Workers' Comp - Federal

Statement of Accepted Facts question

Immortal — Thu, 19 Nov 2009 15:06:19 GMT

I recently received a copy of my entire OWCP case file via a Privacy Act request (everyone should also do same) and it included the SOAF. My question is how complete should it be?

For example it starts with the basic chronology and ends with the treatments. But for some odd reason it does not include the surgery I had which was approved by OWCP. I thought that was a very odd ommission. The case file does include the surgical reports relating to the surgery but it is not reflected on the SOAF. I went to see the OWCP referred Doctor for the ordered second opinion and told him about same and he told me that only treatments are included on the SOAF and not any surgery. I find this hard to believe. If the SOAF is suppose to be a chronology of the events in my case shouldn't the surgery be included?

The SOAF included the Doctors that I have "seen". They included radiologists who I never saw who interpreted the MRI's etc... and I was also wondering if that could be considered incorrect; it also did not include the name of a Doctor who I did see but the case file reflects his examination-should I also ask to have this SOAF amended?

Thirdly the SOAF reflects that I am still being treated for a torn meniscus but that is not true-I am being treated for a lesion and something else they got right.

Please let me know if I should ask to amend my SOAF based on the above,

It should be noted another reason to ask for a complete copy of your case file, I found two medical examination reports that do not belong to me-so much for medical privacy.

Thanks!

accepting a light duty position???

RinR — Thu, 19 Nov 2009 18:29:45 GMT

My injury occured on July 2005. At the time I was told that there were no permanent light duty positions. I was retrained in a different profession. As soon as I started working again and using my arms repetitively all of my symptoms returned. I was then told that I could return to TSA because now they do have permanent light duty positons. I accepted the job because I thought I had no other choice. I went off work again in March due to the problems associated with my original injury. They denied the claim at first. I appealed and won. I got surgery in Sept. I am now recovering, I still have problems with my neck arm and hand. I am scheduled to return to my light duty position in December.

My question is: Do I have to go back to a light duty position that really isn't a real job?? It is sitting at the exit lane all day. I have lost any ability to promote, transfer to a different airport, recieve merit increases, bid for days off or shifts, etc.

Thank you,

Rebecca

SSDI and OWCP

74HM — Thu, 19 Nov 2009 14:54:18 GMT

If SSDI is approved while you are on OWCP does the claimant have option to choose either one or does your OWCP pay automatically get reduced or offset.

Long Term Disability when work is available.

eam147 — Tue, 17 Nov 2009 08:41:02 GMT

This is going to be strange. I was sent home in March of 2002 and just returned to work on October 26, 2009.

I am a US Postal Worker who was injured on the job in July of 1997. I have 3 accepeted claims: Major Depression, Left Hand Carpel Tunnel, Right hand Dequervain Syndrome w/ 2 surgeries on rt wrist. I was placed on limited from Sepetember of 1997 until March of 2002.

In March of 2002 I returned from a doctors appointment and gave my supervisor my ca-17 with new restrictions attached. At the time my limited duty job consitised of answering phones and filing papers.

The only change on the ca-17 was that I needed to work on the day shift, instead of the night shift due to my medications and stress of the job. At that time there were limited and light duty people working the day shift.

My supervisor took my new restrictions to the plant manager and was told to put me out on owcp. I was placed on the rolls of the owcp at the end of March even though the Postal Service states that "they will accommmodate any limited duty up to total bedrest"

I was never put on total bedrest, I was never informed of my rights.The first time that the postal service contacted me was in 2005 for a update on my restrictions. I stated that they are the same as when you sent me home.

The next time I heard from the Postal Service was in August of 2007. At that time they were in the process of trying to seperate me from service due to my mental condition.

The whole time I was out up until 2007. I was contacted by the postal service on 2 occasions. 1. for the update of my medical in 2005 2. when I received the letter about the process of separation.

