More Disability Retirement for Bipolar Disorder

I recently wrote about my decision to apply for disability retirement within the Federal Employee Retirement System.  As you can imagine, there are many steps involved in producing the documentation for a disability retirement application.

To begin with, the required documentation is extensive: Application for Immediate Retirement, Applicant's Statement of Disability, Supervisor's Statement, Physician's Statement(s), and Agency Certification of Reassignment and Accommodation Efforts.  I am responsible for getting these processed, assembled, and sent off for application review.

In this post I am going to provide a look into a specific, essential element of the disability retirement application process, the Physician's Statement.  This part needs to be carefully prepared for a successful application.

A Physician's Statement is really a request for the treating physician(s) to provide the information necessary to complete "Medical Documentation Requirements".  These requirements direct the physician to provide the following information: (1) a comprehensive history of patient's medical condition(s); (2) copies of tests and examinations; (3) diagnosis of patient's condition; (4) assessment of condition status (static, changing, estimate of recovery or remission); and (5) any restrictions placed on patient activities.

The comprehensive history of patient's medical condition is the most important of the "Medical Documentation Requirements."  Comprehensive history must include detailed information regarding symptoms and history, past and current physical findings, hospitalizations, and results of laboratory studies and therapy of this condition(s).  It should provide a discussion of patient compliance with therapy, response to therapy, and plans for future therapy.

The comprehensive history section also requests documentation showing specific information to show why this patient is not able to perform his or her duties.  This is a key portion since it directly addresses an eligibility requirement, specifically that the applicant is unable to perform useful and efficient service because of disease or injury.  It is absolutely necessary to establish a cause and effect relationship between a bipolar symptom(s) and compromised, adverse performance of a specific job element.

The application examiner wants to see a direct connection between my bipolar symptoms and a compromised work function.  For example, my Physician's Statement explains the poor memory and limited concentration from bipolar depression decreases my ability to read, analyze, and comprehend technical reports (an essential job function).

This example establishes a direct link between my disease-related impairment (cause) and its negative impact on work functioning (effect).

Well, if you are still with me then you can see that the disability retirement process is very involved indeed.  I've only focused on a single item of one area of the application.  It should be evident that a successful application requires careful, purposeful preparation.  This is why some folks hire attorneys specializing in disability retirement cases.

I am trying it alone.  I am doing my own research and preparation.  We'll see what happens!

Disability Retirement for Bipolar Disorder

I've been working on my disability retirement application lately.  I am applying for disability retirement from the Federal Government through the Federal Employee Retirement System (FERS).  My medical reason for retirement is bipolar disorder.

Early Consideration

I first considered FERS disability retirement (not to be confused with social security disability) probably ten years ago.  It was after my second visit by Mr. Mania.  I had managed to get myself on administrative leave for several months.  So, while I sat in my backyard and watched the grass grow, I began to contemplate how my disability affected my job.

Upon return to work I watched as the depression came on and settled in for a couple of years.  This deep and intrusive bipolar depression was making work unbearable at times.  Again I would wonder if my ability to work was compromised enough that I should look at disability retirement.

In the end however, I decided I could make it work.  I made it through that depression episode and became high functioning for many years, until recently.

Today's Perspective

After observing my last manic meltdown at work I have reconsidered my employment situation.  I now believe (most of the time) I am not entirely capable of managing my illness in such a way that will keep me continuously high functioning at my current job.

I need work that is structured differently.  I need the ability to work independently on a task by task basis.  I need to be able to work when well, which doesn't necessarily fit today's 9 to 5 paradigm (although that is changing).  My wellness and ability to function changes during the day and from day to day.

When I'm high functioning I can do a full week's worth of work, but just not in the regular work week routine.  I would benefit greatly if I had the ability to start and stop work as needed.

Future

The future depends a lot on whether I am approved for disability retirement.  Since I'm still putting together my application, it will be several months before I know.

