LWOP Common Mistakes, Denials and Proper Filing Tutorial - Episode 66

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 & OWCP for Federal Employees

Welcome to today’s episode, where we’re diving into the often-misunderstood world of Leave Without Pay (LWOP) and Office of Workers’ Compensation Programs (OWCP) claims for federal employees. These topics can feel like navigating a maze, with confusion stemming from miscommunication, agency policies, and the complexities of managing leave during a workplace injury. Let’s break it down in a way that’s clear and actionable, so you can feel empowered in your career.

LWOP and OWCP: How They Connect: When you’re on an approved OWCP claim, LWOP is typically granted to protect you from being marked Absent Without Leave (AWOL). The Federal Employees’ Compensation Act (FECA) even mandates Continuation of Pay (COP) for up to 45 days, where your agency covers your regular pay during disability related to a workplace injury.

 But here’s the part you have to pay attention to: Employee Agencies can still take adverse actions, like AWOL charges, if you don’t properly request and secure LWOP approval, even with an OWCP claim. See Transcript for more information

Dr. Taylor’s contact information is: fedcompconsultants@protonmail.com 

If you need a medical provider or assistance with an OWCP /  DOL claim in Tamps, Pensacola Florida. south Mississippi or Daphne Alabama    you can make an appointment to see Dr. Taylor, or Dr. Sullivan   at the clinic at  FWC Medical Centers. To make a consultation with Dr. Taylor  call the clinic at 813-215-4356 or go  to our website at  https://fedcompconsultants.com/

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Transcript

HI I’m Dr. Stephen Taylor a federal Workers Compensation Consultant and a medical provider in Tampa & Pensacola Florida who has been helping government employees with work-related injuries, disability, FERS Disability, VA disability and other types of Federal program filings for 30 years. I have helped too many people to count  all over the country with properly filing their Federal Workers Compensation Claims and/or disability claims for about three decades. After all these years I have decided  to create a tutorial podcast to assist with all kinds of topics related to injured federal workers and/or contractors. The name of this tutorial podcast is  Federal Workers Compensation Coffee break Podcast. It is based on the lunch and learn short learning format.  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 over a cup of coffee. So let’s get out coffee going and dive into LWOP mistakes and Denials. 

 Understanding LWOP denials and common mistakes by Employee agency & OWCP for Federal Employees

Welcome to today’s episode, where we’re diving into the often-misunderstood world of Leave Without Pay (LWOP) and Office of Workers’ Compensation Programs (OWCP) claims for federal employees. These topics can feel like navigating a maze, with confusion stemming from miscommunication, agency policies, and the complexities of managing leave during a workplace injury. Let’s break it down in a way that’s clear and actionable, so you can feel empowered in your career.

 What is Leave Without Pay (LWOP)?

LWOP allows federal employees to stay on agency rolls without using sick or annual leave while absent from work. It’s a lifeline when you’ve exhausted your leave or can’t work due to circumstances like a workplace injury. Agencies have flexibility in approving LWOP, but their discretion is more limited for approved OWCP claims or Family and Medical Leave Act (FMLA) cases.

However, LWOP isn’t guaranteed forever. If an employee’s absence becomes a significant burden to the agency with no clear return date, the agency may deny LWOP, even for valid medical reasons. This can lead to tough situations, so understanding your rights and responsibilities is key.

 LWOP and OWCP: How They Connect

When you’re on an approved OWCP claim, LWOP is typically granted to protect you from being marked Absent Without Leave (AWOL). The Federal Employees’ Compensation Act (FECA) even mandates Continuation of Pay (COP) for up to 45 days, where your agency covers your regular pay during disability related to a workplace injury.

But here’s the part you have to pay attention to

Employee Agencies can still take adverse actions, like AWOL charges, if you don’t properly request and secure LWOP approval, even with an OWCP claim. After the first year of a compensable injury, agencies aren’t obligated to keep you on the rolls indefinitely. Poor coordination between all the individuals involved in agencies, OWCP Claims examiners, supervisors, doctor’s office’s, OWCP HR specialists, and HR often complicates matters, leaving employees in limbo.

 Common Pitfalls and Agency Challenges

One major issue is the disconnect between the communication of the OWCP administration and your employee agency HR of your employer. Some agencies separate OWCP functions from HR, yet expect HR to handle leave tracking without clear updates communicating an injured  employee’s OWCP status. This can result in employees lingering on agency rolls for months and even years, when they could’ve been removed after a year on an approved claim.

Another challenge is miscommunication. Employees sometimes assume LWOP is automatically granted once an OWCP claim is filed. That’s not the case. You need to actively request LWOP, provide medical documentation, and follow your agency’s specific process. Without this, you risk AWOL charges or even removal.

So her is where Dr. Taylor, will address your questions by synthesizing practical insights, regulatory guidance, and real-world considerations for federal employees. 

