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On The Job Injury Information
NOTE: OWCP uses the AMA Guides 6th Edition
PEN has totally redesigned our Injury Section in an effort to help you locate the information and resources you need. We have also designed a new OWCP Knowledge Base that may answer many of your questions. We also have a new section on Scheduled Awards.
All information contained here is for informational purposes only - you should seek help, support, and guidance from your union, USPS Human Resources or managers, and/or legal guidance from an attorney. Do not rely solely upon information contained here. We wish you every success.
We cannot answer questions or provide advice relating to on the job injuries or medical problems. Please visit our On The Job Injury forum.
The Benefits of Free OWCP Claims Assistance
Why does it seem like most doctors are reticent to treat federal employee and postal worker injuries? If you were to ask around you would find that many of the reluctant doctors cite a bad experience in dealing with their patient's injury claims that made them want to swear off occupational medicine, especially for federal workers. In many of these instances, the provider would find themselves unprepared and unequipped to handle the situation surrounding the claim due to their lack of training in legal medicine. Unable to efficiently navigate the forms and the claims process associated with the Office of Workers' Compensation, these doctors grow frustrated and weary of the process.
These frustrations are not exclusive to the providers. Patients who have been injured while performing work-related responsibilities also become frustrated as their patience is challenged by the OWCP claims process. This is certainly true for those who have had their claim denied due to incorrect filing. Adding to the patient's grief are the high fees sometimes associated with counsel and claims assistance. Those who cannot afford these fees are often left feeling like they are without an ally in their efforts to get treatment for their work injury.
These patients should not despair, however, for they have an ally in Accuhealth Pain & Injury Clinic in Dallas. The physicians and medical staff at Accuhealth are dedicated to occupational medicine and treating injured postal workers with comprehensive care. Furthermore, Accuhealth retains a former OWCP claims examiner on staff in order to offer free claims assistance to their patients. Having a staff that is expertly trained in federal workers' compensation has been a tremendous benefit for hundreds of their patients.
Many workers who have sustained an injury suspect their company's doctor to be pro-employer and wish to choose their own treating doctor outside of the company. Though federal and state laws support their desires to pursue another treating doctor, these workers sometimes remain with the company doctor due to a perceived lack of valid alternatives. However, the OWCP claims experience and expertise of the medical staff at Accuhealth makes the clinic an ideal choice and has given scores of injured workers the confidence to leave their company doctor in favor of an independent treating doctor. Additionally, Accuhealth's postal worker patients have benefited from the clinic's pro-employee determination and its dedication to comprehensive treatment. Their patients are at ease knowing that their doctor will not end their treatment prematurely and/or send them back to work until they are rehabilitated.
Article written exclusively for PEN by Accuhealth Pain & Injury Clinic
RED FLAGS for Your Claim
OWCP ANDERSON LETTER -
FECA is administered by the Office of Workers' Compensation Programs (OWCP), United States Department of Labor. OWCP determines whether the employee, or a survivor of the employee, is entitled to benefits under FECA. The director of OWCP and his or her designees have the exclusive authority to administer, interpret, and enforce the provisions of the Act.
Letter Carrier Duties
The Long and Short Of A
Let's talk about Schedule Awards that are provisions of the Federal Employees' Compensation Act (FECA) at 5 U.S.C. 8107. I'm going to use, as an example, one of my clients who works for the USPS.
Mr. X sustained an injury that is not uncommon for a City Carrier. While crossing a lawn, he stepped in an unseen hole and sustained a derangement of his right knee's lateral menicus, other internal derangement of the right knee, right old disruption of his anterior cruciate ligament, and aggravation of his right knee's primary osteoarthritis. Needless to say, this was a significant injury. This injury resulted in Mr. X being placed on the Periodic Rolls and paid by OWCP for 20 months. Once Mr. X returned to work and his physician determined that he had reached Maximum Medical Improvement (MMI), we filed a CA-7 for his Schedule Award. Fortunately for us, his physician could do his impairment rating which is required to be done utilizing the 6th Edition of the AMA Guides to the Evaluation of Permanent Impairment. If his physician couldn't have done the impairment rating, he would have been able to refer Mr. X to a doctor who could do said impairment rating. If the treating physician didn't know of a doctor that could provide a probative impairment rating, we had two options. The first was to find one on our own and the second would be to request OWCP to set up through their medical contractor.
Once the impairment rating is received by the Claims Examiner (CE), he/she refers it to the District Office Medical Advisor (DMA) for his determination in regards to it being probative. The DMA , after review, could either agree with the treating physician or determine it failed to meet the regulations of Section 8107 of the FECA. The CE would be ordered to set up a Second Opinion with the medical contractor for a doctor who is familiar with the requirements.
With Mr. X, the DMA agreed with the treating physician and authorized payment of his Schedule Award. Mr. X was found to have a 12% impairment to his right knee. Now, let's see what the 12% impairment means monetarily.
The 12% was input into the impairment calculator by the CE which came up with 34.56 weeks of compensation.
Mr. X's weekly pay rate was his date disability began pay rate (DDB) of $928.61. His compensation rate was 75% (because he has dependents; i.e: wife) that equals to $713.51.
Multiply $713.51 by 34.56 weeks and his award came to $24,658.86. Since this was less than a year, OWCP deposited into Mr. X's bank account the entire amount of $24,658.86 tax free.
As a retired CE, I can tell you that a Schedule Award has the lowest priority on a CE's "To Do List". I've seen individuals actually have to wait for years to get their award processed. In Mr. X's case, I didn't allow this to happen and the entire process took less than 10 minutes.
A large number of representatives require 20% to 40% of an award for their services. Do the math in Mr. X's case. He could have been paid a tidy sum to say the least. My advice is to be very diligent in who you select to represent you to obtain an award given for an impairment that is going to affect your quality of life forever.
Now let's consider your impairment increases over time. For example, down the road, Mr. X's impairment increases to 15%. He would be entitled to file for another award which OWCP would calculate by subtracting the previous 12% from the new 15% and pay for another 3%.
Diligence and aggressiveness in holding the CE to his/her obligation of timeliness is the key. If you don't understand the system, you are at the mercy of the CE.
Till next time brother's and sister's, remember you are not meant to grovel in the dirt as chickens but to soar on wings of eagles. Sadly, the CE wants you to remain a chicken.
Lonnie Boylan of Boylan and Associates
Till next time, Good Luck and God Bless.
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