This is the Strange part. I never had a single problem with OWCP! Not one problem. They sent me on 2 second opinions for my hands and may major depression. On both occasions the doctors stated that I was being treated by competent doctors. There were no negitave reports.

My problem is that the postal service failed to follow their own accomadations statement and procedures for light and limited employees. They failed to follow the directions in the ELM for light or limited employees.

I was getting 75% of my salary the whole time I was out on disability. I want the postal service to pay me the other 25% of my salary for the entire time I was out of work when there was work available and my rights as a Injured Employee were violated.

I don't know what to do since time limits on filing a EEO have pasted. I need help or a lawyer that can give me some advice as to if I can recover the 25% and any other damages.

Thanks

taking care of myself

TCOM!

DOL OWCP Disability Retirement

Oblio — Fri, 06 Nov 2009 00:41:35 GMT

Hi, I was hoping somebody can tell me the first steps to take towards applying for Fed OWCP Disability Retirement. I have searched their website and found nothing. I have worked many years with work restrictions and now the doctor has said I can no longer work. I just don't know where to start and afraid to call OWCP without some kind of knowledge of what I am talking about or need to ask for. I'd appreciate a point in the right direction to gather information. Thanks!

Schedule Award

klkrkl3 — Sat, 14 Nov 2009 10:13:38 GMT

I received a schedule award in 2004 my rating was 25% for one leg and 30% for the other. I believe this rating also included my hips and was calculated with the AMA 5th edition. Since then I have had two total knee replacements and one revision of one knee and left with bad blister scars on another leg. My total rating now is 21% for one leg and 21% for the other leg with a combined total of 38% and a 15% whole person impairment using the AMA 6th edition. Question: Do I qualify for an additional schedule award since both my knees had to be replaced? If so, how many weeks and will they deduct from the previous award? Does the 288 weeks apply to one leg or two legs combine?

Is there backpay when switching from OPM to OWCP?

Sarah2010 — Thu, 12 Nov 2009 19:13:00 GMT

Hello,

I hope someone can answer this question because I've been trying to find an answer for some time. My question is in regards to the Labor Department's Election form (Form CA-1105).

I have approved disability claims with both OWCP and OPM and I was told that I can switch between the two agencies at any time. I was originally with OWCP and switched to OPM about 2 years ago. Now I would like to switch back to OWCP due to a death in the family and financial reasons.

I read on a website that I would be eligible for retroactive pay (backpay) from OWCP for the difference in pay between OPM and OWCP for the 2 years that I have been with OPM. Is this accurate?

If so, does the retroactive date (when I switched to OPM 2 years ago) go on the "election date" line on Form CA-1105?

Is this how I let OWCP know that I want to claim backpay (e.g. the difference in pay between OWCP and OPM) for the 2 years that I was with OPM?

If anyone can answer this, I would greatly appreciate it.

Thank you for your help

Federal WC Claims Examiner Forcing Use of Their Choice of MD

cygnet14 — Wed, 11 Nov 2009 21:26:43 GMT

I was injured in Europe working civilian for USArmy as RN. I had an accident resulting being placed on workers comp. Was sent back to US after base closures and had multiple surgeries in US. I attended a pain clinic for over 8 years and was told that I was stable on my meds, would be on them for the rest of my life and referred to my own primary MD to dispense monthly meds. Everything was fine for 2 years then Dept of Labor says it was not authorized. They forced me to see a pain managment Dr of their choice who at their request is removing me from all meds ( due to cost). This Dr does not know what he is doing. I am in severe pain but DOL will not allow me to go to a pain managment md of my own choice. I had 2 second opinions (paim management md's) at my own expense who say it is insane what this Dr is doing with totally removing all meds. I would have gladly gone back to pain clinic I was formarly treated at but they no longer take Federal Work Comp cases only state WC. My Dr sees me monthly as he is decreasing the pain meds. He sees me in severe pain many times in tears from pain but will only go along with DOL. I have been 100% on workers comp since the injury which was over 17 YEARS ago. I have not worked 1 day since but have continously been on Federel WC. Is there an attorney in the San Diego area I can consult. There are many other issues to this as my pay has been also wrong for over 9 years. They declared me dependant free after a divorce but I have minors as my dependents living with me.Right now however my pain issue is the most important. I am allowed no choice. Is this legal? Thanks C

