Many federal employees run into an issue with the Office of Workers Compensation Programs when a claim is closed. OWCP can close a file for a number of reasons, but a few of the common instances are when no activity has been seen for an extended period of time, or if the Claims Examiner determines through medical evidence that the condition has resolved.
The problem is that sometimes those reasons aren’t an accurate description of what is happening in the file. The long period of inactivity may be caused because the claimant’s treating doctor has been using the injured worker’s private insurance, instead of billing the OWCP. The adverse medical information may have come from a second opinion doctor that doesn’t understand the full scope of the at-work injury.
Either of these reasons can cause a major headache to the federal workers compensation claimant. A closed claim means that the employee can no longer seek medical care under the OWCP claim. They are also no longer eligible for compensation benefits, either periodic or schedule award. Finding a way to reopen a file can take lots of time and energy that most injured federal employees simply don’t have.
FedDoctor.com is working hard to locate and showcase doctors around the country that specifically understand the nuances of the federal compensation system. A doctor that knows how to reopen a case can get you back on the right track.
Your treating physician, or new federal doctor, will need to write a report to ask the claims examiner to reopen the file. The report needs to be specific about how the original injury has not resolved and that future treatment is required. A causation report about the injury is also helpful. Perhaps this treatment isn’t even going to make the injury heal completely and is more of a maintenance. After all, not all treatment leads to full recovery. Some patients require care for the rest of their lives due to the chronic nature of their injury.
Remember, because the OWCP file has been closed, your federal doctor will not be able to bill workers comp. You will have to pay out of pocket, or bill your private insurance if you are eligible.
Once the claim has been reopened, you can begin getting more treatment under the OWCP file. You will also be eligible to claim for compensation with the case permits.
Making sure you understand the proper procedures when your federal workers compensation claim is closed can save a lot of trouble in the future. Finding a federal doctor can be a great start to the process.
Tags: causation report, federal doctor, federal workers comp doctor, federal workers compensation doctor, owcp doctor, schedule award doctor