Workers' Comp - Federal

Proposed termination of benefits letter

mertie1 — Wed, 05 May 2010 11:56:50 GMT

I received a letter of Proposed Termination of Benefits from OWCP. They are proposing this based on the second opinion exam I had back in 11-09. The second OP doctor disagrees with MY treating doctor. Am I not legally entitled to an IME exam to resolve this conflict before they threaten to terminate my benefits?

My DR is already writing out a narrative to dispute this....which I am paying for. But I thought any conflict like this was then referred to an IME exam. This was classified as a SECOND opinion exam btw. Also...this second OP doctor said I can return to my previous position...with no restrictions at all. The problem is...there IS not position. My route was put up for bid a year ago. And the post office rescinded the last job offer and hasn't offered anything since. I was actually in the middle of the vocational rehab process when OWCP decided again to send me to this 3rd second opinion doctor.

Thanks in advance for any advise.

Change of treating physician....

chunkygirdle — Tue, 24 Aug 2010 00:26:18 GMT

I sent a letter to OWCP requesting a change of treating physician and all my reasons why for my accepted shoulder claim on March 1st which is now almost 6 months and haven't heard a thing back. Am I to understand that if your primary care physician refers you to someone else, then you don't need OWCP approval? If this is true, shouldn't OWCP still send you a response?

neck claim denied for casual relationship.

chunkygirdle — Fri, 03 Sep 2010 20:55:55 GMT

Well i knew this would happen. Neck claim denied. Diagnosis of cervical spondylosis and cervical radiculitis. On 2/10/2010 I was bending over lifting heavy parcels at postoffice when existing problem in my shoulder muscle, from an already existing accepted shoulder claim shot up into my neck. My neck was being treated under the shoulder claim by the way. HR insisted this was a new event and insisted i fill out a CA-1. Truth is it is a consequential injury of the shoulder claim that got worse over time. What is the best way to appeal, reconsideration? Am i correct in I now have to file a Ca-2a for consequential injury and attach a medical narrative as to how the neck problem resulted from the shoulder injury? ThankYou to all who can comment? The problem is, what are my options in getting this medical narrative to attach?

Figuring % rating..

chunkygirdle — Wed, 25 Aug 2010 02:38:33 GMT

I was injured on 4/08-SHOULDER SPRAIN,UPPER ARM & ACJ. This injury has accelerated pre-existing arthritis in my shoulder already. But how can doc give you a rating when no ones knows how far or how bad that arthritis will actually get or where it might spread? Anyone with the same??

Help in Finding an ECAB Decision

FrustFed — Wed, 01 Sep 2010 00:23:30 GMT

Preferrably an Attorney or a Paralegal maybe able to assist me or anyone else. Can anyone cite the ECAB Decision that affirms or denies a claimant the right to recieve a scheduled award from the date of the de nova decision and not back date the award since MMI. I was informed that it was a recent decision, I have read about 100 decisions and can't find that one. I would really appreciate some one helping me find that case if it exists..

Cases relating to UNAVAILABILITY FOR DUTY MSPB

dnt711 — Tue, 24 Aug 2010 17:14:07 GMT

Does anyone know anything federal employees who get terminated or removed from duty because of charges of UNAVAILABLITY FOR DUTY?

Wondering??

chunkygirdle — Fri, 27 Aug 2010 04:01:47 GMT

Some of the places i've went for therapy, they've been contacted by I'm not sure who and told the claim only has $1500 to spend and thats it. One PT place I went was discouraged by someone to not put anymore on my shoulder claim. Someone is interfering every where I go.

