OWCP and reports from someone who is not considered a physician

In a federal workers compensation case, reports must be from a physician. A physician includes  a podiatrist for a foot condition, a psychologist who has a Ph.D., and a chiropractor ONLY for the condition of subluxation. The Employees Compensation Appeals Board has held that a report from a non-physician will be considered medical evidence if countersigned by a qualified physician. This is also found in the Procedure Manual, at Chapter 2.805.3a(1) (January 2013).

Why does OWCP claim not to have received my CA-1032 or other information?

When you send something to OWCP it is scanned to your file. The file contains both scanned documents and an index, or table of contents, that points to the documents received to your file. It is quite common for a CA-1032 or other document to be incorrectly indexed to your file. Your claims examiner will look at that index and not see that a CA-1032 form is listed and assume you did not return it. If you sent in the form and then get a letter saying your claim is going to be suspended because you did not return the form, you should call in and speak to the customer service representative or your claims examiner and ask them to look at the incoming documents scanned to your file around the time the "missing" document should have arrived, not just the index. Most likely it is there and was just not coded correctly when it was scanned.

Get SSA to "pay" your attorney fees in your workers compensation case

This is a topic I posted on about 2 years ago. If you are receiving a check from OWCP and are also entitled to Social Security Disability payments from SSA, you can get SSA to "pay" your attorney fees as an "excludable expense." This also applies to other expenses related to your workers compensation such as paying for medical reports.

SSA has a document available online explaining how to report your attorney fees paid in connection with receiving FECA wage loss benefits from OWCP. The attorney fees (and other qualifying expenses) will be used to reduce the offset amount. Please click on the link below to SSA POMS - DI 52150.050 - Excludable Expenses, and carefully follow SSA's instructions:

link updated 1/26/15: the url below is correct, if the link does not work, cut and paste the link in your browser.

https://secure.ssa.gov/poms.nsf/lnx/0452150050
If this link does not work, do a google search for the document number  "0452150050"

OWCP announces a change of contact number for ACS effective 1/1/2015

Effective January 2, 2015 the ACS customer service number for questions related to provider enrollment, Federal Employees' Compensation Act (FECA) bill payment, and FECA medical authorization status is changing to a new toll free number, (844) 493-1966. Please continue to use the current ACS contact number of (850) 558-1818 until January 2, 2015, when that number will be disconnected. By providing a toll free number, we will be able to offer a more stable service for our stakeholders.

OWCP and other workers compensation systems no longer meet their basic goals

The idea behind workers compensation systems was that injured workers should get immediate benefits allowing them to not lose income and get the medical care they need to return to work as quickly as possible so as to avoid simple injuries becoming serious and the destruction of families due to lengthy waits to receive replacement income. Unfortunately, this system is presently failing many injured workers. This is an interesting article on how OWCP other state systems no longer provide the benefits that they were intended to provide because of the increasing complexity of a system that become more employer oriented by the day:
 http://www.nesri.org/news/2013/03/workers-compensation-the-systems-devastating-economic-impact-on-workers-lives

OWCP changes case jurisdiction for some FECA claims arising in Maryland to the Philadelphia district office

Continuing a trend that started some years ago, OWCP has taken more cases away from the Washington DC district office and assigned them to the Philadelphia district office. This means that anyone with a claim that has been reassigned should assume that their claim is going to receive a renewed level of scrutiny.

It is critical that your file has current narrative medical reports addressing causation and your ongoing need for benefits from OWCP. Many of the cases being transferred to Philadelphia have not gotten much attention in a long time.

As a general rule of thumb, you should be seeing a doctor regarding your conditions not less than once every four months. OWCP expects to see "current" (not more than six months old) medical information from your doctor about your injury.

If there is not current information in your file you should expect to be shopped for a second opinion examination.

Here is the link from OWCP explaining the reassignment of case jurisdiction.

http://www.dol.gov/owcp/dfec/casejurisdiction.htm

How do I find a physician willing to bill OWCP for treating me?

Unfortunately, because the federal employees compensation act process makes OWCP's claims actions unreviewable by any court, those running OWCP have created a system that is designed completely for their own convenience, not the convenience of the injured worker. Some years ago, OWCP began to require that medical providers "enroll" in the OWCP system so that they can get a "provider number" from OWCP. Without a provider number, physicians cannot bill OWCP for treating you. Medical providers already need to enroll with and get a number from Medicare. Why OWCP could not use that existing system, and supplement it with their own system for the obscure situation where a provider does not have a medicare number only makes sense if you recall that OWCP is only concerned about making this process convenient for OWCP. The practical effect is that many injured workers have a great deal of trouble finding a medical provider willing to treat them. If you are having difficulty finding someone to treat you, OWCP does have a tool that allows you to search their database for physicians who have provider numbers. If you click on the link below, and click on the "accept" button, then you select that you want to search in the "FECA" program. you can then do a search:

https://owcp.dol.acs-inc.com/portal/providersearch/agreement.do

The search function is fairly straightforward. One limitation is that certain specialties are not broken out. For instance, under specialties, they do not allow you to limit your search to "psychiatrist" or "psychologist". Therefore, to find a specialist who is not categorized, you need to first do a search in the geographic region you are looking in, then, for any physician who does not have a specialty listed, you can google that doctor's name and see whether that doctor is the type of specialist you are looking for.

If you are unable to locate a provider in your region willing to bill OWCP for treating you, you should document that you went through the list and bring this to the attention of your congressman and request a congressional inquiry. This problem is routinely brought to the attention of those running OWCP, they do not seem to be concerned. The only way they will fix this situation is if they receive scrutiny. If a congressman were to conduct hearings on this issue and ask the director of the program to explain why they are unconcerned with this situation, it might get fixed.