OWCP Launches Initiative To Assist With Claims Arising From The September 11th Terrorist Attacks

In a recent "news" item, OWCP announced a new initiative to assist federal employees with FECA claims arising from the September 11th Terrorist Attacks. Information about this can be found on the OWCP website at:

https://www.dol.gov/owcp/dfec/FECAClaimsSeptember11.htm

However, the biggest issue with these cases, which is NOT addressed in the announcement and guidance offered by OWCP, is the severe and unreasonable approach taken by OWCP in approaching timeliness. The biggest obstacle to 9/11 claims at this point in time is making sure that a claim is explained in a manner that does not allow OWCP to deny the claim on the basis that allows OWCP to unreasonably determine that the claimant should have known they had an injury and missed their time limitation for filing the claim within three years of when they knew or should have known of their injury.

If you are contemplating filing a claim for a medical condition arising from 9/11, or your presence at Ground Zero, or work related to that event, please realize that you must either explain that you have still been exposed to work factors contributing to your condition within three years of the date of filing your claim, or you must have a medical condition that was "latent" meaning it did not arise until more recently (such as cancer) and you must file your claim within three years of when you knew or should have known that your condition arose from that exposure. You can also show that you gave your supervisor written notice of your injury at the time the injury occurred.

This can be particularly complex in a claim for PTSD or other mental health condition arising from exposure. There are many cases in which OWCP essentially says, you should have known you have PTSD if you were there and if you file your claim more than three years after that exposure they will deny your claim on timeliness. There are sometimes ways to work around this issue, but it is critical that if you are filing a claim now, for a condition that you relate to exposure that occurred more than three years ago, you stand a very good chance of getting a denial unless your claim can be explained in a way that allows you to meet the three year time limitation.

OWCP Periodic Roll payment schedule 2018

OWCP's 2018 payment schedule is now accessible on the web. It can become confusing to understand what date the next payment is due from OWCP as they issue payments on a 28 day cycle, 13 times a year. Here is a link to the 2018 payment schedule:

https://www.dol.gov/owcp/dfec/regs/compliance/Periodic-Roll-Payment-Schedule.htm

OWCP's medical bill processing web portal - new address effective December 31, 2017

Effective December 31, 2017, the web address for OWCP’s medical bill processor (currently Conduent) will change. The web address “https://owcp.dol.acs-inc.com” will no longer be valid for access to the Web Bill Processing Portal.  

The new web address is https://owcpmed.dol.gov

 

Arnold Berman - Did OWCP decide your schedule award based upon a report from this doctor? If so, there seems to be a good chance he got it wrong.

When you suffer a permanent injury to a body part, you are often due a schedule award for that permanent condition. Your impairment rating should be for all of the conditions impairing the rated body part, not just the accepted condition. OWCP sends files to doctors to review the schedule award requests. They call those doctors District Medical Advisors (DMA). A DMA reviews your file and writes a memo advising OWCP whether or not your rating was done correctly and your schedule award is processed based upon those memos. Unfortunately, Arnold Berman has continued to make basic errors in his reports regarding concepts that are so well established that OWCP ran a special training program this past May and required all of the DMAs to attend so that they would not continue to make the same types of basic errors over and over. It is unclear why, even after that training, Arnold Berman continues to make such errors that result in a lower rating than what someone is entitled to receive. OWCP has recognized in this most recent case that Arnold Berman failed to follow the basic concepts applicable to the case and arranged for some sort of remedial training so that this hopefully does not continue to occur.

If your schedule award is based upon a DMA memo by Anold Berman, there is a good chance he rated you lower than what you should have been rated.

Why did OWCP send me a letter telling me to meet with a Quality Assurance Specialist ("QAS")

I recently heard of a claimant whose benefits are handled by the Cleveland OWCP office who received a letter demanding that the claimant travel 4.5 hours to meet with an individual who was identified as a Quality Assurance Specialist (QAS). This time the letter did not provide the name of the person the claimant was to meet with. The last time I saw a letter like this, the person identified as the QAS was actually a criminal investigator from USDOL.

Its not clear whether the persons receiving these letters are being specifically targeted 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 explicit 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 the person acting as a "QAS" in the previous such communication I reviewed regarding this was in reality a criminal investigator, makes me concerned that if you receive a letter like this, you may want to have a lawyer handle your communications regarding the request that you meet with the "QAS" person.

Under limited circumstances you can get reimbursed for attorney fees and other unreimbursed expenses related to your OWCP claim

This is a topic I posted some years ago, but its important and bears repeating. If you are receiving a check from OWCP and are also entitled to Social Security Disability payments from SSA, you may be able to recover your attorney fees from SSA if your Social Security disability check is being offset (reduced) because you are receiving a check from OWCP. 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 attorney fees paid in connection with receiving 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:

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

How do I find out the injury codes that OWCP has approved on my federal workers compensation case?

I frequently speak to OWCP claimants who do not know what specific medical conditions their case is approved for. This can lead to problems when it turns out your case was only approved for a minor condition or aspects of your injuries were never accepted. This is also important information to share with your doctors as bills will not get paid, surgery will not get authorized, and a multitude of other problems can arise if your doctors are not using the codes your case is approved for or explaining in reports why the coding needs to be corrected.

If you are not sure what medical conditions your case is approved for, you can now view that information through OWCP's Claimant Query System (CQS) system. Many current federal employees are able to access CQS through the National Finance Center (NFC) website:

https://www.nfc.usda.gov/index.php


However, if you do not have NFC access, such as anyone who is no longer a federal employee, you can log in directly to the CQS system by following this link:

https://owcpconnect.dol.gov/owcplogin/?site=cqs

It is important to make sure that your doctors are aware of the exact accepted medical conditions from your case and that you make sure that if conditions need to be upgraded or added to your case, that you arrange for your doctor to provide a good narrative report explaining how the additional condition(s) relate to the mechanism of how you were injured.