailed (but very selective) references to various medical reports submitted by the applicant as part of the disability retirement packet — they all boil down to the same thing:  a denial at the initial application stage.

Often, an initial reaction to the denial encompasses a myriad of responses, ranging from incredulity, to resignation, to anger, to indignation.  Set aside the emotionalism.  Further, there is often the reaction to that “one piece” of medical information which the applicant believes should have turned that “denial” into an “approval” — that “one piece” of medical note, statement, sentence, or paragraph which the OPM representative conveniently disregarded or chose not to reference.  Don’t ruminate over it.  It may well be that it was deliberately disregarded; it may even have been overlooked.  More than likely, the OPM representative was fully aware of it, but decided to selectively choose his or her basis as the more “important” and “substantive” evidence, forming the core rationale of the denial.  Don’t waste time.  More work is needed — both medical as well as legal.

Sincerely,

Robert R. McGill, Esquire

 

OPM Disability Retirement: As Strong As the Weakest Link

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Have you ever heard the phrase, that “X is only as strong as the weakest link”?  What does that mean?  When applied to Federal Disability Retirement applications, it has significance and application on multiple levels.  Filing for Federal Disability Retirement benefits under FERS and CSRS has multiple, and almost an infinite amount of, potholes, dangers, traps and landmines, both hidden and apparent — and that is from the viewpoint of the attorney.

I can only imagine what it is like for the Federal or Postal employee who thinks as follows:  I have a serious medical condition; there is a benefit called “disability retirement”; let me make copies of my medical records, fill out the forms, and submit it.  I should get it with no problems.  I get telephone calls almost on a daily basis from people who say, “I can’t believe that the Office of Personnel Management disapproved my claim.  What did I do wrong?”  Often, it is the Office of Personnel Management that “did something wrong”, and it is up to the Attorney to point that fact out.

Now, back to the original thought of this blog:  A case is only as strong as the weakest link.  As Federal Disability Retirement applications have many complex issues surrounding and central to the application and the application process, it is important to make sure that even the weakest link of the packet — whether it is the doctor’s report, the Applicant’s Statement of Disability, the legal arguments to be made, etc. — make sure that the weakest of the links is strong enough to withstand the selective (and often unfair) reasoning and attacks of the Office of Personnel Management.

Sincerely,

Robert R. McGill, Esquire

 

FERS Disability Retirement: Use of Medical Reports

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People often ask me whether or not a certain type of medical report should or should not be used.  As with almost all such questions, the answer is, “It Depends”.  On what?  On the content; in the manner it is written; and by whom.  This latter basis is often a determinative one.  For instance, should a medical report from a Chiropractor be used in an FERS Disability Retirement case?

Let me answer this question in a circuitous manner — I handled an MSPB case years ago where I had no “medical” doctors testify, but I had two chiropractors testify (I needed both of them, not because two makes better than one, but merely because they treated my client in sequence over the relevant period of time).  To the great consternation of the OPM representative, we won the case.

Thus, chiropractors can provide valid medical opinions, and the MSPB has accepted the testimony of chiropractors — as well as therapists — standing alone, without the primary support of a medical doctor.  However, my customary approach in the utilization of therapists and chiropractors, as well as physicians’ assistants, nurses, etc., is that they are most effective as secondary support to a primary medical narrative from a medical doctor.

This will often present an interesting conundrum in that, often, chiropractors and therapists will write the more detailed, substantive, and interesting report than the medical doctor.  That is okay.  To use such reports as a piggy-back upon the short, concise and straightforward medical report is often the best way to use such valuable resources.

Sincerely,

Robert R. McGill, Esquire

FERS Disability Retirement: The First Denial

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Your Federal disability retirement application was well-prepared:  perhaps it was prepared with the help of an attorney; the medical documentation seemed solidly unequivocal; the doctor made the necessary connections between one’s medical conditions and the type of essential elements of one’s job; the packet, by all accounts, should have been approved, and by all expectations, the approval should have been reasonably expected.

Instead, you receive a letter stating that your disability retirement application was disapproved, and a “Discussion” section follows, explaining why the Office of Personnel Management denied your application.  Why did this happen?  There are multiple reasons why such a denial can occur:  the OPM specialist could be a person who lacks a clear understanding of the applicable laws governing disability retirement applications (more often than not, this is the case, and what you actually get in the so-called “Discussion” Section of the denial letter is merely a regurgitation of the statutory criteria for eligibility for disability retirement, without a recognition of the interpretation of such criteria by Federal Judges for the Federal Court of Appeals or by Administrative Judges from the Merit Systems Protection Board); it could be as simple as the OPM representative selectively choosing to read the medical reports and records, and disregarding or ignoring supportive portions of the medical records and reports; or it could be that additional medical reports and records need to be obtained in order to “shore up” the application.