2 Claims??

chunkygirdle — Mon, 23 Aug 2010 02:30:49 GMT

Hi! Newbie here. I am so happy to have found this site, what a relief. I've had a few simplier ?? answered on one of those Fed Advocate sites, but now I have a few more important concerns. I filed a CA-1 on 4/11/08 for a shoulder injury caused by another employee by way of opening a door. It is an accepted claim for SPRAIN OF RIGHT SHOULDER, UPPER ARM & OTHER SPECIFIED SITES 8408. I need to write my CE and find out exactly what OTHER SPECIFIED SITES means. Kept working at the time and seen a othro who said assessment was a brachial plexus injury. But no testing that was done specifically showed that. I have read that a brachial plexus injury is hard to show, not sure if this is really true or not. The testing showed arthritis in the shoulder which is now worse, positive tinel over the ulnar nerve right elbow, positive pressure at Guyon canal, and a NCS that says evidence of moderate stage right median nerve entrapment neuropathy at the region of the CT, but its not carpal tunnel I have. He has come to the conclusion its a brachial plexus injury based on this? Will his assessment stand without medical evidence to show it? Or maybe all this stuff does show it. What happens if this is what it is and it is something that is hard to medically show? Early on in this shoulder claim my neck became an accepted part. ACS authorized a cervical MRI[which showed nothing wrong] but i had alot of pain and burning in my neck. They also authorized McKenzie PT for my neck and paid for modalities for me to take home, for excercise at home. All of this was covered on the original shoulder claim. Does this automatically include the neck as part of this original injury? Is this enough to show the neck was involved from the start? I have remained working in pain and trying different therapies. The scapula muscle has been in trouble from the start and on 2/10/10 from bending and lifting heavier parcels, the pain and burning from the scapula muscle went up into the shoulder and then shot up into my neck. I'm a rural carrier USPS. HRM insisted this was a new injury and another CA-1 was filed for the neck. A second cervical MRI was done, now showing bulged discs and degenerative change. I'm here to tell ya, I never had a single ache or pain anywhere until the shoulder injury and now I have a list. So I have 2 claim #'s for shoulder and neck. Do I have to have a medical report that says the neck is part of the original injury if the neck was treated as part of the original injury on that claim? Or because the neck was treated on the original shoulder claim from the start, is it part of the original injury with having to do nothing else? Or do I have to have a doctor tie it all together? OWCP never did send a letter that the neck claim was accepted with the ICD code, but yet they gave me a second claim #. Could this be because it is part of the original injury already? But now I get a letter from the OWCP asking for evidence on my neck. Thats because reports from both claims have gotten alittle mixed up, which now i need to send in the medical report for my neck situation. Some MD's have stated verbally to me that the neck is not separate and is directly related to the shoulder injury. My pain management MD is writing the report and is referring me to a Neurosurgical MD. He has also placed a weight restriction of no more than 20lb of lifting. I'm suppose to be able to lift 70lb. If I'm at full duty with just a weight restriction, is that enough for the USPS to boot me into limited or something like that? They already granted the Reasonable Accommodation I requested and have already done things to help with the heavier parcels. So what is the likelihood that now its in writing they would move me off the route? I do want to keep working until the day I can't anymore. Right now I'm on a muscle relaxer that is actually helping, so far anyways. If your on a muscle relaxer that has stopped alot of the symptoms, do they consider that improvement versus the permanent damage you actually have? Thankyou.

Impairment rating/schedule of award advice

CC58 — Sat, 28 Aug 2010 19:28:46 GMT

I am a Federal employee who had a workers comp accident. I had a dislocation of shoulder, broken left arm and ruptured tendon in left shoulder. i just received award of compensation. Dr. rated me for a humerous fracture only. There was no mention of dislocation.Does anyone know if there is a separate impairment rating for a dislocation of shoulder? Does anyone know if dislocation rating is higher than broken arm in the 6th Edition AMA. Should I have been rated for both or just the higher of the two injuries?

I need a pain pill!!

chunkygirdle — Fri, 27 Aug 2010 03:55:58 GMT

Thank you Mr. Reiselt for all your responses. Do you have any idea how an ortho can make an assessment of a brachial plexus injury and bicep tendinitis without any tests showing it? If that is his assessment, why is my excepted condition say just a sprain? Also, how long does a claim have to be inactive before they close it?

Controverted Claim?

chunkygirdle — Tue, 24 Aug 2010 01:16:00 GMT

What does it mean for your agency to controvert a claim? If I have an accepted claim for shoulder, and a year or so later I file another CA-1 for the neck, if USPS controverted this neck claim, what exactly would that mean?

OWCP COMP/ OPM DISABILTY RETIREMENT

backrack — Wed, 25 Aug 2010 04:43:50 GMT

I have several owcp cases that are approved and have taken OPM disablity retirement because of delay in the last case being approved. Now that the most recent on the job injury has be accepted by OWCP I filed the necessary CA7 to get my comp pay. Part of this time I had no pay at all (cop ran out) and then DR kicking in. I have received a letter from my CE stating the compensation due me- but no check. I am constantly writing letters to OWCP asking where is the check. One reply was that until OPM told OWCP how much I would need to reimberse OPM that I could not get any check. The next response from OWCP was that OPM had to stop paying me before they would pay anything - even the back pay. Mind you some of this comp is due me for time I was not paid by my employing agency or OPM. My last letter has not been addressed as of yet but I did sent a copy of my correspondence to my congressman along with a letter asking for help. Is it true that I should not get any OWCP pay until OPM notifies OWCP how much I need to reimberse them and that my retirement has to stop completely before I get a comp check?

Sceduled award

FrustFed — Mon, 23 Aug 2010 18:34:40 GMT

After a successful appeal relative to a scheduled award, and since my DOI, I have been collecting WC wages for four years. Their referre DOCTOR indicated that I was at max medical improvement after one year, . Can OWCP consider the wages I have collected for the past four years part of my award. I was approved for OPM disability after one year, and if so since it is a significant amount of money, can I go back to OPM and collect pay form them if OWCP decides to do this. According to their referre Doctor and two of their other Docs I am totallly disabled along with FIve of my DOCs Also what are the tax implications for the past four years if OWCP decides to do this and OPM furnsihes me my back pay for the past four years. I would appreciate any legal guidance on this isssue.

