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Help With OWCP Claims PEN is proud to announce our association with Edward Daniel. Mr. Daniel is a retired OWCP claims manager/examiner and a former part of the OWCP management team. Mr. Daniel has more than 20 years of OWCP claims experience. We are providing this section of PEN in an effort to assist our postal and federal readers with information and help that they need for their OWCP workers' compensation claims. Although we cannot get involved with your case or claim we can offer you assistance through Mr. Daniel if you so choose. For your information we have asked Mr. Daniel to answer 5 frequently asked OWCP claim questions. If you desire you may contact Mr. Daniel with your request for his assistance with your claim. 5
QUESTIONS WITH RETIRED (1). PEN: Mr. Daniel, we have been told that the AMA, American Medical Association, has published volume six of their AMA Guides to the Evaluation of Permanent Impairment - as you know, the AMA Guides provide physicians with the information required by OWCP to rate employees impairments and disabilities. Currently, OWCP requires medical providers to use Edition 5 of these AMA guides. In your opinion, when will OWCP start requiring physicians to use the new Edition 6 of the AMA Guides to the Evaluation of Permanent Impairment? Mr. Daniel: If I had a crystal ball I could give you an answer to that question. The Sixth Edition will be utilized in Federal workers’ compensation system, which covers all federal employees, Federal Employer’s Liability Act (FELA), and citizens of Washington, D.C. Under FECA, benefits are provided for permanent impairment to specific body parts including extremities, hearing, vision, and loss of specific organs. The Sixth Edition has a new approach to rating impairment. Its hybrid methodology makes claim to increased internal consistency, standardization, ease of application, and a simplified rating process. But insofar as this may be true, it is at the expense of validity, and the process has resulted in the same old flat ratings, only at lower values. Some reviewers have predicted a 40% reduction in the value of impairment ratings from the Fifth Edition to the Sixth Edition of the guides. It is coming, be ready for it. (2). PEN: Is it necessary for OWCP claimants to request a copy of their claim file and, if so, how do they submit such a request? Mr. Daniel: Yes, an injured worker should request a copy of their file on a yearly basis to see what has been added to the file. The Federal Register, 20 CFR 10.12, states in part “a claimant seeking copies of his or her official FECA file should address a request to the District Director of the OWCP office having custody of the file”. Keep in mind that you are entitled to one “free” copy of the file. So, when you request another copy, request copies of documents submitted to the file subsequent to the date of the last request. (3). PEN: What is the best way for OWCP claimants to contact their claims examiner? Mr. Daniel: The best way to contact your assigned Claims Examiner (CE) is by the telephone. But you should follow-up with a letter to the CE confirming your telephone conversation a re-stating everything that was discussed and /or agreed upon. This way the conversation is recorded in the file. I believe only what I see in black and white. What was said can be denied. (3). PEN: What is an SOAF and what does OWCP use these for? Mr. Daniel: SOAF stands for Statement of Accepted Facts. The CE prepares the SOAF to be sent to the 2nd opinion or Referee physician. The SOAF contains all the actual facts that the CE has accepted as being true and accurate. The SOAF should not have any opinions or conclusion by the CE. The 2nd opinion or referee physician is to frame his/her opinion around the SOAF. Questions continue in right column. OWCP Knowledge Base that may answer many of your questions. We also have a PEN section on Scheduled Awards. All information contained here is for informational purposes only - you should seek help, support, and guidance from your union, USPS Human Resources or managers, and/or legal guidance from an attorney. Do not rely solely upon information contained here. We wish you every success. We cannot answer questions or provide advice relating to on the job injuries or medical problems. Please visit our On The Job Injury forum.
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(4). PEN: Many times claimants submit claims for Scheduled Awards for their injury or injuries - if a claimant has had a schedule award paid for an injury and then a year or so later their injury gets worse can they submit a new claim for the increase in their impairment and, if so, how is this done? Mr. Daniel: The Schedule Award (S/A) is a snapshot of the injured workers impairment at the time of assessment. The snapshot says “this is you now. You may not get any better, but you could get worse”. Remember, you are not disputing the original award of impairment, but you are seeking an increase on the previous award. This is a medical question and must be supported by a new assessment by a physician. You would use OWCP form CA-7 for this purpose. (5). PEN: Mr. Daniel, please explain to our readers exactly how you may be able to assist them with their OWCP claim. Mr. Daniel: There are many pitfalls along the way following the acceptance of a claim. In most cases the acceptance of traumatic and occupational claims can be straight forward and simple to get approved, but it is what happens after the claim is accepted that can cause a lot of problems. Always remember, there is more than one way to skin a cat. I can guide injured workers pass the pitfalls and toward getting all of the entitlement provided under the FECA. CLICK HERE TO CONTACT MR. DANIEL YOU MAY NEED
FORMS: CA-1, CA-2, CA2a, Ca-7 and much
more.
Dept. of
Labor (DOL): Index of Resources About Claims
Under The Federal Employees' Compensation Act
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