Continued…
So it seems that most doctors either don’t do federal workers compensation, or don’t understand it. They may be very compassionate, genuine, caring physicians who just can’t make heads or tails of the OWCP.
If your doctor is eager to help and willing to help you fight your way through the process, you may still be facing an uphill battle. The issue becomes that first visit to the ER or urgent care facility. Remember from Part 3 of this series when the doctor didn’t preform and MRI after your twisted knee injury. The emergency doctor was most likely not especially thorough with the documentation on cause of injury. The report may say ‘slipped on stairs’ when what you need to say is ‘slipped on stairs while working at their job for the federal government’.
I know it seems like a small difference, but the OWCP Claims Examiner will want all of the dots connected. It is not their job to make assumptions. It is their job to examine the evidence presented and make a determination. This case might be denied.
Or even more complicating, imagine the ER doctor did state it was a work injury and the claim is opened with the accepted condition of ‘Knee Sprain’. Now your own doctor is willing to give this a fighting chance and work with you on your federal workers comp claim. First, the doctor orders an MRI and discovers that your injury is more severe than originally thought. You have torn your meniscus and will require a knee operation to return to health. The doctor submits a request for pre-authorization from the ACS website and is flatly denied.
Frustrated, but maybe not yet willing to give up, the doctor writes a letter to the OWCP CE stating that the surgery is necessary for you to get better. Remember, the Examiner is simply evaluating the evidence presented, and so far, doesn’t think your work injury warrants an operation.
To be Continued…
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