Archive for February, 2013

How OWCP works with ACS

Sunday, February 10th, 2013

Many federal employees with OWCP claims have become familiar with ACS.

ACS Inc., short for Affiliated Computer Services, is a massive, private company that is contracted by many of world’s largest corporations to handle information services and business process outsourcing. ACS was a Fortune 500 hundred company until it was acquired by Xerox in 2010. As of the acquisition date, ACS employed over 74,000.

What that means to the federal workers compensation claimant is that your medical providers have to work with the ACS to get paid for the health care services that they provide to you under FECA (Federal Employee Compensation Act).

When you go to see your doctor, they have to submit their bill to the ACS, not the OWCP for payment.

The OWCP directs any injured federal employee to what is known as the ACS medical provider portal to find a doctor once an injury has occurred. This list is enormous. It includes any doctor that has ever applied for a provider number from ACS. This list is not full of doctors that want to treat injured federal employees. It includes second opinion doctors, referee doctors, and scores of doctors that at one time tried to get paid for a service. This in on way guarantees that they are interested in helping you now.

FedDoctor was brought to life based on this issue. Federal employees need a place that they can find quality medical providers that specifically want to help them when they are injured at work.

We strive to find doctors that support federal employees. Search now and get started on your recovery.

Getting an OWCP claim accepted

Thursday, February 7th, 2013

Getting a federal workers compensation claim accepted by the OWCP can be difficult. In order to have an accepted claim, you must prove that the injury occurred as a result of your employment.

It sounds simple and it should be, however, medical documentation is necessary to establish the cause of injury. Often, this evidence is hard to get right, even for doctors that typically deal with workers compensation issues.

Part of the reason OWCP can be difficult for physicians is that the rules are different for federal workers comp than most state comp laws. Many doctors that are used to state law comp (which is far more common) are not aware of how the OWCP claims examiners adjudicate claims. The cause of injury must be very clear if not exhaustive.

Normal logical thinking would lead one to understand that if a doctor indicates in medical notes that the injury is work related, that would be enough to conclude that a claim should be opened and approved. But OWCP often requires more. A more detailed causation report may be required to describe exactly what actions or movements caused the particular injury.

These reports require much more time than most doctors are used to giving in these matters. Generally, doctors want to get going on the treatment and help their patients heal and return to full capacity as soon as possible. But if the claim is not accepted, the treatments may never be authorized.

That is why selecting a physician for your federal workers compensation claim is so important to your benefits. Without good documentation, your claim may never get off the ground and could result in a long drawn out fight with OWCP to get any benefits at all.

FedDoctor is here to help you with this particular problem. You don’t have to switch all of your care to your federal doctor, but it can be beneficial to at least see them for your work injury. While many FedDoctors treat other injury and illness types, they all spend a significant portion of their time trying to stay on top of the federal comp rules and regulations to ensure that when you present in their office with a federal on-the-job injury, they can help you get the treatment you are entitled to.

Many federal employees unfortunately think that they will not get injured at work and that this information doesn’t apply to them. The numbers indicate differently. 1 in 17 federal employees files a claim every year. Many never file claims because they have heard horror stories from those that have.

This kind of action can lead to even bigger problems later on. If an initial injury is never accepted by OWCP, later injuries that stem from them won’t be covered either. If a minor injury now develops into a major problem later, the employee can have a hard time getting the federal workers compensation office to accept it later. Claims examiners can point the previous, unaccepted condition as a “preexisting condition” and deny coverage based on a lack of relevant causation.

Whether you have an ongoing claim, or you were just injured, or even if you have never had an injury, understanding the difficulties that federal employees face is important. Share this information with you union and and encourage your coworkers to be prepared in case an injury occurs.

FedDoctor wants all federal employees to find competent care for federal workers compensation injury claims. We are constantly looking to add more federal doctors in your area. We don’t accept just any doctors to be on the site. We seek doctors who have a specific interest in helping with federal comp claims. If you are seeing a good federal doctor now, let us know! We want to help them treat more federal employees!

Whether you need a causation report or an impairment rating for a schedule award, FedDoctor is here to help you. Start your search for quality care today.