In any event, whatever the reason for the denial, one should not panic.  It is merely one step in a long, administrative process.  The mere fact that OPM denies your disability retirement application does not mean that they are “right” in doing so; indeed, in my opinion, they are rarely right.  That is why one has the right to have it “reconsidered”, and the opportunity to make further legal arguments, and obtain further medical documentation in support of your claim.  And, beyond that, you have the right to file an appeal to the Merit Systems Protection Board — and beyond.  Never give up; always take it to the next step.  In most cases, it will prove that OPM was in error, and in fighting the denial, you will have secured some semblence of financial security for your future.

Sincerely,

Robert R. McGill, Esquire

 

The Affirmative Approach to OPM Disability Retirement Filing

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The road which leads to one’s future financial security is irreversibly tied to the extent of how affirmatively one takes one’s future into one’s own hand (now, that was indeed a mouthful).  By this, I mean merely that, in preparing an application for Federal Disability Retirement, there are going to be all sorts of “outside forces” which pull you towards every different direction.  Friends will tell you one thing; your Agency will tell you something else; your coworkers will give you stories (both good and bad); your Human Resources Department may give you advice; ultimately, you must take an affirmative approach and make sure that your application is coherent, logically structured, and medically supported.

By way of example, an Agency’s Human Resources Department will often insist that the Physician’s Statement, SF 3112C, is a “required” form.  It is not.  They will often give you the form with the return address of the Agency stamped in the upper blank box, for the medical report and records to be returned to the H.R. Department.  Upon receipt, the H.R. Department simply includes the medical documentation (without review or determination that it is helpful to your case), and forwards the packet to the Office of Personnel Management.  This would be the “non-affirmative” approach of doing things.  To take the affirmative approach would be:  Make sure that the medical documentation you submit to OPM is the extent, type, and quality that you want to submit.

Remember:  the applicant has the burden of proof, by a preponderance of the evidence, to show that you are entitled to Federal Disability Retirement benefits.  Don’t let third parties (i.e., friends, coworkers, Agency, H.R. Department personnel, etc.) make the decisions for you.  Take the affirmative approach — either by yourself, or through your attorney.

Sincerely,

Robert R. McGill, Esquire

 

FERS Disability Retirement: Medical Documentation

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As I often tell my clients in preparing a Federal Disability Retirement application:  The “lynchpin of the application is the medical report”.  Thus, it is important to speak to the doctor about the legal requirements of a medical narrative report.  Doctors, by their very nature, hate to write reports; they are doctors, and doctors perform medical duties; writing a report is an “administrative” duty, and further, writing a medical report for a FERS Disability Retirement application is a “legal administrative” duty — the farthest thing from what a doctor would like to do.

Additionally, many potential applicants don’t understand that for certain medical conditions — Fibromyalgia, Chronic Fatigue Syndrome, and Multiple Chemical/Environmental Sensitivity cases, and “contact Dermatitis” cases, as well as other related conditions — there are many “do’s and don’t’s” with respect to the substance and content of the medical reports.

The Office of Personnel Management looks for certain key phrases which doctors will often write about in describing certain medical conditions, and it is important to caution the doctors about certain key elements.  It is not that the doctors should not describe the symptoms in a certain manner; rather, once the doctor understands what the legal requirements are, a treating doctor will more fully understand what needs to be said in order to meet that legal requirement.

In other words, doctors will often use “standard medical-ese” in describing symptoms; a fuller explanation is more often needed in order to meet the legal requirements of being eligible for disability retirement.  That is where an attorney’s assistance is often crucial.

Sincerely,

Robert R. McGill, Esquire
Federal Disability Retirement Lawyer

 

CSRS & FERS Disability Retirement: Reasonable Accommodation by the Agency

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Often, aside from having submitted insufficient medical documentation to support a Federal Disability retirement application, the Office of Personnel Management will deny a case based upon a statement submitted by the Supervisor, normally on SF 3112B (aptly entitled, “Supervisor’s Statement”).

Now, in preparing a Federal Disability Retirement application, I rarely worry about what will be on a Supervisor’s Statement, primarily because the applicant rarely has any control over the contents of the statement, anyway, and therefore to focus upon that which one has little or no control over, is simply a waste of time.  Instead, I focus upon obtaining an overwhelmingly convincing medical narrative report from the doctor, which then essentially makes the Supervisor’s Statement — if it is viewed somewhat as “negative evidence” by the Office of Personnel Management — a moot and irrelevant point of contention.

More often than not, when the Office of Personnel Management refers to the Supervisor’s Statement as revealing some basis for denying a disability retirement application, I find that OPM has either mis-read the import of the statement, or has selectively misquoted from the Supervisor’s Statement.

Remember that the law requires that the Agency provide a “reasonable accommodation”; more often than not, what the Supervisor or the Agency has provided, is neither “reasonable”, nor an “accommodation” under the law.

In any event, whether by misquote, unfair and selective reasoning, misreading, “unreasonable”, or not an “accommodation” at all, I rarely find that the Supervisor’s Statement is helpful or unhelpful; and, certainly, I have never found that a Supervisor’s Statement contains any substance which would or should be the basis of a denial from the Office of Personnel Management.

