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Thursday, March 9, 2017

Does the majority in Congress represent the people of the United States or just corporations?



Lawmakers in Congress are about to vote on bills that would seriously jeopardize Americans' right to their day in court. I need your help to stop this dangerous legislation which will make it easier for corporations like cable companies, banks, credit card companies, and drug companies to break the law and get away with it. 

If these bills become law, this sweeping legislation would make it virtually impossible for Americans who are cheated or wronged to seek justice in our courts.


Please send a STRONG message to Congress and tell your representative to vote "no" on each bill. The following link is an online tool that will allow you to automatically write or call your members of Congress, and helps explain why your representatives should strongly oppose this bill:

You can also call the Capitol Switchboard at (202) 224-3121 and ask the operator to connect you to your Congressional Representatives or visit this link to find and contact your two Senators and your Representative.

Tuesday, January 31, 2017

OWCP 2017 periodic roll payment schedule available online

OWCP has published the payment dates for periodic roll payments for 2017 which can be found at the following link: https://www.dol.gov/owcp/dfec/regs/compliance/Periodic-Roll-Payment-Schedule.htm

Thursday, January 12, 2017

Did OWCP use Dr. Garelick to rate your upper extremity schedule award?

David H. Garelick, MD, is a district medical advisor (DMA) for OWCP reviewing schedule award requests. OWCP recently acknowledged that he has been misapplying the AMA Guides, 6th Edition ("AMAG6"), with regard to upper extremity schedule award calculations. This has probably been occurring since 2009. As a result, many claimants received smaller schedule award percentages than they should have for arm injuries when there was a loss of range of motion. If this applies to you or someone you know, you should investigate whether the award was properly calculated using the corrected Table 15-5 in the revised AMAG6 released May 2009. If you are concerned about whether Dr. Garelick was involved in your schedule award, you can write to OWCP requesting a copy of the “DMA memo that was used to determine my schedule award.” The DMA memo will be signed by the doctor who authored it. This only applies to arm ratings and only if you have a loss of range of motion that was excluded from your rating.

Monday, December 19, 2016

Disturbing Trend of Claims Examiners trying to invent reasons not to pay benefits

In a number of recent claims that OWCP has approved, after protracted fights (2-7 years), I have found claims examiners refusing to commence payment of wage loss benefits. In what is perhaps the most egregious recent example, a USPS employee who suffered an emotional injury during Hurricane Katrina finally underwent a referee examination and received a notice that the claim was approved based upon the referee agreeing that compensable factors caused the injury and also caused total disability. Upon receiving the notices from OWCP, we submitted the necessary paperwork to switch the claimant from an approved disability retirement pension to receiving FECA benefits.

The next thing that happened is that OWCP reassigned the case to a new claims examiner named Rowena Daniels. Ms. Daniels looked at the paperwork we had submitted to start the process of paying wage loss benefits and decided to call the claimant to berate her that she was not entitled to wage loss benefits since she was receiving her pension. However, Ms. Daniels made a major mistake. She dialed my number, not the claimant's. You can imagine my surprise when I answered my phone and was met by a barrage of anger from Ms. Daniels who was screaming at me that I was not entitled to wage loss benefits since I was receiving my pension.

Eventually, when I could get a word in, I brought to her attention that she was speaking to me, not my client, and I then advised her that she was wrong. She angrily stated that I would get a letter from her and hung up. Needless to say, her letter advised that my client needed to prove she was disabled in order to get benefits, that there was no medical evidence, and giving us 30 days to submit that information. Even though the referee examiner's report was the weight of medical evidence.

This situation was brought to the attention of OWCP management, and my client quickly received her wage retroactive loss benefits. OWCP apologized for the letter saying that the client needed to prove her entitlement to benefits. They made no mention of the call I documented from Ms. Daniels.

Thursday, November 10, 2016

Open Season starts next week: November 14 - December 12, 2016

Its that time of year, if you need to make a change on your health benefit enrollment, or just want to explore your options, remember that you need to do this over the web since OWCP no longer mails out brochures. A good place to start is here:
Note that if your employing agency transferred your health insurance enrollment responsibility to OWCP,  you must send your completed SF2809 to the OWCP District Office handling your case. If you are not sure, send it to both your agency and OWCP.

Be sure to go to the OPM website to get started:

https://www.opm.gov/healthcare-insurance/open-season/

Tuesday, May 17, 2016

What does it mean that OWCP sent me a letter from a Quality Assurance Specialist ("QAS")?

When you are receiving FECA benefits you are going to be regularly scrutinized. Your employing agency may do surveillance and OWCP will also periodically require all sorts of information from you. I was recently shown a letter signed by the district director of an OWCP office asking the claimant to contact an individual who was identified as a Quality Assurance Specialist (QAS). The person identified on the letter as the QAS is actually a criminal investigator from the USDOL. Its not clear whether the target here is the claimant or the claimant's physician. Or perhaps this is just the usual routine over the top OWCP bullying techniques.

When OWCP sends you a letter telling you to do something, if there is an explicity threat that if you don't cooperate your benefits will be sanctioned, then you cannot ignore the letter. However, if the letter does not give you notice that there is a penalty for not responding, then you may want to consider whether or not you respond. The fact that this letter was signed by the district director, provided the name of an OWCP claims supervisor and a direct dial number for him (OWCP employees typically make it impossible to find their direct dial info), and lastly the person identified benignly as a "QAS" is in reality a criminal investigator, makes me concerned that this person may have a serious problem. This person should perhaps have a lawyer contact the QAS on their behalf to find out what is going on and act as an intermediary.

Thursday, November 12, 2015

Open Season - its time to review your health insurance plan

Even though you may be out of work receiving workers compensation from OWCP, you still need to stay on top of your health insurance enrollment. OWCP, and the federal government in general, no longer mail out brochures. You need to research any changes you might need to make and get your forms from the OPM website. A good place to start is here:


Please keep in mind that if you become eligible for Medicare, that is now considered your primary insurance and you need to change to a version of your health insurance plan that takes into account that you have Medicare as primary and health insurance as secondary. Otherwise you are paying too much for your health insurance. I have a client who reduced her health insurance premium from $800 per month to $200 per month by making this change. This is not a change that is limited only to Open Season. Becoming eligible for Medicare is an event that allows you to immediately change your health insurance enrollment without waiting for Open Season. The OPM website explains:

Can I Change My FEHB Enrollment When I Become Eligible for Medicare? 
Yes, you may change your FEHB enrollment to any available plan or option at any time beginning 30 days before you become eligible for Medicare. You may use this enrollment change opportunity only once. You may also change your enrollment during the annual Open Season, or because of another event that permits enrollment changes (such as a change in family status).

Another change is that beginning this coming year every plan must include an option for self plus one in addition to the previous choices of individual and family; this includes dental insurance.

Note that if your agency transferred your health insurance enrollment responsibility to OWCP,  you must send your completed SF2809 to the OWCP District Office handling your case. If you are not sure, send it to both your agency and OWCP.

Be sure to go to the OPM website to get started:

https://www.opm.gov/healthcare-insurance/open-season/