OWCP DISTRICT 25

CorgieMomma — Sun, 11 Jul 2010 10:16:09 GMT

I recently underwent a 2nd opinion with a physician that specializes in Orthopedics, the problem here is that I was referred by my original orthopod to a neurologist and haven't seen the orthopod in 7-years. I don't understand why the OWCP would not send me to a neurologist when that is the treatment that is in question. I have since discovered that the 2nd opinion, obviously, disagreed with my neurologist. I was not supplied a copy of his report and had to request it in writing, which I have done under the provisions of the Freedom of Information Act 1974. I tried, without sucess to have the second opinion changed to a neurologist. Now I am scheduled for a referee examination w/neuro, in the letter it said I could change the appointment but to avoid making the appointment later than 1-week after the original date, I however, had to make it much earlier. I had several other appointments in the timeframe that the OWCP chose and it was imperative that I change the referee appointment to fit into a cardiology and several dentals. I notified my claims examiner and she in turn notified the scheduler, at which time I received a phone call from her who verbally bashed me and told me that I was not allowed to chnage the appontment, but: the letter said I could. I was then told that she wasn't going do a - z and that I better go to that appontment. I am so confused, but not beaten. I have won everythng on my own but honestly I am tired of feeling like their personal kickball. I've dealt with them for 10-years. I need to know about filing an appeal if denied and a formal complaint process.

Need help in getting benefits restored under OWCP

refagra — Wed, 18 Aug 2010 00:16:07 GMT

Suffered an on-the-job injury in 1986, had surgery for it in 1987. Although condition continued and working became difficult for me, I was able to work for many years as I held a union job (US Customs Service). I was unable to perform full duties and when returned to the job, injuries prevented me from performing all duties. Subsequently I applied for disability retirement which was accepted. I had the option of OWCP benefits or disability retirement. OWCP was better so I claimed that.

Three years later I obtained a job with a local union and OWCP assisted with my wages to the union. After about 4 months and OWCP not re-imbursing the union, I was let go due to reorganizing. Not actually told I was fired though. So this job placement was not really a success but OWCP reduced my benefits by $32K which was what the pay was.

Then I returned to work for the Federal government in a sedentary position. OWCP never followed through to appprove the job, I continued to work for another 5 years in it, receiving my pay and the reduced OWCP benefit.

Additional medical problems surfaced, HBP, back pain were causing problems and I quit the job. Never applied for reinstatement of full benefits with OWCP or reinstatement of the disability retirement. And OWCP never actively pursued me to work.

Can I get full OWCP benefits restored? I am now 70 with foot, ankle, knee, back, heart problems, etc. which would prevent me from returning to my original job.

Seeing a second opinion Doctor this week.

CouzinX — Tue, 17 Aug 2010 02:08:42 GMT

After being accepted, having surgery and eventually being sent back to work full duty, I have finally gotten the approval to see a SO Dr. this week. I wasn't happy with my original doctor sending me back to work full duty, as I was still experiencing issues from my surgery ( Lateral Epicondilytis), but didn't want to rock the boat just yet. The OWCP was fully aware of my situation and I told her exactly what was going on. I informed her that I would continue to work (albeit a little slower and taking it easy) but that I would keep her informed of what was going on. Earlier this month, I told her that I wanted a second opinion, since I don't believe after 1 month, that the original doctor truly understood the work I did and how it relates to my injury.She even wanted to know if I could switch or transfer jobs. That is not an option where I am at. (By the way - I am a automation clerk at the USPS)

I can truly tell that in the past few weeks of work, the initial injury (area) is starting to flare up again. So, long story short - I get to see a doctor that I CHOSE for a consultation this week and wonder if there is anything I should know or ask going in?

Thanks,

Federal OWCP Questions

Getagrip — Thu, 15 Jul 2010 23:48:58 GMT

I work for the National Park Service as a maintenance worker. I was injured on the job Nov. of 2009 due to their neglect and placed on OWCP. I just now being informed that I am to go to a Voc Rehab 60 miles each way. My question is that I am a 90% disabled vet, prostate cancer and PTSD. I wear 6-8 pads per day and I take 5 medications for PTSD that are potent. How does my disability fit into the task of VR? I don't think I can handle many jobs with my disabilities. Will OWCP terminate me if I refuse to take jobs that affect my disabilities. How does the ADA play into this?

Medical Authorization

sleeplessinCA — Wed, 11 Aug 2010 18:09:43 GMT

I was injured on the job and my doctor has requested surgery. My case was heldup in appeals for 2 years. The appeal was remanded back to OWCP, I elected from OPM to OWCP, awaiting OWCP to process retoractive reimbursement. My condition has worsened, How long does OWCP have to authorize my doctors request?

my HR contacted Dr's office to get me light duty. Can she?