Sincerely,

Robert R. McGill, Esquire

FERS Medical Retirement: Psychiatric Disabilities

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I am often asked, on an initial interview/consultation of a potential client, whether or not psychiatric medical disabilities (Major Depression, Generalized Anxiety Disorder, PTSD, panic attacks, Bi-polar disorder, etc.) are “more difficult” to prove than physical disabilities. This question is similar, of course, to the question often asked of certain other kinds of disabilities, like Fibromyalgia, chronic fatigue syndrome, Irritable Bowel Syndrome, and other similar (often designated as “auto-immune” disabilities) medical conditions.

In my experience, there is no single generic answer to the question of whether or not a particular medical disability is “more difficult” to prove than another. In my experience, I have gotten approved an application for Major Depression based upon a single-page note from a Psychiatrist; on the converse/inverse experience, I have had cases rejected at the First Stage of the process (but, fortunately, had the same cases approved at the Second, Reconsideration Stage) showing chronic, failed-back syndrome cases where prior surgical discectomies, multiple diagnostic MRIs showing incontrovertible basis for severe and radiating pain, and multiple specialists verifying the client’s clear and irrefutable inability to perform the essential elements of his/her job.

In preparing a Federal disability retirement retirement application, my many years of experience has taught me a number of elementary & foundational lessons: First, a clear and concise presentation of providing a direct nexus between the particular medical condition and the type of job that the Federal/Postal employeee performs, is very important; Second, it is very rarely the volume of records which is convincing; rather, it is the quality of the medical report which is paramount; and Third, it often depends upon which OPM Disability Specialist it is assigned to, which sometimes “makes the difference” between approval and denial.

Sincerely,

Robert R. McGill, Esquire

 

The Emergency Federal Disability Filing

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On the desk of one of the Circuit Court clerks, in an adjacent county, is a sign which reads: “The fact that you waited until today does not make it into my emergency.”  Those who stand in line to file an emergency pleading, either try to ignore the prominently-displayed sign, or hope that some other clerk will attend to his or her needs.  Yet, we all know that there are times when, for one reason or another — the year passed so quickly; the medical reports which we expected months ago just arrived; “life happened” and the 1-year mark for filing for disability retirement is upon us — we have a couple of weeks, or perhaps a week, or perhaps only a couple of days, to file for Federal disability retirement benefits.

When such an emergency filing becomes necessary, three things must happen: First, the three essential forms must be quickly filled out (whether they are adequately and sufficiently filled out is another matter — but just remember that if you don’t at least meet the 1-year statute of limitations for filing for Federal disability retirement benefits, you are left with no argument at all; whereas, at least by filling out the forms and filing, regardless of their adequacy or completeness, you can at least argue later that it meant x or y).

Those three (3) forms are: SF 3107 Application for Immediate Retirement for FERS; SF 2801 for CSRS; Schedules A, B & C for FERS & CSRS; and SF 3112A, Applicant’s Statement of Disability for FERS & CSRS.

Second, fax the three completed forms to Boyers, PA, and Express Mail or FedEx it (and get a fax confirmation sheet); and Third, follow up with a phone call to Boyers to get the name of the person who will confirm that he/she received the fax.  Every now and then, “life happens”, and emergency filings are necessary.  In a perfect world, such emergencies should be unnecessary; and while the clerk in the Circuit Court in an adjacent county might look with disgust upon the lawyer or pro-se individual attempting to file an “emergency” pleading, whether it is his emergency, her emergency, or someone else’s fault, the fact still remains: It needs to be filed on time.

Sincerely,

Robert R. McGill, Esquire

 

OPM Disability Retirement: The “No Other Choice” Case

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Then, of course, there are cases where an individual has “no other choice” than to file for disability retirement. Sometimes, it is a chance that is taken — the chance of paying an attorney.  Yes, adverse removal actions can impact one’s chances of obtaining disability retirement benefits.

A case study: A recent client was removed from a Federal Agency for criminal conduct (obviously, no names will be used, and the facts will be somewhat altered to protect the client’s confidentiality of information).  The individual was nowhere near retirement age; but suffice it to say that he/she had been a loyal employee for 20 years.  He/she had a medical condition — a psychiatric condition, which pre-dated the criminal conduct.  He/she hired me to obtain disability retirement.

What choice did the person have?  He/she really had “no other choice” other than to walk away with nothing, or take the chance of paying an attorney (in this case, me).

I was blunt about the entire affair: Normally, I am able to get most of my clients approved at the first or second stage of the process, and I will normally ascribe a “success-rate” to a case; in this instance, the probable rate of success, in my opinion, was lower than my normal prediction.

Nevertheless, he/she wanted to go forward with it. I contacted the doctors and guided them into writing a forthright medical report; today, the client is receiving his/her disability retirement annuity. Did the person “deserve it” despite the criminal conduct? Absolutely! His/her medical condition pre-dated the criminal conduct, and in fact was a major factor in the actuation of the criminal conduct itself.

I am happy for the client, and from a professional standpoint, it is always satisfying to win a case where a client entrusted a case in which he/she had “no other choice” — but once the choice was made, to have made the right choice.

Sincerely,

Robert R. McGill
Federal Disability Attorney