As If It Could Not Get Any More Complicated.

ewrster — Tue, 10 Nov 2009 18:27:29 GMT

Quick question to all: If one injures, for example, a shoulder joint while doing OWCP-approved physical therapy for an injury to another part of the body, is that something reportable and/or compensable by DOL? In the course of doing some wall push-ups to strengthen my cervical spine (an OWCP-accepted injury), I felt something pop in my right arm/shoulder joint and cannot lift it above my waist without pain.

I am waiting to see a different ortho, who only does shoulders, and made the appointment under my own Federal Blue Cross/Blue Shield. When they asked it this was "work-related" I said not really, but I'll wait to tell the doctor the circumstances.

After all the nonsense I've been through with OWCP/DOL, the last thing I want to do is complicate matters. But if this is something that is going to impact my getting back to duty and earning a paycheck, or will stop my rehabbing of the neck injury, then I don't think I have a choice.

Does anyone know the best way to proceed with this issue?

Thank you in advance.

Physician's Statement

74HM — Sat, 07 Nov 2009 18:58:45 GMT

In section B on the back of the physician's statement it asks the physician to complete the statement within 2 weeks. Do they mean 2 weeks of fileing for OPM and then you send the physician's statement later?

I have not filed anything yet for OPM but I did file for SSDI.

Would it be best to send all OPM forms with the physician's statement all at once?

Also, if hiring anniversary date is coming up within a few months, would it be better to file OPM after that date?

second denial Please help

ronan — Sun, 08 Oct 2006 15:51:44 GMT

I have been out on owcp since mid 03 due to a neck injury. Before the neck injury I had three back injuries sustained while at work. All were workers comp and I have case file numbers for all going back many years. While being treated for the neck injury I began having intense back pain. I was advised to file for recurrent back injury and did so. My claim was denied. I was advised to file for reconsideration and did so. I just recieved the verdict. The evidence in my case was sufficient for the office to reopen and conduct a merit review. However my docs failed to explain the relationship between my diagnoses and my work injuries. So denial again. What do I do now?

Urology doctors/ Impairment rating

JOEL16 — Tue, 20 Oct 2009 18:11:34 GMT

Can someone please find a Urologist that can perform an impairment rating. I have called every urology office in Pennsylvania and cannot find one. I've been waiting for the Dept. of Labor to find me one for over 7 months and continue to get the same answer. "These things take time, and you'll have to wait your turn."

I had a back surgery and developed sexual issues which continue 2 years after my surgery. If anyone had a back surgery, I'm sure you know the situation. This is documented with my psychiatrist and is the cause for my depression. The depression diagnosis was accepted by the Dept. of Labor as a condition of my injury along with a 21% disability for my back issues.

Thank you!

Separation from Service OR Resign?

MissyM — Thu, 29 Oct 2009 15:19:54 GMT

I recently received a letter giving me the options to Resign , Return to Full Duty or be Separated

from service. I have been completely disabled for 8 years and had my SS Disability approved a few years ago. They told me there is not a light duty position available for me. So my options are to resign or be separated.

My question is which is better for me? I have read that they can hassle you over the "cause" of separation rather than simply say it is because of work comp issues. If that is the case is it better to resign? Which does the DOL find more acceptable? Does it impact me applying for disability retirement if I resign?

The manager of HR that sent me the letter was very hostile on the phone so I do not expect too

much cooperation from them regarding my case but I remain hopeful while holding my breath!

Thank You for your time and help!!