Understanding a Schedule Award – Part 4

Monday, February 4th, 2013

… Continued from Part 3

 

Hopefully now, you have had an independent medical evaluation by a quality federal doctor (hopefully FedDoctor was helpful!). Once you get your report back, it is time to go to work.

In order to get a good handle on how to calculate what your award might be, the next step is to understand what the OWCP List of Scheduled Members looks like. The federal workers compensation office uses this list of body parts to value each individual section of your body based on its importance to the whole body. Remember, this is very different from Whole Person Impairment (WPI) but uses the same type of principles.

For instance, an entire leg is valued at 288 weeks of compensation. A toe (other than great toe) is only worth 16 weeks. Here is a list of the other body parts and their corresponding weeks of compensation:

Arm 312 weeks
Fourth Finger 15 weeks
Leg 288 weeks
Hearing (1 ear) 52 weeks
Hand 244 weeks
Hearing (both) 200 weeks
Foot 205 weeks
Breast 52 weeks
Eye 160 weeks
Kidney (1) 156 weeks
Thumb 75 weeks
Larynx 160 weeks
First Finger 46 weeks
Lung (1) 156 weeks
Great Toe 38 weeks
Penis/Female Sex Organs 205 weeks
Second Finger 30 weeks
Testicle/Ovary (1) 52 weeks
Third Finger 25 weeks
Tongue 160 weeks
Toe (other) 16 weeks

The new impairment rating that your doctor provided to you is multiplied by the body part’s number of weeks of compensation. If your doctor assigned a 10% impairment to your leg, that would correspond to 28.8 weeks of compensation.

Your compensation rate is the same as your lost wage reimbursement rate. 75% of pay if you have dependents, and 66% if you do not. Multiply that weekly comp rate by the number of weeks of compensation from your impairment rating and body part and voila! You have your schedule award amount.

Now comes the hard part, submitting your claim to OWCP and hoping it is approved for the full amount! A good doctor, like the ones on this site, will be helpful. The stronger the report, the better your chances are of getting the claim approved for the highest amount of impairment.

Good luck, and don’t be afraid to ask an attorney for help. This is not legal advice, but it may be a good idea to get some!

Understanding a Schedule Award – Part 3

Friday, February 1st, 2013

… Continued from Part 2

 

In the 6th edition, it specifically requires you to be at MMI before the impairment can be rated. Have patience! Getting the rating appointment with a good doctor could be a waste of time if you haven’t allowed an adequate amount of healing time to elapse.

Federal workers compensation is difficult enough without having to redo your work or take more time to see a doctor. It is important to try to get it as right as you can on the first try. Once the fight begins, you will benefit from having all of your ducks in a row.

FedDoctor is the only place online to find quality federal doctors all over the country that help the federal employee! Using this resource and sharing it with your friends and co-workers can net you more money when it comes time to file the schedule award claim.

So now that you have reached MMI, schedule your visit with a qualified doctor to have your impairment rated. You can use your treating physician, but make sure that they fully understand the type of report they are generating.

As we discussed previously, the rating must be done in accordance with the AMA Guides 6th edition. Not all doctors know how to use this version as most states have chosen not to adopt this version. In addition to being done using the 6th edition, federal workers compensation schedule awards are not done using Whole Person Impairment (WPI), but rather stay at the local level using Regional Impairment.

To explain the difference, here is an example. If you have a 10% loss of use to your upper extremity (UE) that may equate to a 2% loss of the whole person. The difference is clear: 2% WPI vs. 10% UE.

OWCP does not accept WPI ratings at all. If your report is done using WPI, you have a significant chance of having the entire report thrown out by the district medical advisor in your OWCP regional office.

Your impairment rating should be left in the regional format. In addition, it is generally not helpful to have your doctor rate additional parts of your body that are not included on that claim number. If you have multiple claims, have separate reports done. OWCP often has different claims examiners responsible for different claims and they won’t necessarily both get a copy of the report. This seems like a minor detail, but it can cause confusion and delay or ruin your schedule award claim.

To be continued…

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