Kagillan — Fri, 06 Aug 2010 12:38:21 GMT

I was injured last year in Iraq. I have had 2 surgiers on my left shoulder and not trying to get into UVA to see if there is anything they can do. John Hopkins said there is nothing they can do and it will always be like this.

At my last dr appointment my Dr, DOL nurse and myself talked about me returning to work and it was decided that i still would not return on light duty due to my constant pain, the pain meds i am on and the fact that I get a max of 5 hours a sleep a night with ambien.

My doc had me off work until I could get a second opinion and that we would start the federal disability retirement paper work depending on that outcome.

On 08/04, my wonderful HR person contacted my dr and told them they had a light duty position available for me. Never she never talked to the dr but got someone at the drs office to say I could go back to light duty with strict limitations. I love my job and would love to go back to work. There is no way I can though.

Does she have the right to call my drs office. Shouldnt she be dealing with my DOL nurse and OWCP?

Federal OCWP move?

StewardL — Tue, 10 Aug 2010 09:42:22 GMT

I am on OCWP for bilateral rotator cuff tears (i.e. both shoulders). Both arms were torn on the job. I finished surgery on the first shoulder, but am still not yet recovered enough in order to have my second shoulder surgery. I need to move to California soon (before my 2nd shoulder), which means I will be changing to a different administering OCWP office.

I'm worried that the change in adminstering offices might prompt them to fully review my file and find some reason to throw me out, even though I'm not yet done with my surgeries. Is this a legitimate concern for me to have?

If so, are there likely issues I can expect them to throw at me and prepare for?

I heard the California (San Fran) office is really aggressive in throwing people out of OWCP. I'm sure it varies, but has anyone had experiences that might shed light on that reputation?

I really appreciate anyone that is reading this. Thanks.

federal workers comp

melungeon — Wed, 11 Aug 2010 18:38:42 GMT

had voc rehab evaluation done 4 mo ago. at that visit the voc rehab counselor said that he would be recommending disability due to injury limitations, other diagnosis', and age. i have not heard anything from anyone since. question: what is the next step, what is going to happen now?

EMG/NVC

dnt711 — Thu, 14 May 2009 21:12:55 GMT

Has anyone done this procedure before, is it painful? I’m supposed to have it done on my lower-back. Thank you in advance.

Federal W/C - Can DOL docs overide my doctors info?

MsRenee — Thu, 05 Aug 2010 19:02:22 GMT

Im a letter carrier and i got injured on the job earlier this yr (occupatienal disease) and DOL took until to the end of April to approve my case. Now, my doc still has me out and my case examiner is claiming that ive been out long enough. Im not sure when my doc will put me back to work and now the c.e. wants me to go to another doc to put me back to work doing anything even its its just answering the phone.. Can the DOL docs overide my doctors infomation and put me back to work? I just applied for ssi and i'm going to phyical rehab in the meantime.

My next question is: Are there any Fed W/C attorneys that will take my case or assist me without such a huge down payment up front or payment plan.Please Advise Me.. Thank You.

Limited duty job offer

kjsj — Tue, 27 Jul 2010 23:23:03 GMT

I have been out on Fed workers comp for two and a half years from the post office...I was a pmr with no benefits. I have had my back surgery and have 2 fingers that are numb and cold due to the nerve damage from my neck..I signed up on my disabled social security 3 weeks ago because the rehabilitation guy said he contacted the post office 6 months ago and they had nothing for me with my limitations..well now I get a letter from DOL and they now have a modified limited job offer at the PO , because the postmaster needs some time off...I was told that I needed to sign the job agreement and try it or my benefits would be cut out..So I did and my Postmaster is trating me like crap....She will not speak to me the entire day(2 hours in the morning and she has me go home and come back for 2 more hours in the evening) for a total of 22 hours a week , 4 hours a day..she is so rude to me...My neck and back have been hurting along with headaches from the stress at the PO...Do I have to continue this job under these circumstances..I have workes 2 days for a toltal of 6 hours...

possible privacy act violation by IME

mem2008 — Mon, 02 Aug 2010 22:45:21 GMT

Gordon,

I filed a complaint against the IME who did the referee exam with the medical board in the state where he is licensed. OWCP told him he could not release any case file records to the state medical board. However, the doctor claims the state medical board told him they were exempt from confidentiality issues and he provided the entire case file to them.

Questions:

1) The exam was done over three months ago and he submitted his report to OWCP. Shouldn't the IME have returned the records to OWCP after he completed his report?

2) Is there any such exemption for a state agency with respect to records under DOL OWCP control?

3) I think this a Privacy Act violation. If so, how should I proceed?

Thanks for any advice you can offer.