Missy

Federal Workman Comp Bad Faith Violation or Delaying tactic

fdburgess — Mon, 12 Oct 2009 15:46:20 GMT

I was a registered nurse at the Gainesville VA hospital from 1992 to 2005. In 2005, I was trying to protect a patient from injuring himself and suffered a right wrist ligament injury.

Unable to accommodate me they did not have a position for a nurse with the use of one hand on restrictions and with intractable pain, I was retired on OPM disability retirement with an income cut by approx. 2/3--66,000 to 24,000 a year.

Accepted by the Dept. of Labor in Feb. 2009. The injury required surgery on my hand/wrist –a pre-existing condition of a short wrist bone never bothered me before the injury, as documented by my doctor.

The adjuster refuses to issue a formal decision why I do not deserve back wage loss based on wrist injury and surgery alone. I cannot appeal my claim until he does so and he is aware of this. He is attempting to rescind the injury approval and deny me back wages, stating I had the surgery for the pre-existing condition and not for the injury and that’s why the VA can’t accommodate me. My lawyer added an emotional claim, my psychiatrist sent his opinion that the injury caused a setback but the adjuster states it was “too generic and vague” Letters were sent to clarify, the adjuster will not accept them but requested my psychiatric records from the 80s to now. My doctor refuse to send over 18 years of records, the adjuster won’t make a decision without them. He wants to “just deny the claim”. I am caught in the middle suffering financial disaster after another.

Second Opinion

74HM — Mon, 26 Oct 2009 16:59:26 GMT

At Second Opinions, is the claimant required to fill out those doctor office question sheets about history, injuries etc.? The Medical Consultant's Network that OWCP uses, just says to bring your license for ID and says nothing about filling out office question paperwork.

Limited Duty

rfreeman2247 — Fri, 23 Oct 2009 05:43:54 GMT

I have an accepted traumatic injury claim. I underwent an FCE in July and the treating physician placed permanent restrictions on my work capacity. I have not worked since placed on these restrictions.

I have made several requests for a Permanent Modified Limited Duty Job Assignment. I have not yet received one. I have submitted several CA-7’s that have not been processed.

I was told by Injury Comp. to file a recurrence. I was told by OWCP the file was open and I did not need to file a recurrence. OWCP then requested medical evidence stating these restrictions were related to the original injury. The physician and I have both submitted this medical documentation. OWCP then left a phone message stating I need to file a CA-1 for new traumatic injury.

I received a letter from the Postmaster today and have been scheduled for an Investigative Interview.

Any suggestions?

Workmen Compensation

Franceschini17 — Tue, 27 Oct 2009 23:56:49 GMT

I was a federal employee for over twenty five years with the Air Force. During that time, I hurt my back about four or five times. Every time I hurt, I basically 'threw my back". There were times, where I was somewhat incapacited or not able to move around. The first time I got hurt, I was in bed for a week. Right after, I began a series of therapeutic exercises, which when on for about three weeks. The other times I would stayed home and recover from it. My back has never being the same after the first injury. Well, in May of this year, I retired and filed a C-2 for WC. I gathered all my medical records including doctor visits,therapy and other pertinent information to the case and mailed them to WC in Kentucky.

After months of waiting, they denied the case based on the fact that I have never being treated on a reccuring basis. In order for me to get any monetary award for all the pain and suffering, I had to have being seeing a doctor on a periodic basis. I know my back is not well and I am afraid that I will never be recompensated based on their ruling.

What do you think, are they right?