Meanwhile, I am considering work alternatives.  This isn't going well.  I struggle to find something that is both seemingly worthwhile and sustainable from an illness management perspective.  My depression is obscuring things that would otherwise be liked or enjoyable. What a pisser.

Next Up - Psychiatrist Appointment

Every two months I have an appointment with my psychiatrist for "medication management."  That's what they call the 20 minutes I have to meet, discuss, and make any changes to my medications.

I met with Dr. G on Friday.  It was in the morning so I was sure to be groggy and miss some something.

We talked about the usual stuff: sleep, meds compliance, exercise, diet, and medication effectiveness.  However, we spent most of the time going over my disability retirement application.

Disability Retirement

The disability retirement program is for federal service, not social security disability.  However, as a condition of the federal program I also have to apply for social security disability.  I did this last month.  I am doubtful they will approve my application.

Social security disability has a higher bar or threshold for acceptance than the federal disability retirement.  They require that you must not be able to perform any gainful work due to a medical condition that will last at least 12 months.  However, for the federal system the applicant need only be unable to work in their current job because of a medical condition.

Anyway, Dr. G and I spent a lot of the appointment discussing how my bipolar impacts my ability to do my work.  For example, during a bipolar depression I struggle with concentration and memory problems.  This makes it difficult for me to effectively read and analyze technical reports, which is an essential function of my job.

Dr. G typed what we came up with in her notes.  The notes will be used to document how the illness impacted my ability to do my job.  When the notes are typed up in the required format along with some additional information it is called the Physician's Statement.

Medication

Dr. G and I discussed possible changes to my medications.  She mentioned Seroquel and Remeron.  I am reluctant to start another mood stabilizer at this point.

I am trying to reduce my psych meds.  I recently got of Abilify and now I am considering stopping Cymbalta.  I don't think it is doing much anymore.

However, I do want to try the supplement N-Acetyl-L-Cysteine or NAC.  I recently did some research into NAC and it seems worth trying.  So we agreed that I'll try the NAC and see how things go.  In the meantime I will research Seroquel and Remeron although I'm not very excited about either of them.

That's about it.  Won't be writing about Dr. G for a while since my next appointment isn't until May.  She's overbooked.

Bipolar and Disability Retirement

Well folks, the time has come.  After 17 years of being an environmental engineer I am now unemployed due to events from my last manic episode.

I had three manic spells during the time I've been working as an engineer.  I managed to climb out of the aftermath of the first two episodes by the skin of my teeth.  But this last one did me in.  I'm guessing some of you have had similar experiences.

So, after some consideration I decided to apply for disability retirement benefits.  I'm trying to get the benefits for the debilitating effects of bipolar disorder.  Long-term depression and anxiety are my incapacitating enemies these days.

I don't know how much I will get if approved.  I figure the most I'll get a fraction of my previous pay, which won't be enough for my current living costs.

Therefore, I still need to find other sources of income or I must start drastically reducing my standard of living.  I can just see myself now, living in a trailer by the freeway.  Not!

Social Security has this cheery blurb on their website: "While we spend a great deal of time working to succeed in our jobs and careers, few of us think about ensuring that we have a safety net to fall back on should we become disabled.  This is an area where Social Security can provide valuable help to you."  This makes me want to go out and buy a t-shirt that says I'M DISABLED.  Well, not really.

One good thing is that the application process can be done completely online these days, which saves you the hassle of making copies, mail, and delivery to the local SS office.  The less time spent dealing with the post office or a case worker the better.

For SS disability you must demonstrate you (1) can not perform the work you used to do; (2) can not adjust to other work because of your disability; and (3) expected the disability to last for a year or longer.

Today I'm working on the part where I report specifics about my disability.  They say it should only take 90 minutes to complete.  Yeah, right.  It's going to take that much time just for me to locate all the information they ask for.  I can see this is going to be fun.

Have you applied for disability before?  What was your experience?