Federal employees with medical conditions often face difficult decisions about how to continue working safely and effectively.
In many cases, a well-supported medical opinion can help clarify functional limitations, support reasonable accommodation requests, and provide objective medical documentation for your agency.
Our practice provides independent, MD physician-authored medical opinion letters for federal employees seeking disability accommodations. Each opinion is based on a careful review of your medical records, your condition, and the specific demands of your position.
Veterans employed by, or applying to, federal agencies are sometimes required to provide medical documentation to support a reasonable accommodation request.
A MD physician-authored medical opinion may be useful when:
In many cases, treating clinicians are unable or unwilling to provide this type of documentation, particularly when occupational or functional analysis is required. Our role is to provide a clear, medically grounded assessment of your condition and its impact on your work capacity.
Physicians trained in occupational and environmental medicine focus on the intersection of health and work. This includes evaluating how medical conditions may affect functional capacity, work activities, and symptom management in occupational settings.
Medical opinions in this context typically address:
These opinions are medical in nature and are not determinations of employment eligibility or legal entitlement.
When offered, these medical opinions are limited to:
They do NOT include:
Final accommodation determinations are made solely by the requesting agency.
This specialty medical opinion / nexus letter service is provided on a case-by-case basis and only in select circumstances.
In general, inquiries must meet the following criteria:
Not all requests are appropriate for this type of medical opinion.
Medical opinions are based on a review of available records (e.g. Functional Capacity Evaluation), written documentation, and other materials provided by the Veteran. In some cases, a telehealth consultation may be conducted if clinically appropriate; in those cases, the Veteran must be physically located within the state of Washington. The method of review is determined on a case-by-case basis based on the nature of the request.
This specialty medical opinion / nexus letter service:
The medical opinion in this specialty nexus letter reflects clinical judgment based on available information at the time of review.
This is for federal applicants or employees who need physician documentation for Schedule A hiring eligibility.
This service includes review of relevant medical records (up to 50 pages) and, when medically supported, preparation of a physician Schedule A disability certification letter.
Best suited for: Individuals who have been asked to provide medical documentation establishing eligibility for Schedule A hiring authority but do not require a broader workplace disability evaluation. This service does not include a reasonable accommodation opinion, functional capacity assessment, OPM Disability Retirement opinion, or certification of a specific workplace accommodation.
A focused physician evaluation for federal employees with a clearly defined medical condition, established functional limitations, and a specific workplace accommodation request.
This service includes review of relevant medical records (up to 50 pages), the employee's essential job duties, and available agency documentation. When medically supported, the physician provides a written opinion addressing how the employee's medical condition affects work-related functioning and whether the requested accommodation is medically reasonable.
Best suited for: Employees with a relatively straightforward accommodation request in which the diagnosis, functional limitations, essential job duties and requested accommodation are already reasonably well defined.
This service is generally not intended for cases requiring extensive analysis of multiple medical conditions, substantial disagreement regarding essential job functions, complex telework or remote-work determinations, or a detailed assessment of whether the employee can continue performing the essential duties of the position.
An in-depth physician evaluation for more complex federal workplace accommodation cases requiring detailed analysis of medical conditions, functional limitations, essential job duties, and the relationship between those limitations and the requested accommodation.
This service includes review of relevant medical records (up to 50 pages), the employee’s position description and essential job functions, available agency forms or correspondence, and other documentation needed to evaluate the accommodation request. The physician assesses the functional effects of the employee’s medical condition and, when medically supported, provides a detailed written opinion explaining the medical basis for work-related restrictions or accommodations.
The evaluation may include analysis of multiple interacting medical conditions, limitations affecting several essential job functions, work attendance or schedule tolerance, travel or field duties, concentration and cognitive demands, mobility, physical endurance, environmental restrictions, and the medical rationale for telework or other substantial workplace modifications. When appropriate, the report may also distinguish between a medically necessary restriction and an employee preference and may address whether the requested accommodation would allow the employee to continue performing the essential functions of the position.
Best suited for: Employees whose accommodation request involves multiple medical conditions, significant or overlapping functional limitations, complex essential job duties, or a request that requires more extensive physician analysis.
This level is particularly appropriate for cases involving telework or remote-work requests, limitations affecting travel or fieldwork, multiple requested restrictions, questions regarding the employee’s ability to perform essential duties, or situations in which the agency has requested detailed medical clarification. It may also be appropriate when prior medical documentation has been considered insufficient and a more comprehensive explanation of the employee’s medical limitations and occupational impact is needed.
Some federal employees pursue accommodations to remain in their roles. Others reach a point when continuing to work is no longer medically feasible.
If your condition significantly limits your ability to perform the essential functions of your position—even with reasonable accommodations—you may also be considering Federal Disability Retirement through the Office of Personnel Management (OPM).
We provide medical opinion support for both scenarios.
If you are unsure which path applies to your situation, a structured medical record review can help clarify whether a medically supportable opinion can be provided.
Veterans who have been asked by a federal agency to submit medical documentation for an accommodation request may complete our Disability Accommodations Intake Form. The information will be reviewed by our licensed MD physician and occupational medicine specialist to determine whether their case is appropriate for review.
Medical opinions are provided independently and in accordance with professional medical standards. Services are limited in scope and offered selectively.
Accommodation opinions are medical assessments of functional limitations and do not constitute treatment, employment determinations, or legal advice.