DOL - OWCP CLAIM FILING INTRODUCTION: DOL - OWCP Coffeebreak Podcast Introductions

Episode 1 is an introduction to Dr. Taylor and his history as an  OWCP -  DOL ( Department of Labor)  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. 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, Department of Labor, OWCP, FECA ACT, FERS, longshore-maritime, DOD contractors, VA benefits. I cover these relevant topics in a short coffee break style format  because we like to discuss topics that are related to helping you the government employee with filing your claim, understanding your rights and responsibilities, relevant rules and provisions. I also like to cover topics that people are always wanting information on to help you successfully  navigate the convoluted waters of federal claim filing. I do this to assist you, you and your doctor  or your coworkers with claim filing denials or with appropriate filing of benefit claims, disability  or injured worker claims. T 

Dr. Taylor's contact information for more information or assistance is:
fedcompconsultants@protonmail.com

If you need an OWCP approved medical provider, You can make a  a consultation with me to discuss your case or if you know someone in Tampa or Pensacola Florida and Atlanta and south Georgia or Alabama,  who is recently injured you can call the clinic at 813-877-6900 or 813-215-4356 or go  to our website at https://fedcompconsultants.com/    & https://mrtherapycenter.com/  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 or send me a message on the website at fedcompconsultants.com

Transcript

·        TYPES OF CLAIMS

·        Traumatic Injury

·        Occupational Disease

·        Basic

·        Extended

·        Death Claims

·        Traumatic

·        Exposure

·        Consequential to accepted claim

·        Death gratuity for injuries incurred in connection with service with 

an armed force

·        Recurrence

·        Consequential Injury 

·         

·        A traumatic injury (TI) is defined as:

·        A wound or other condition of the body caused by a specific event 

or series of events or incidents within a single work day or work 

shift. A traumatic injury is identifiable as to time and place of 

occurrence and member or function of the body affected.

·        Examples: dog bite, knee strain after a trip and fall, neck strain after an 

auto accident, or a broken ankle after a slip on ice

·        Form CA-1 (Notice of Traumatic Injury) should be completed by the injured 

employee and an agency supervisor or injury compensation specialist. 

·         

·        An occupational disease (OD) is defined as:

A condition produced in the work environment over a period longer than 

one workday or shift.  It may result from systemic infection, repeated stress 

or strain or conditions of the work environment.

 |
 | ·        OWCP separates occupational disease claims into two types: ·        Basic ·        Extended ·        Form CA-2 (Notice of Occupational Disease) should be completed by the injured employee and an agency supervisor or injury compensation specialist.  Occupational Disease - Basic ·        In these type of claims, the work exposure and the medical condition are well established and the relationship between them is apparent. These cases can be adjudicated with an initial request for information and perhaps a follow-up query for clarification. Some will clearly address all five basic requirements and may be adjudicated if all necessary evidence is in file.  ·        Examples: ·        A claim for carpal tunnel syndrome from a postal letter-sorting machine operator where medical tests establish the diagnosis. Tendonitis of the shoulder which developed from the duties of a Transportation Security Administration worker from lifting heavy luggage over several days/months.  Occupational Disease - Extended |  

·        In these types of claims, comprehensive factual and medical development 

is required because the nature of exposure is in question, the diagnosis is 

not clearly identified, and/or the relationship of the condition to the exposure

 is not obvious.

·        Second opinion examinations are often required in these claims before a 

·        decision can be made on entitlement

·        Examples:

·        Hearing loss due to continuous noise exposure

·        Asbestos-related illnesses

·        Stress-related conditions (cardiac, emotional, gastrointestinal)
 

Death Claims

1.    Traumatic - the result of a traumatic injury.  An example would be death 

upon impact in a car accident.

2.    Exposure - the result of prolonged exposure to work factors.  An example 

would be employee who was exposed to asbestos for years during 

employment and died of mesothelioma.

3. Consequential[ST1]  - begins as a traumatic injury or occupational disease, but the 

claimant has passed away as a consequence of his or her injury/illness.

