Federal Workers Compensation Coffee Break

 A growing problem that injured federal workers keep running into: employing agencies that try to short-circuit the OWCP process by offering modified duty straight to the injured employee—or handing them agency medical-clearance forms—while deliberately leaving the claims examiner out of the loop. That’s not just poor practice. In many cases it violates the Federal Employees’ Compensation Act.”

Cor...

Today we’re talking about a common challenge: when an OWCP second opinion (SECOP) doctor gives an opinion you disagree with, leaves key questions unanswered, or when the claims examiner misinterprets the report.

You don’t have to accept incomplete or unclear medical evidence. There are established procedures under the FECA Act, the DFEC Procedure Manual, and related guidance that allow you (or your treating physician) to...

What Is the Bruner Presumption?

Facing a potential adverse action due to a medical issue as a federal employee can be incredibly difficult and stressful. However, a powerful but often underutilized tool — the Bruner Presumption — can significantly strengthen your FERS disability retirement application if you understand the ins and outs of this tool in your disability application. 

Stemming from the 1993 Federal Circu...

This episode is an emailer asking a question and being answered in the podcast episode. The scenario the emailer presented for an injured federal employee is the following:

An injured worker  came in her OWCP doctor's office  for an urgent care visit appointment due to her shoulder being in severe pain and cannot raise it. This shoulder injury is an accepted condition and she is on modified duty. She has been working 8 hou...

There is recent evidence that OWCP (under the U.S. Department of Labor) has increasingly began to outsource significant portions of claims-related services for FECA (federal workers' compensation) to third-party vendors, including private companies traditionally known for state workers' compensation claims management. This is a change in the entire structure of the FECA and OWCP government division's responsibilities. 

OWCP has...

CHALLENGING VALIDITY OF OWCP CLAIMS –
If the validity of a claim is questioned, the Agency supervisor should investigate the circumstances and report the results to OWCP. However, filing of the claim
should not be delayed whether the claim is disputed or what OWCP calls controverted. 
A. Allegations Must be supported by factual evidence.
1) Different Versions of incident by several witnesses, whose accounts

OWCP CLAIMS PROCESSING –

Certain procedures and responsibilities have to be accomplished once the

forms and information have reached OWCP for appropriate adjudication of

claim.

A. Initial Processing –

Once claim is received with all supporting documentation (when possible)

claim number will be assigned to the case. OWCP will notify the

employee and agency once claim has been received. Uncontroverted

claims with medical bills to...

Continuation of Pay (COP) is continuation of regular pay up to 45 calendar

days for periods of disability and or medical care, which occur in connection

with a Traumatic Injury. COP must begin within 45 days of the injury.

A. Entitlement –

Permanent and Temporary employees are entitled to COP when

Traumatic Injury is reported within 30 days. Medical documentation must

support all periods of COP. Normally, COP will begin the day fol...

OWCP Claims for Compensation for federal - civil employees injuries, must meet certain requirements before being accepted.  These five (5) requirements ( also known as the 5 elements of coverage determination criteria) must be met within the sequence below and if not, claim will be adjudicated or held up by requesting information from the injured work to satisfy each of the 5 element requirement in sequential order to be given...

                                  Initiating Claims with OWCP.

Procedures initiating claims with OWCP for an employee who has (A)

suffered a Traumatic Injury, (B) suffers from an Occupational Injury or

Disease, (C) Recurrence of Injury or Disease, and (D) Death:

Seasosn 5 podcast episode 1 explaining  how OWCP works from an OWCP Claims examiner's ...

A psychiatric condition is accepted under FECA only if a qualified mental health professional diagnoses an emotional condition and provides a rationalized opinion that it was directly caused or substantially aggravated by specific, substantiated incidents or conditions of federal employment — not by general job stress or properly conducted personnel actions.

If you are pursuing such a claim, almost all successful claimants use...

CA-7 Form is used When the CE first becomes aware that the claimant is disabled from work (even if the COP period has not expired or a wage-loss claim has not yet been received).

(b) The first CA-7, Claim for Compensation, is approved for a nonintermittent period of leave without pay, and medical evidence supports continued disability from work. The CA-7 form asks the claimant to reportall earnings from employment (outside of his/he...

OWCP Schedule Awards. If you’ve got a permanent impairment from a work injury, this could mean a lump-sum payout to help with the long haul. We’ll break it down for you injured feds: Who’s eligible? What’s the filing process? And what’s this “impairment rating” everyone’s talking about? Plus, we’ll touch on how this plays out for our maritime folks under Longshore—because ...

The Federal Employees' Compensation Act (FECA) provides comprehensive protections for injured federal workers during the adjudication and appeals process for claim denials, including denials of wage-loss (off-work) benefits and impairment ratings for scheduled awards. While FECA does not explicitly prohibit an employing agency from initiating administrative actions like separation for extended absence, it establishes strong safegua...

Federal Workers Compensation Coffee Break Podcast is an educational podcast that covers relevant federal workers compensation topics that affect injured government employees. Today's podcast covers relevant information about Impairment Ratings for a Schedule Award calculations and eligibility. 

Schedule awards are for an OWCP accepted condition arising out of an on-the-job injury. The awards are generally for the permanent loss...

In this episode of the Federal Workers Compensation Coffee Break Podcast, Dr. Taylor, a seasoned OWCP and federal healthcare consultant, provides an update on the OWCP Appeal Process. Dr. Taylor discusses FECA ACT § 10.600 which covers how can final decisions of OWCP be reviewed?

There are three methods for reviewing a formal decision of the OWCP (§§ 10.125 through 10.127 discuss how decisions are made). These methods are: reconside...

In this episode of the Federal Workers Compensation Coffee Break Podcast, Dr. Taylor, a seasoned OWCP and federal healthcare consultant, provides an update on effectively communicating with the Office of Workers' Compensation Programs (OWCP) as an injured federal employee. The podcast focuses on using the Employees' Compensation Operations & Management Portal (ECOMP) for online correspondence, including registering an account, ...

Federal Workers Compensation Coffeebreak is with an OWCP Consultant, Dr. Stephen Taylor, who is a medical provider in Tampa & Pensacola Florida and Daphne Alabama who has been helping government employees with OWCP, DOL and Longshore work-related injuries, disability, FERS Disability, VA disability and other types of Federal program filings for 30 years. 

Understanding LWOP denials and common mistakes by Employee agency &am...

Dr. Stephen Taylor is an OWCP -  DOL provider and consultant who enjoys teaching all things federal workers compensation related. This is an educational short form format podcast for learning how to successfully file federal workers compensation claims. So grab a cup of coffee and lets begin. You will be glad you did!
Here at this podcast we discuss all sorts of topics related to  federal  workers compensation, De...