By Peter Casciano
Recent case law (Henderson v. OPM) from the Merit Systems Protection Board (MSPB) reveals that one’s medical evidence need not “unambiguously and without contradiction” indicate that an employee cannot meet the requirements of their position.
I am often asked, “How do I know if my doctors have documented my disability sufficiently?” Or, “Have my doctors said enough to win Federal Disability Retirement?” Recently, we have been given guidance from the MSPB which should help deserving FDR applicants obtain disability benefits.
In the underlying case, the applicant was denied benefits on reconsideration because “her medical records did not support a finding that her conditions…precluded her from attending the workplace or performing useful and efficient service.” OPM’s reasoning here is typical and contains language that we often see in their denial letters.
The applicant then appealed to an administrative judge who found that the medical evidence did not sufficiently explain why she could not perform her job duties. This reason is what is commonly referred to as “the nexus” between one’s medical condition and their inability to do their job. We, often times, run into reluctance from treating physicians who say, “I don’t know if she could do her job or not. I’ m not a vocational expert.” The administrative judge here used a doctor’s reluctance, to opine about the patient’s inability to do her job, to uphold the denial.
The claimant then appealed again, and the administrative judge was reversed. The three judge panel found that the medical evidence need not explicitly say why the employee cannot perform their job. Henderson allows for the decision maker to look to the totality of circumstances to determine if the applicant’s condition is so severe as to render their successful performance of their job impossible. The court goes on to say that “all pertinent evidence will be considered” when determining entitlement to disability retirement.