 Understanding Administratively Acceptable Medical Information for LWOP

When a federal employee requests LWOP in connection with an OWCP claim, agencies require medical documentation to justify the absence. This documentation must meet the threshold of being "administratively acceptable," a term rooted in federal regulations (e.g., 5 C.F.R. § 630.403) and OWCP guidelines. However, the ambiguity lies in what agencies deem sufficient, as interpretations vary across agencies, supervisors, and HR offices. 

 What Makes Medical Information "Administratively Acceptable"?

Administratively acceptable medical information is documentation from a qualified healthcare provider (typically a treating physician) that clearly justifies the need for LWOP due to a medical condition, often linked to an OWCP-covered workplace injury. The Office of Personnel Management (OPM) and OWCP provide general guidance, but agencies have discretion in setting specific requirements. Based on regulatory standards and practical experience, the documentation should include:

1. Physician’s Credentials and Signature:

   - The document must come from a licensed physician (MD, DO, or other provider recognized by OWCP, such as a chiropractor for specific conditions).

   - Include the physician’s name, title, contact information, and signature to verify authenticity.

2. Diagnosis and Connection to OWCP Claim:

   - Clearly state the medical diagnosis (e.g., "posterior tibial tendinitis" or "shoulder labrum tear") and link it to the workplace injury or condition covered by the OWCP claim.

   - If the OWCP claim is pending, note that the condition is under review but still requires absence from duty.

3. Explanation of Work Incapacity:

   - Detail how the condition prevents the employee from performing their job duties. For example, "Due to severe shoulder pain and limited range of motion, the patient cannot lift objects over 10 pounds, a requirement of their postal carrier position."

   - Be specific about functional limitations to align with the employee’s job description.

4. Duration of Absence:

   - Specify the expected timeframe for LWOP (e.g., "The patient requires 6 weeks of absence starting 07/15/2025 for surgical recovery").

   - If the duration is uncertain, provide an estimated range and note the need for follow-up evaluations (e.g., "Reassessment scheduled for 08/30/2025").

5. Treatment Plan and Prognosis:

   - Outline the treatment (e.g., surgery, physical therapy, or medication) and its impact on the employee’s ability to work.

   - Include a prognosis, such as expected recovery milestones or potential for return to work (RTW), to demonstrate the absence is not indefinite.

6. Format and Clarity:

   - Use a professional letterhead or medical office form.

   - Write in clear, concise language, avoiding overly technical jargon that might confuse HR or supervisors.

   - Agencies often prefer a letter or a completed OWCP form like CA-7 (Claim for Compensation) or CA-17 (Duty Status Report) to supplement the request.

 Regulatory Context

Under 5 C.F.R. § 630.403, agencies may require "administratively acceptable evidence" for leave requests, including LWOP. For OWCP-related LWOP, this aligns with 20 C.F.R. § 10.336, which requires medical evidence to support Continuation of Pay (COP) or compensation claims. While OWCP and agency processes are distinct, the medical documentation often serves dual purposes:

- For OWCP, it supports the claim’s validity (e.g., proving the injury is work-related).

- For LWOP, it justifies the absence to the agency, ensuring the employee avoids AWOL charges.

Agencies cannot demand overly intrusive details (e.g., full medical records) unless justified, per OPM guidance. However, they can deny LWOP if the documentation lacks specificity or fails to tie the absence to the OWCP condition, as seen in cases like *Sambrano v. Department of Justice*, 116 M.S.P.R. 449 (2011).

 Common Pitfalls and Challenges

- Vague Documentation: Physicians may provide brief notes (e.g., "Patient is unable to work") without explaining the condition’s impact or duration. This often leads to LWOP denials or delays.

- Miscommunication with Supervisors: As you’ve seen, employees sometimes share medical info only with OWCP specialists, not supervisors or HR, assuming it’s sufficient. Agencies treat LWOP requests as separate from OWCP claims, requiring direct submission to the appropriate office.

- Inconsistent Agency Standards: Some agencies accept a simple doctor’s note, while others demand detailed forms or OWCP approval status. This lack of uniformity confuses employees and physicians.

- Pending OWCP Claims: When a claim is under review, employees may struggle to provide "acceptable" evidence, risking AWOL charges if LWOP is denied.

- Overreliance on OWCP Forms: Employees may submit CA-17 or CA-20 (Attending Physician’s Report) to OWCP but fail to provide a separate LWOP-specific letter to HR, causing administrative gaps.

 Best Practices for Employees and Physicians

For Employees:

1. Request a Tailored Letter: Ask your physician for a letter specifically addressing the LWOP request, not just the OWCP claim. Share your job description to help them explain why you can’t work.

2. Follow Agency Procedures: Submit the medical documentation through your agency’s designated process (e.g., to your supervisor or HR). Clarify with HR what format they prefer.

