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Wednesday, November 13, 2013

Resolution of a third party case may entitle you to be paid additional money by OPM

In a small number of OWCP claims, the cause of the injury is due to the negligence of a third party. You cannot sue your employer and coworkers, but if your injury was caused by an entity outside of the federal government you might have a third party case. When your third party case is resolved, your lawyer will distribute the money that is recovered, including repaying OWCP for some or all of the wage loss payments you have received. When that occurs you are repaying the workers compensation payments that you previously received. If you are also approved for your regular or disability pension, repaying the workers compensation wage loss pay may trigger entitlement to a payment from OPM for that closed period of time that you have had to repay OWCP. This can add up to a significant amount of money. If you have settled a third party case, you may be entitled to a payment from OPM for the period that you repaid OWCP.

Wednesday, October 23, 2013

Timeliness of claims - statute of limitations - don't rely on your OWCP claims examiner

I have recently had several OWCP clients' workers compensation claims erroneously denied as being untimely. The time for filing a traumatic injury claim is within three years of when you knew or should have known you were injured. There are circumstances where you can get around the time limitation. With regard to an occupational injury or disease, there is also a three year time limitation. However, with an occupational injury or disease, the claim is timely so long as it is filed within three years of when you were last exposed to the work factors contributing to your condition. That means if you are subjected to loud noise on the job, and have known for more than three years that that noise has damaged your hearing, you can file your claim up until it has been more than three years since you were last exposed to noise on the job. This type of claim can still be filed even after three years have passed since you were last exposed under certain circumstances. Its not clear why different claims examiners in different OWCP offices are getting this wrong and erroneously denying claims filed far more than three years after the injured worker was aware of their illness, but well within three years of when they were last exposed to the relevant work factors that contribute to the illness. If your claim is denied for any reason, keep in mind that you are entitled to appeal rights for a reason. The reason is that far too many OWCP claims examiners are poorly trained and unfamiliar with basic principles applicable to this system. Those running OWCP spend far too much time lobbying Congress to strip benefits from this program and far too much time working with employing agencies to come up with strategies to deny injured workers benefits that they are entitled to receive. Instead, those running this program should be focusing on providing competent training and mentoring to claims examiners who all too often are assigned so many cases that they are unable to provide quality work. In the end, its much easier to deny a claim and let someone else figure it out, especially in a work environment that values the volume of work completed and places no value on the quality of work completed.

Friday, October 4, 2013

The Government Shutdown and OWCP benefits

I have been receiving many concerned calls from FECA claimants regarding the status of their OWCP benefits in light of the government shutdown. OWCP is continuing to operate. While district offices are not answering telephones, wage loss payments, medical bills, and many case adjudication actions are all continuing to occur. The Branch of Hearings and Review is not conducting hearings during the shutdown.

Thursday, August 29, 2013

OWCP recognizes entitlement to Augmented FECA Compensation Based on Claimant's Same Sex Spouse

OWCP now recognizes that same sex spouses are entitled to receive compensation at the augmented rate. If you are in a same sex marriage, you are entitled to receive augmented compensation pay retroactively back to the date of your marriage so long as you have lived with your spouse during this time period. Send a letter to your claims examiner requesting these benefits. You should include a copy of your marriage certificate and in your letter you need to confirm that you have lived with your spouse from the date of your marriage to the present. You may want to print out the link below and include that with your letter in case your claims examiner is unaware of this rule. As always, every piece of paper you send to OWCP should have your claim number clearly marked on the top right.

Friday, May 31, 2013

Receipt of SSA retirement benefits triggers offset for OWCP claimants who were in the FERS system

OWCP seems to be focusing increasingly on finding claimants who have received overpayments triggered by the conversion of their SSA disability benefit to a retirement benefit when persons attain their official retirement age. Note that when you complete and sign the Form EN1032 that your OWCP claims examiner is supposed to send you within thirty days of your birthday each year, that form asks, amongst many other things, whether you have received SSA benefits as part of an annuity under the Federal Employees Retirement System (FERS). That form also includes a statement where you acknowledge that "I understand that I must immediately report to OWCP...any change in income from federally assisted disability or benefit programs." If you begin receiving SSA benefits because of age (an SSA disability converts at your official retirement age to a regular retirement) there arises an offset that reduces your OWCP benefits based upon the portion of the SSA benefits attributable to years of federal service as an employee under the FERS retirement program. OWCP will receive a calculation of this amount from SSA and will reduce your benefits. Generally, you will receive a notification from SSA that you are about to be switched from the SSA disability to the SSA regular retirement. When you receive that letter, you need to send a copy to OWCP and ask them to determine if there will be any change to your compensation rate. If you do not do this, OWCP will generally treat the overpayment that arises as an at fault determination using the language from the 1032 form to impute that you were aware of this. The entire issue is very complicated. You need to be aware that when you begin receiving regular retirement payments from SSA and if you worked under the FERS retirement system, you will get caught up in this and likely find that a portion of your compensation is taken away due to the offset against your compensation benefits.

Friday, May 24, 2013

Be Careful With Your Schedule Award

There seems to be an increasing number of lawyers and nonlawyer representatives wanting to only represent OWCP claimant's with their schedule awards. There are some traps for the unwary, and it is important to understand whether someone is looking out for your interests or just their own. Firstly, you cannot collect a schedule award and wage loss benefits. I get calls from folks regularly who want to switch to their pension so they can collect their schedule award. Keep in mind that most schedule awards are not that substantial. A schedule award is most valuable to someone who is back to work, or someone drawing a CSRS pension, or someone already collecting a wage loss check from OWCP for a different injury. For OWCP claimants in the FERS system who are disabled and collecting SSD, if you switch to your pension to collect the schedule award, you are really not gaining that much: only the value of your pension check that is already being offset because of your SSD benefit. That is because whether you collect a schedule award check or wage loss check, the workers compensation offset by SSA from disability benefit recipients often significantly reduces injured workers' SSD payment and when you get SSD, OPM reduces your pension check.