Tag Archives: OPM Disability medical documentation

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.

Providing Medical Information

In every area of law, in most facets of life, and certainly in the administrative procedures of preparing, formulating and filing for Federal Disability Retirement benefits either under FERS with the Office of Personnel Management, one must determine the extent, scope and substance of the information which will be provided to the requesting entity.

Most of the time, the extent of information is pre-determined by the requirements which must be satisfied.  Similarly, the scope of the information to be submitted must meet certain criteria, but additionally, it will depend upon the question asked.  More importantly, the substance of the information one needs to provide, will be determined by the question asked, the criteria to be addressed, and the statutory and regulatory guidelines which must be met — in the case of FERS Disability Retirement, that which would meet the legal standard of “preponderance of the evidence.”

In venturing and maneuvering through the administrative process of applying for Federal Disability Retirement benefits, however, there will be times when either the Agency or the Office of Personnel Management may request “additional” information, indicating that they are not satisfied with what has been submitted.

An appraisal of what information is being asked; whether the question is properly formulated as posed, or whether it can be reformulated and still satisfied; and the harm or good in responding fully or partially to the request — these are all determinations which are best guided by the advice and counsel of an attorney who understands the laws governing the legal criteria in Federal Disability Retirement cases.

Not every question deserves a full answer.  Sometimes, the question itself must be re-formulated and answered in the re-formulated format.  Agencies are not gods; they are not omnipotent, and certainly not omniscient.

Sincerely,

Robert R. McGill, Esquire
FERS Disability Retirement Lawyer

While we strive to keep legal information on the blog accurate and up to date, we do not give any assurances and will not be responsible for the accuracy, completeness, or timeliness of the information published in this blog.  Instead, you should contact the author for information about specific laws and trends with the Office of Personnel Management or to discuss the particulars of your case with a free (30 minutes) telephone consultation.