An indefinite suspension based on medical inability or fitness-for-duty concerns is one of the most confusing and emotionally overwhelming adverse actions a federal employee can face.
It often comes without warning—after an injury, illness, psychological evaluation, workplace incident, or dispute with management.
Employees are suddenly told they are “unfit,” “unable to perform,” or “a safety risk,” even when medical evidence does not support these claims.

These cases are highly technical, deeply personal, and often mishandled by agencies.
Most federal employees do not realize:

  • You have MSPB due process rights

  • The agency must prove medical inability—not simply assert it

  • You may be entitled to reasonable accommodation

  • You may qualify for reassignment

  • You may be targeted in retaliation for protected activity

  • You may still be able to perform the essential duties

  • Agencies frequently violate legal standards in these cases

This guide explains how indefinite suspensions for medical reasons work, what legal standards agencies must follow, and how NSLF defends employees in these high-stakes cases.

If you received notice of a medical inability or fitness-for-duty suspension, speak with a federal employment lawyer immediately:
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What Is an Indefinite Suspension Based on Medical Inability?

An indefinite suspension removes you from duty and pay status until the agency resolves a medical or fitness-for-duty determination.

Agencies typically impose these suspensions when:

  • An employee is alleged to be unable to perform essential duties

  • A medical condition is claimed to pose safety risks

  • A psychiatrist or agency doctor raises concerns (often inaccurately)

  • The agency alleges erratic behavior or mental health issues

  • An employee is placed on extended leave and the agency refuses accommodation

Unlike simple medical leave, an indefinite suspension is an adverse action, which means:

  • You have full MSPB appeal rights

  • You are entitled to due process

  • The agency must prove its case

Most employees do not realize they can fight these suspensions—and win.

What the Agency Must Prove

Under MSPB law, the agency must prove:

  1. You cannot perform the essential duties of your job

  2. The medical condition will continue for the foreseeable future

  3. Your presence at work poses unacceptable risk, or no accommodation is possible

  4. The indefinite suspension promotes the efficiency of the service

Agencies frequently fail to meet one or more of these requirements.

Common Reasons Agencies Claim Medical Inability

Psychiatric or Psychological Concerns

Often arising from:

  • Workplace stress

  • Supervisor conflict

  • Whistleblower retaliation

  • Misinterpretation of emotional reactions

  • Inaccurate agency psych evaluations

  • Single incidents blown out of proportion

Psychological FD evaluations are among the most abused tools in federal HR.

Physical Injuries or Chronic Conditions

Including:

  • Back injuries

  • Autoimmune conditions

  • Migraines

  • Chronic pain

  • Post-surgical recovery

  • Complications from workplace accidents

Agencies often assume “inability” without analyzing accommodations.

Perceived Workplace Safety Risk

Sometimes tied to:

  • Domestic incidents

  • Mental health episodes

  • Misunderstood communications

  • Breakdowns during conflict

  • Supervisor panic or overreaction

These suspensions are often retaliatory or based on stigma.

Your Due Process Rights During a Fitness-for-Duty Indefinite Suspension

You are legally entitled to:

  • Advance written notice of the suspension

  • The evidence the agency relies on

  • A real opportunity to submit medical documentation

  • Representation

  • A written decision

  • Right to MSPB appeal

Agencies frequently violate these rights by:

  • Refusing to disclose medical “concerns”

  • Providing vague or conclusory allegations

  • Relying on incomplete or outdated medical opinions

  • Ignoring your doctor’s certification

  • Rushing the process

  • Failing to conduct a proper accommodation analysis

Each of these is a legal weakness that NSLF uses to your advantage.

Reasonable Accommodation Violations Are Common

Before suspending you indefinitely, the agency must analyze:

  • Reasonable accommodations

  • Telework and remote options

  • Alternative duties

  • Modified work schedules

  • Temporary reassignment

  • Rehabilitation or medical treatment options

Most agencies skip this entirely.
This is a major MSPB vulnerability—and a powerful defense.

