Episode 39 Federal Workers Compensation Coffee Break Podcast- FECA Bulletin 23-03, -OWCP expands period for submitting evidence in initial claims to 60 days

Federal Workers Compensation Coffee Break Podcast is about all things related to Federal Workers Compensation, FECA, OWCP, DOL & Longshore claim filing as an injured federal worker.  The podcast is an educational and informative training on how to navigate the DOL -OWCP claims filing process for all types of injured US government and federal workers. The podcaster has 28 years in assisting with federal workers compensation as a consultant and trainer. The podcast is free and is educational. If you need help with anything related to a federal workers compensation claim...help is just a cup of coffee away.

                                                                 FECA Bulletin 23-03

         OWCP expands period for submitting evidence in initial claims to 60 days

The Fiscal Year 2023 National Defense Authorization Act (NDAA)  law has some legislated changes that affect OWCP & DOL. Under Section 5305(c) of the Act, effective March 7, 2023, injured federal workers covered by the Office of Workers’ Compensation Programs (OWCP) will now have 60 days to supply evidence in support of an initial claim. Specifically, the legislation directed the secretary of labor to  amend the Federal Employees’ Compensation Act (FECA) regulations at 20 CFR 10.121 to increase the minimum time to submit supporting documentation on an initial claim from 30 to 60 days, and 2) modify the FECA procedure manual to do the same. OWCP has explained the revised regulations and changes in FECA Bulletin 23-03 that it issued on Jan. 9 of this year. 

The FECA Bulletin basically says “Claimants should be aware that the expanded 60-day time frame applies only to the initial adjudication of a claim.”

The Department of Labor published a final rule in the Federal Register which became effective on March 7, 2023) amending 20 CFR 10.121 to read:

If the claimant submits factual evidence, medical evidence, or both, but OWCP determines that this evidence is not sufficient to meet the burden of proof, OWCP will inform the claimant of the additional evidence needed. You the claimant will be allowed at least 60 days to submit the evidence required.

Dr. Taylor's educational podcast utilizes his experience and history as a DOL - OWCP provider and his years of consulting and teaching all things federal workers compensation related. This is an educational short form format for learning how to successfully file federal workers compensation claims.
Dr. Taylor’s contact information for more information or assistance is:
https://fedcompconsultants@protonmail.com

If you need an OWCP approved medical provider, Dr. Taylor is located at M & R Medical & Therapy in Tampa at 4150 N. Armenia Ave. Ste. 102, Tampa Florida 33607 (813) 877-6900
https://mrtherapycenter.com/

Transcript

FECA bulletin 23-03 -OWCP expands period for submitting evidence in initial claims to 60 days

 On Dec. 23, 2022, President Biden signed the Fiscal Year 2023 National Defense Authorization Act (NDAA) into law. Under Section 5305(c) of the Act, effective March 7, 2023, injured federal workers covered by the Office of Workers’ Compensation Programs (OWCP) will now have 60 days to supply evidence in support of an initial claim. Specifically, the legislation directed the secretary of labor to 1) amend the Federal Employees’ Compensation Act (FECA) regulations at 20 CFR 10.121 to increase the minimum time to submit supporting documentation on an initial claim from 30 to 60 days, and 2) modify the FECA procedure manual to do the same. OWCP has explained the revised regulations and changes in FECA Bulletin 23-03 that it issued on Jan. 9 of this year. 

The FECA Bulletin basically says “Claimants should be aware that the expanded 60-day time frame applies only to the initial adjudication of a claim.”

In accordance with the NDAA legislation, on Jan. 6, the Department of Labor published a final rule in the Federal Register which became effective on March 7, 2023) amending 20 CFR 10.121 to read:

If the claimant submits factual evidence, medical evidence, or both, but OWCP determines that this evidence is not sufficient to meet the burden of proof, OWCP will inform the claimant of the additional evidence needed. You the claimant will be allowed at least 60 days to submit the evidence required. OWCP is not required to notify the claimant a second time if the evidence submitted in response to its first request is not sufficient to meet the burden of proof. WHAT! WTH!

Note here that the 60-day period applies to cases where the claims examiner, after an initial review of the case, determines that the claim needs additional factual or medical evidence to be accepted. In such instances, the claims examiner will issue what OWCP calls a development letter. The additional evidence sought by the claims examiner in the development letter will always be related to one or more of the five basic elements that every claimant has the burden of proof to establish for his or her claim to be accepted.

OK in review of this FECA Bulletin I think that  the new expanded time frame is beneficial for injured government workers who are in the initial stages of filing their claims. Historically, claims examiners were required to allow at least 30 days for a response to all initial development letters before denying a claim. Injured letter carriers often had trouble obtaining the required evidence within the 30-day limit. In particular, it was hard for injured workers to schedule appointments with their attending physicians to obtain the requested medical evidence within such a tight time constraint. And it only got worse during the COVID-19 pandemic. When claimants could not obtain the necessary evidence within the 30-day period allowed. by the development letter, their claims were denied. Because fixing an initial denial through the appeals process can add months to the eventual acceptance of the claim, the expanded development period will allow more claims to be accepted during their initial adjudication.

While the expanded time frame will be beneficial for claimants overall… I have some concerns here!

So, in a lot of ways this makes sense, but I worry that if you give OWCP CEs 60 days…they will use the 60 days to delay authorization and approvals of peoples claims. The last thing that we need is a mandated reason to be able to delay the approval of a claim. (But I will not go on a rant here…so ..)

My big concern is that in cases where the claimant has obtained and submitted the necessary evidence well before the 60-day period ends, claims examiners might not be aware of this fact and wait until after the 60-day period has ended to issue a decision. Because of this, it is prudent for YOU the claimant, once you and your medical provider have submitted all requested evidence into ECOMP, to reach out to your claims examiners to advise your CE that you have completed your response to the development letter and request prompt adjudication of their claim. You can do this both by phoning their claims examiner and also by uploading a brief note into ECOMP.

Finally, claimants should be aware that the expanded 60-day time frame applies only to the initial adjudication of a claim. In established claims that have been accepted, a 30-day time frame still applies to development letters issued for any number of adjudicatory issues for which OWCP may issue a formal decision: denials of requested wage-loss compensation, denials of schedule awards, denials of reimbursement, denials of requested medical procedures or durable medical equipment, etc. A 30-day time frame also still applies for claimants to respond to notices of proposed action in accepted claims, such as termination or reduction of benefits. And it applies for claimants to respond to proposed sanctions for such things as failing to attend OWCP directed medical exams, refusing suitable work, failing to cooperate with vocational rehabilitation efforts, or failing to complete required forms. 

Well that does it for this episode of Federal Workers Comp Coffee break  Podcast. 

I want to thank you for listening and want to remind you to share this podcast with other federal workers you think would benefit from this information. Also, if you need an approved medical provider for your DOL -OWCP Or Longshore case in Florida you can find me in Tampa and in Jacksonville. To make a consult with me to discuss your case or if you know someone in Florida who is recently injured you can call the clinic at 813-877-6900 or in Oklahoma at 844-625-5300. Also, if you are in another state and you want me to assist you with claim questions or assistance for your doctor you can email me at fedcompconsultants@protonmail.com

I need to warm up this coffee and get going. As usual I want to thank all of you who put on that uniform, that badge, deliver that mail, take care of our veterans and make this government run… a big thank you. I do this for free just for you…We could not do this without all of the work all of you out there do…so a big thank you. And remember if you have an injured federal claim and you need assistance….I am  here to help!

C-ya next time of to get my coffee warmed up. Keep sending those emails and questions and comments. I appreciate hearing from all of you.