Thank you

Jose Rodriguez

ECAB for final decision of OWCP

2Blessed — Tue, 27 Oct 2009 05:46:30 GMT

Do I need an attorney to draft an ECAB response to a final decision made by OWCP regarding what they state was an overpayment? I talked with my CE about getting information to support my disagreement to their preliminary finding and unfortunately didn't get what I needed prior to them making a final decision. I have documentation supporting my arguement but if I read this correctlly, I can't submit it with my ECAB appeal. In a nutshell, OWCP claims I owe them $12,290.27 for unpaid life insurance premiums from the date of 10/3/02 (my date of injury is 8/18/02) up to 8/1/09 (the date I got approved for OPM disability retirement). However, I was employed and working for the FAA up until 4/27/2008 and my life insurance premiums were being deducted from my paycheck. I receieved a lost wages compensation check every 28 days from OWCP, the difference from being on shift work and having to go to a straight 80 hour work week. Once separated, my life insurance premiums were not paid. I only discovered this when I needed to establish my own health insurance due to divorce from my now ex-husband, another federal employee. So I agree I owe OWCP for overpayment but the time period is incorrect and should be recalculated from the date of separation. What I have is from payroll, showing GLI deductions from my pay from the time frame in question. To me, it seems obvious and straight forward but without submitting the "proof" (which makes me wonder how OWCP came up with their numbers, being that I was on payroll?) I don't want to risk getting the appeal thrown out because I didn't follow the rules. Thank you in advance!

Direct Deposit

74HM — Sat, 24 Oct 2009 11:24:58 GMT

OWCP pay was coming Direct Deposit for a few years but recently they are sending check. Does anyone know why this would happen?

Board of review decision

pizzapizza — Tue, 15 Sep 2009 22:35:39 GMT

I recently received a decision from the Dept. Of Labor hearing representative for Appeals which states that my case be remanded to the district in the "instant case" and issued a "de novo" decision. It mentions a scheduled award criteria and the DMA. The decision states that I have provided sufficient medical evidence and should be deemed SOAF? What does all this mean? What happens next? It also declares a 25% disability as per AMA 6th Edition?

Schedule Award

rfreeman2247 — Fri, 23 Oct 2009 06:18:53 GMT

I filed for a Schedule Award in 2007. OWCP acknowledged the request but questioned representation. I re-submitted documentation resolving that issue, and waited. I submitted an inquiry and was told that I had to undergo an IR using the 6th edition of the AMA guides. I submitted a letter explaining that the request had been made in 2007 including all necessary documentation. The DMA applied the results of the 5th edition IR I had submitted with my request to the 6th edition and reduced the award. It was notated in the award letter that since I had filed for the award in 2007 and my son was still a dependant at that time they were compensating me at the 75% rate. Can they do this?

Need help!! Work comp is terminating me.

halfdozenboyz — Fri, 23 Oct 2009 00:24:34 GMT

I have been on workers comp for about seven years now. I had back surgery in 2005 and it failed. I have been through there doctors and referee doctors three times now. The first two times I won but was without pay for months at a time. Finally in early 2008 they found me totally disabled! I never heard from them until earlier this year and they said there was a discrepence between my Doc and there's.?? They sent me to another ref doc who spent a total of 5 min on me...My fusion was determined FAILED.. Even in his report he agreed but said I can work 8 hours..Of course the PO offered me a light duty job which my doctor advised me to refuse. Now I get a letter that says WC is going to terminate my benefits. Do I have any recourse? And am I eligable for my postal retirement? I know I have a year from termination but, now that I refused the job offer, have I lost any hope of disability retirement?

Gordon..

lisette7 — Wed, 21 Oct 2009 23:57:09 GMT

Injured on duty in 1991, worked a 4hr day until 1993, and then went out totally on OWCP due to a worsening of my condition.

Sent for 2 secop's and an IME that said my conditions all resolved (they're not). Ordered back to work in August,working only 4hrs, lasted only a few days, when I then aggravated my existing injuries.

I filled out a CA1, had MRI's and EMG's that show radiculopathies, and now I have 4 herniated discs, 2 cervical and 2 lumbar. The radiculopathies cause pain and weakness in 1 arm and siatica in 1 leg. I have muscle spasm that has never gone away in my back, neck,shoulders.

Applied for OPM DR and was recently approved, I have been separated.

My OWCP claim for this new incident was denied based upon my drs letter not being suffcient. My dr will be writing a new letter that will clarify things for the CE.