Recurrences injuries

 | ·        Two types of recurrences: ·        Recurrence of medical condition: Need for additional treatment after release from treatment. ·        Recurrence of disability: Inability to work after returning to work, caused by a spontaneous change in medical condition without an intervening injury or new exposure.
  Form CA-2a 'Notice of Recurrence' should be completed by the injured employee ·        and an agency supervisor or injury compensation specialist. Consequential Injury  Occurs because of weakness or impairment caused by a work related injury, and it may affect the same part of the body as the original injury or a different area altogether. ·        For example: A claimant with an accepted knee injury may limp for a ·        number of years.  The limping causes internal derangement in the other knee and this constitutes a consequential injury  So lets review the basics of filing each of these type of claim filings 1.Employee Notifies Employer &/or OWCP of an Injury with 3 basic types of Claim Forms CA-1, CA-2 or CA-2a. Form CA-1 is used for a Notification of Traumatic Injury: Notify Employer and give Employer Form CA-1. You can complete the form electronically in the  ECOMP PORTAL to provide A copy to OWCP. Employer Must Send Their Section of the Claim Form to OWCP within 10 Days!2 2 2nd type Form CA-2 Notification of Occupational Disease and Claim for Compensation: Electronically file it in ECOMP portal  or mail to OWCP. There are key things to remember about filing a Form  CA-2 …. First  Employee’s Typed and signed witness statement as to the how, why, where , when and what Occurred to create the occupational illness and/or injuries Second,  Your Physician’s  Medical Rationale Causation narrative along with attaching a  Form CA-35A-H checklist The third type of claim injury filing is a Form CA-2a Notice of Recurrence: You can file Electronically in the ECOMP portal or mail to OWCP. Two recurrence filing tips for a CA-2a form 1)    Employee’s Typed Narrative witness statement of facts 2)    Your Physician’s Medical Rationale Causation narrative 3)    We will do a complete podcast on each of these three type of injury claim filings in the future. What happens next… 1.    OWCP will assigns you a Claim Number and assign you a designated  Claims Examiner. 2.    Things to note about these two things.. • Receiving an OWCP Claim number does NOT mean your claim is accepted. • When your claim is accepted you should get an acceptance letter listing all the accepted conditions. Make sure everything is accepted! If not, have your physician write an Upgrade or consequential Conditions Request medical report. • Your Claims Examiner is the judge for your claim. It is best to correspond in writing and to keep proof of all conversations and keep a diary of all communications. 3.    Employee Selects Treating Physician. Under OWCP you have the sole right to select your physician! • OWCP is Administrative Law requiring your physician’s documentation. Under OWCP, your physician’s medical opinion has higher probative legal value. Your physician must be an expert in federal med/legal rules and provisions and be able to provide OWCP medical rationale narratives & forms, Temporary Total Disability form for payments getting you paid while off work, work restrictions and work accommodations, getting OWCP to pre-approve payment for your treatment, tests, surgeries so that you do not pay for anything, and protecting you from harassment. Unfortunately, Med/legal report writing and OWCP rules/provisions are not similar to classical medical training report writing and are not taught in medical schools. • It is not uncommon for injured employees to have a physician for surgery and A treating physician who fills out all of your forms and provides OWCP with required documentation. • To change your treating physician, simply send a letter to OWCP by the ECOMP online portal or By mail with the  reason you are changing. • OWCP can send you for second opinion exams and reports but not mandate where your Go for your treatments unless you agree. 4. Treatment • CA-1 Acute Injuries: Employer can authorize treatment with a Form CA-16. If your Employer denies treatment. You can still go to the physician or facility of your choice! For acute injuries you may initially see the employer’s physician and then followup with the physician of your choice. • CA-2 & CA-2a Claims: Only OWCP authorizes treatment. Your physician gets authorization from OWCP. Denials of Claims: 3 Paths to successful claim filing…first  Do not give up!  OWCP Rules and provisions are Fair but OWCP claims examiners are not going to be helpful or fair. The problem is that many physicians are not familiar with OWCP resulting in Claims Examiners denying claims due to simple language descriptions required in federal workers Compensation that are not required in the real world. Find the right place to go. 1.    Reconsideration in Writing. First Method. Your physician provides a new MED/Legal Narrative Rationale Report. You can appeal up to 4 times. 2.    Oral Hearing. Often successful. By phone or live. Your physician, yourself And a representative can provides  case related testimony. 3.    ECAB Employee’s Compensation Appeals Board: Judges are supposed To be Fair & Knowledgeable. But be Careful! I don’t find this to be true And typically Use ECAB appeals as a last resort. Ok let’s see if you have been paying attention…  1)    A traumatic injury (TI) is defined as a wound or other condition of the body caused by a Specific event or series of events or incidents within a single work day or work shift. Form CA-1 should be used to provide notice of a traumatic injury. 2)    An occupational disease (OD) is defined as a condition produced in the work environment over a period longer than one workday or shift. Form CA2 should be used to provide notice of an occupational disease. 3)    Death claims can be the result of a traumatic injury, prolonged exposure, or a consequence  of an initial TI or OD condition. 4)    There are two types of injury claim recurrences: recurrence of medical condition or recurrence of disability. Form CA-2a should be used for recurrence claims. 5)    A consequential injury occurs because of weakness or impairment caused by a work related injury directly leading to further injury or additional injuries. It may affect the same part of the body as the original injury or a different body part area altogether. Occupational Disease
 | Well that does it for this episode of OWCP - DOL  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 be kind enough to leave a review on the platform you found this podcast so others will also find 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 Pensacola. To make a consultation with me to discuss your case or if you know someone if Florida who is recently injured you can call the clinic at 813-877-6900 or 813-215-4356 or go  to our website at https://fedcompconsultants.com/    & https://mrtherapycenter.com/  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 or send me a message on the website at fedcompconsultants.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!. See you next time. Off to get my coffee! |  

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