Indefinite Medical Suspensions Are Often Retaliatory

A significant percentage of medical inability suspensions arise after:

  • EEO complaints

  • Whistleblower disclosures

  • Supervisor conflict

  • Hostile work environment allegations

  • Prior adverse actions

  • Performance disputes

Agencies often weaponize medical evaluations to remove employees they view as “problematic.”
NSLF sees this tactic constantly.

Impact on Security Clearances, Suitability, and Career

Medical-based suspensions can create serious collateral consequences:

  • Clearance suspension or revocation

  • Suitability concerns

  • Restricted mobility within the federal government

  • Loss of promotability

  • HR notes that follow you

  • Denied reinstatement opportunities

  • Allegations of instability or safety risk

The longer the suspension lingers, the greater the damage.
This is why early, aggressive intervention matters.

Should You Resign or Go on Disability?

Almost never resign.

Resignation:

  • Waives your MSPB rights

  • Damages your clearance

  • May end your FEHB coverage

  • Makes you appear “unable to cope”

  • Strengthens the agency’s narrative

  • Eliminates settlement leverage

  • Allows negative notes to follow you forever

Resignation in medical cases is often a catastrophic mistake.

How NSLF Defends Indefinite Suspensions for Medical Inability

Our attorneys—former JAGs, agency counsel, federal adjudicators, and national security lawyers—fight these cases using a multi-layered strategy:

  • Challenging faulty medical evaluations

  • Presenting countervailing medical evidence

  • Identifying due process defects

  • Challenging the agency’s claim of future inability

  • Proving you can perform the essential duties

  • Forcing the agency to conduct proper accommodation analysis

  • Demanding reassignment consideration

  • Leveraging retaliation indicators

  • Challenging safety-risk assumptions

  • Pursuing reinstatement

  • Negotiating clean-record settlements

  • Appealing to MSPB when needed

Medical inability cases are among the most winnable when handled correctly.

Why Federal Employees Choose NSLF

Federal employees choose NSLF because:

  • 4.9-star nationwide rating
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  • Former federal employees, agency counsel, JAGs, prosecutors, adjudicators

  • Expertise in medical inability, accommodation, MSPB, disability, and clearance overlap

  • Nationwide representation

  • Attorney Review Board for complex matters

  • Disabled-veteran-founded firm

  • Financing available:
    Pay Later by Affirm

We don’t just respond—we engineer outcomes.

Frequently Asked Questions About Medical Inability & Fitness-for-Duty Suspensions

Can the agency suspend me indefinitely based only on one medical evaluation?

Not legally.
They must consider your medical provider’s opinion and conduct a proper analysis.
Most agencies fail this requirement.

Do I have to see the agency’s doctor?

You must comply with legitimate fitness-for-duty exams, but you can challenge improper or biased exams.

Can my job fire me for medical inability?

Only if the agency proves:

  1. You cannot perform essential duties

  2. The condition will continue long-term

  3. No reasonable accommodation exists

  4. Reassignment is impossible

Most agencies cannot meet this standard.

Will this affect my security clearance?

Yes, it can—especially where the agency alleges:

  • Psychological instability

  • Erratic behavior

  • Substance issues

  • Safety concerns

NSLF fights these clearance collateral issues.

What if my doctor says I can work?

Your provider’s certification is powerful evidence.
Agencies must consider it.

Can I be reassigned instead of suspended?

Often yes. Agencies frequently ignore reassignment obligations, giving employees strong MSPB leverage.

Should I resign?

Never.
Resignation destroys MSPB rights and harms clearances.

Can I get disability retirement instead?

Possibly—but you must weigh:

  • Benefits

  • FEHB retention

  • Long-term income

  • Clearance implications

We provide full analysis.

Do you represent federal employees nationwide?

Yes. We represent employees in all agencies across all states and overseas.

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If you face a medical-inability or fitness-for-duty indefinite suspension, do not go through this alone. These cases are highly winnable when handled early and strategically.

Speak with a former federal insider today:
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