My question is this:

I received COP,but only based on a 4hr day. I submitted a CA7 and CA7a for the 4 days I worked the 4hrs and received comp for those days.

Can I submit a CA7 under my original claim # for 8hrs a day, for the period I was receiving COP and up to now?

Being my "new" claim has been denied, I am told I have to pay back the COP. If OWCP pays me, I would then reimburse the monies to the USPS, continue to pursue the "new" claim, and then when it is accepted, go back and file a CA7 again, for the same time period, as my rate of pay is significantly higher now then in 1991.

I would prefer to stay on comp, as it is more monetarily then DR.

I hope I made myself clear... Thank you...

Multiple Cases OWCP 2nd Opinion/Referee Exam Ordered.

bopchris — Thu, 22 Oct 2009 20:23:26 GMT

Well let me start off by saying I have contacted 2 lawyers already; one of which returned my message and said I don't need his services; the other I am still waiting to hear back from.

Basically here is my backround. I was assaulted and sustained a back injury at work back in 2000. I then returned to work light duty until 2002. I returned to full duty in 2002 with modifications until I re-injured(owcp calls it a new injury) my back at the end of 2003. I still worked for about 6 months and things progressively got worse. My doctor pulled me off work and my employer never let me return. In late 2004 they rushed me threw a fitness for duty examination and terminated me for being unfit for duty(I was a Federal Law Enforcement Officer in the Bureau of Prisons.) I was approved for Medical Retirement almost immediately due to being terminated; However I stayed on OWCP periodic rolls. I just recently this past summer won my Social Security Disability(SSD) appeals, and that is when OWCP problems started again. As soon as I notified OWCP that I got approved for SSD they immediately scheduled a Second Opinion evaluation with one of there paid doctors and gave me less than 10 days notice of the exam. I demanded a SOAF and a copy of all questions, and paperwork sent to there doctor but they arrived 6 days after I had the second opinion. I have requested a copy of the second opinion doctors findings but have yet to receive that also, but just got notice today that I am having a referee exam in 6 days(10 days from the date of the memo.)

BTW the original SOAF is inaccurate and has stuff mission from it and false statements in it. The 2nd opinion doctor was also asked direct "leading" questions by my claims examiner and the doctor refused to discuss anything that wasn't listed on the SOAF or questioned by my examiner.

Here is my problem though what do I do; I know for a fact my employing agency will not offer me a modified job, there own doctor states I can never fully meet the Law Enforcement Officer qualifications again due to my injuries.

Social Security Disability has determined I am unemployable and there is no acceptable job "in this nations economy" or in my geographical area that I qualify for and/or have the ability to perform.

Do I just ride this out and go to the referee examination; and see if OWCP ever offers me a job? Do they have to offer me a job or can they terminate me from the rolls just on medical evidence since I have been out of work and on there rolls for over 5 years?

(The lawyer I talked to said they have to come back with a job offer if the referee examination agrees with there doctor and not mine, or the 6 other doctors the State of Wisconsin and the Social Security Administration has sent me 2; and based on being terminated by my agency he doesn't see them ever offering me a job; so I don't need his services.)

Any and all advice is welcome and thanks for any assistance in advance.(I just want to make sure all my i's r dotted and t's are crossed; because if I get terminated from OWCP I will probably be without compensation for 90-180days while I fight OWCP and get my FECA disability and Social Security Disability payments started. And OWCP has killed all my monetary reserves over the years due to medical bills that aren't covered; or been delayed; or based on a secondary injury that I am still fighting for causal relationship to my primary injuries.

Thanks Again.

Federal Workers' Compensation Survival Benefits

Hana S. Dean — Wed, 21 Oct 2009 04:21:38 GMT

Since my injury while on duty-several years ago-I have not inquired about survival benefits if my death would/wouldn't be directly resulted from my injury . I had only been on active duty only for few months as a civilian DOD employee prior to my injury. I'm only paying for health, not life insurance coverage premium. At my retirement age, I wonder! Your advice is appreciated.