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.

Continuing Your Medical Care

A medical condition never has a simple solution; depending upon the nature, extent and severity of the condition, it must be “managed” and attended to throughout one’s life.  Similarly, while “filing” for one’s Federal Disability Retirement benefit is an “event” which may constitute a series of actions which results in the “approval” of a Federal benefit, the benefit itself must be “managed” and cared for throughout a process of continuing retentive procedures.

One cannot assume that once the benefit of FERS Disability Retirement is obtained — given the hard fight which one must engage in — that the process is thereby over.  That is the reason why the foundational building-blocks which form the underlying administrative process — of the decision of which initial medical conditions to include in one’s Statement of Disability; which medical evidentiary documentation to include; how one should linguistically characterize the impact of the medical condition upon one’s job, tasks, positional duties, etc. — is of great importance in establishing the pattern of management for the future.

For, as other issues, both economic and medical, may potentially intrude upon one’s Federal or Postal Disability Retirement annuity (i.e., whether one has earned income above or below the 80% rule; whether one has been restored medically such that OPM could argue for termination of one’s Federal Disability Retirement benefit, etc.), it is important to maintain a stance of managing one’s Federal Disability Retirement benefit throughout one’s life, until one reaches the bifurcation point at age 62 where it becomes “converted” to regular retirement.

Sincerely,

Robert R. McGill, Esquire
Federal Disability Retirement Attorney

FERS Disability Retirement is a benefit awarded to all Federal and Postal employees meeting the criteria of “disability”, a term which has a special definition under FERS Disability Retirement Laws.  It doesn’t mean that the employee must be “totally disabled”; rather, “disability” is loosely defined as an injury or illness that affects the performance of the main work tasks assigned to a Federal employee.  Thus, while a particular physical condition may qualify a Postal Carrier, the same condition may not qualify an Intelligence Officer working in an office environment.  For an individual assessment of your case, contact the author for a first-time consultation to help you to establish your eligibility.

Confirming your Doctor’s Support

After undergoing all of the those diagnostic tests; after allowing the doctor to clinically examine, prescribe multiple medications based merely upon the say-so of the doctor; after allowing for invasive surgery; sending you to physical therapy; if the time then comes to prepare and file a Federal Disability Retirement application under FERS, it is important to confirm the strength of that “patient-doctor” relationship that has apparently been ongoing and fostered for those many months, years, and sometimes, decades.

It is not enough to get a nebulous “pat-on-the-back-sure-I’ll-support-you” sort of response, and with that, you receive a thick packet from the medical office, you open it, and inside is merely a copy of your medical records. No — “support” must be concrete and definitive. It must mean, specifically, that the doctor is willing to write an excellent medical report outlining his or her opinion in connecting your medical condition with you inability to perform one or more of the essential elements of your job. If it is time to file for FERS Disability Retirement benefits, it is time to have a heart-to-heart talk with the treating doctor, and see how committed he or she really was and is to this “patient-doctor” relationship.

Sincerely,

Robert R. McGill, Esquire
Federal Disability Retirement Lawyer

The information contained in this web site has been prepared by attorney Robert R. McGill, a Maryland-based Federal Disability Attorney, who represents Federal employees nationwide.  Thus, this and other posts have been written for informational purposes and is not legal advice.  It is provided only as general information which may or may not reflect the most current legal developments.

OPM & History of Medical Conditions

There is a distinction to be made between one’s medical history and an extensive discussion of workplace issues which may have contributed to a causal impetus for a medical condition.

The Office of Personnel Management is rarely interested in receiving information concerning the history or causation of a medical condition — especially from the Applicant in a Federal Disability Retirement application.  While the treating doctor may briefly refer to the historical genesis of a medical condition in a narrative report, it is the focus of the present-to-recent-past impact of one’s medical conditions upon the essential elements of one’s job which the Office of Personnel Management is interested in reviewing.

Again, remember that a Federal Disability Retirement application is a “paper presentation” to an onerous, overbearing and overworked Federal bureaucracy, where one’s private affairs (the most private of all — one’s medical conditions and their impact upon one’s personal and professional conduct of affairs) are to be presented, received, and ultimately reviewed.

History of the inception, origin and impact of a medical condition may be peripherally relevant to the treating doctor, and it would be appropriate to include such historical background in a medical report; but for the Applicant, to delve too deeply and extensively upon such historical context may place the peripheral into a central focus where it should not be.

Sincerely,

Robert R. McGill, Esquire
FERS Disability Retirement Attorney

Information here do not constitute legal advice or legal opinions.  Material presented in this blog may or may have not been previously published in the author’s other websites including but not limiting to the Federal Disability Lawyer website, the OPM Disability Retirement blog, Federal Disability Attorney and other resources in the Internet.