3. Track Approvals: Ensure the LWOP is approved via an SF-50 and note the expiration date. Request extensions with updated medical info before the period ends.

4. Communicate Proactively: Inform both your supervisor and HR about your OWCP status, even if pending, to avoid misunderstandings.

5. Consult HR on Benefits: LWOP can affect health insurance or retirement contributions. Ask HR’s benefits section about potential debts or coverage changes.

For Treating Physicians (Guidance You Can Share):

1. Be Specific and Job-Relevant: Describe how the injury impacts the employee’s ability to perform specific job duties, referencing their role if possible.

2. Use Clear Timeframes: State the exact or estimated duration of absence to help agencies plan. If uncertain, schedule a follow-up to reassess.

3. Align with OWCP Standards: Ensure the diagnosis and treatment plan match the OWCP claim to avoid discrepancies.

4. Provide Professional Documentation: Use letterhead, include credentials, and sign the document. Avoid handwritten or overly brief notes.

5. Anticipate Agency Needs: If familiar with the agency’s process (e.g., through prior cases), tailor the letter to meet their expectations, such as including OWCP claim numbers.

Consider a case” A federal postal worker with a torn rotator cuff filed an OWCP claim but was charged AWOL during the claim’s review. The employee submitted a CA-20 to OWCP but didn’t provide a separate LWOP request letter to their supervisor. The physician’s note only said, “Needs 3 months off,” without explaining the injury’s impact on sorting mail or driving. After coaching, the employee resubmitted a detailed letter from their doctor, specifying, “Due to a work-related rotator cuff tear, the patient cannot lift over 5 pounds or drive for 12 weeks, per surgical recovery protocol.” The LWOP was approved, and AWOL charges were dropped. This underscores the need for clear, agency-focused documentation.

 “Have you ever wondered why your LWOP got denied, even with a doctor’s note? Today, we’re cracking the code on what makes medical info ‘administratively acceptable’ for OWCP-related leave.”

- Key Message: “Your doctor’s letter is your ticket to LWOP approval, but it needs to check specific boxes. Don’t assume OWCP forms are enough—agencies want clear, job-specific details.”

- Call to Action: “Talk to your doctor about your job duties, submit a detailed letter to HR, and follow up. If you’re stuck, reach out to your HR benefits team or check ecomp.dol.gov for OWCP resources.”

 Research Gaps and Future Exploration

The ambiguity around “administratively acceptable” stems from:

- Agency Discretion: No universal standard exists, so agencies interpret requirements differently. Researching specific agency policies (e.g., USPS vs. VA) could clarify expectations.

- OWCP-HR Disconnect: The separation of OWCP specialists from local HR creates gaps. Investigating how agencies train HR on OWCP-related LWOP could reveal solutions.

- Employee Education: Many workers don’t know their role in coordinating documentation. A survey of federal employees could quantify how often LWOP denials result from poor medical info.

Administratively acceptable medical information for LWOP requires a physician’s detailed, job-specific letter that links the OWCP-covered condition to the employee’s inability to work, specifies the absence duration, and follows agency protocols. Employees must proactively submit this to HR, not just OWCP, and track approvals to avoid AWOL risks. By sharing these insights on your podcast, you can demystify the process for federal workers, drawing on your expertise and real-world cases. 

 Employee Responsibilities

To protect yourself, take charge of your LWOP process:

1. Submit a Formal LWOP Request: Even with an OWCP claim, request LWOP through your agency’s local process. Include medical documentation that supports your need for leave and ties it to your OWCP claim.

2. Track Approvals and Extensions: Once approved, your LWOP will be documented (often via an SF-50) for a set period. If you need more time, request an extension before the period ends. Agency policies vary—some approve LWOP monthly, others for longer stretches.

3. Monitor Your Benefits: LWOP can affect your benefits, like health insurance premiums, or lead to agency debts. Contact your HR’s benefits or records section to understand impacts and avoid surprises.

Tips for Success

- Engage Actively: Treat your LWOP and OWCP claim like a project you’re managing. Check in with HR, your supervisor, and your OWCP specialist.

- Document Everything: Keep records of all requests, approvals, and communications.

- Know Your Agency’s Rules: Policies differ, so familiarize yourself with your agency’s LWOP and OWCP processes.

- Seek Guidance: If you’re unsure, reach out to HR or a union rep for clarity.

 Closing Thoughts

Navigating LWOP and OWCP can feel overwhelming, but you have more control than you might think. By staying informed, proactive, and engaged, you can avoid common pitfalls and protect your career. If you’re facing these issues, don’t hesitate to reach out to your HR team or check resources like the Office of Personnel Management’s website for guidance.

So,  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, like or subscribe to any of the major podcast platforms or our youtube channel 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 still  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 813-215-4356 or 813-877-6900 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 

Ok… I think that is enough for today…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 this is my 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.