Posts Tagged ‘federal comp doctor’

Why is it hard to find a federal doctor? Part 5

Tuesday, September 18th, 2012

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…

 

Why is it hard to find a federal doctor? Part 3

Saturday, September 15th, 2012

Continued…

Now that we have discussed the structure that the government uses to adjudicate work injury claims and the process of filing a new claim, we will begin to discuss why it is hard to find a doctor that is familiar with the federal system.

When the OWCP Claims Examiner opens (if they do not require additional evidence) a new federal workers compensation claim, they accept certain medical conditions as being work related. If you twist your knee and your doctor diagnoses a knee sprain, the claim will be opened and treatment that typically is prescribed is approved at the treating physician’s discretion.

The Claims Examiner notifies the ACS and all medical bills should be sent directly to the ACS through an online portal. If the treatment rendered and billed falls under the normal scope of treatment, it is approved. If not, the doctor’s bill will be rejected. It seems fairly reasonable on paper, doesn’t it?

Unfortunately, it can be much more cumbersome in real life.

If you were to twist your knee on the job and go to a hospital or urgent treatment center, they often will provide you with immediate and necessary care. Once the injury has been determined to be less than life threatening, a frequent recommendation is to ice, take some over-the-counter pain reliever and follow up with your regular doctor at your (or their) earliest convenience.

An MRI is rarely preformed. The rarity is due to many factors, one of which is often the amount of swelling that may be present in the knee. Doctors are often (and rightly so) conservative with these types of treatment plans. No one wants some doctor they barely know to rush them to surgery only to find once they are in the middle of a procedure that it was less than necessary. Most patients, and certainly the insurance company or federal workers compensation office, would be unhappy, to say the least.

To be Continued…

Why is it hard to find a federal doctor? Part 2

Thursday, September 13th, 2012

Continued…

To understand the way the OWCP operates, you must first understand mechanism of injury, or causation.

For the purposes of the federal workers compensation system, there are two different types of cause; traumatic and occupational (Read about Traumatic here, Occupational here).

A traumatic injury occurs at a given time. For instance, an automobile accident. An occupational injury occurs due to a repetitive hazard or peril such as carpal tunnel syndrome or chemical inhalation.

Both are legitimate injury types and can be caused at the work place or while in the performance of duty. Federal employees are often exposed to these risks on a daily basis. CA-1 and CA-2 forms can be filed based on the type of injury that has occurred.

Once a claim form has been submitted to the agency, it must forward the claim information to the appropriate district office for adjudication. The case will be given a claim number and assigned to a claims examiner (CE). The claims examiner does not have formal legal or medical training. Rather, they work for the Department of Labor and spend the majority of their time looking over submitted evidence to determine whether a claim is legitimate, or not.

Like in any profession, there are some CE’s that are better than others. Essentially what they are looking for is the correct forms to be used by the claimant and for the supporting documentation from the treating physician to be thorough, clear, easy to understand to a lay person, and to clearly identify the cause of injury. Along with any diagnostic studies that could be provided, the CE will use that information to decide whether or not a claim should be opened for compensation, or closed due to lack of evidence.

That does not mean that the more information you send a claims examiner, the better. On the contrary, the CE has dozens, if not hundreds of files that they are responsible for. Your doctor needs to be clear and concise, yet build the cause of injury information and documentation from the ground up.

To be Continued…

OWCP Forms 101

Wednesday, May 16th, 2012

Which form does what? Of course most federal employees are not familiar with OWCP forms because they’ve never had an on the job injury. But if you or someone you know does ever have an injury, you must know which forms do what!

Here is a quick and simple refreshment to help us all remember some of the most important forms involved with OWCP Federal Workers Compensation claims.

CA-1  Notice of Traumatic Injury and Claim for Continuance of Compensation

CA-2  Notice of Occupational Disease and Claim for Compensation

CA-2a  Notice of Recurrence

CA-7  Claim for Compensation (leave without pay, leave buy back, other wages, schedule award)

CA-10  What a federal employee should do when injured at work

CA-17  Duty Status Report

CA-20  Attending Physician’s Report

OWCP-5a  Work Capacity Evaluation Psychiatric/Psychological Conditions

OWCP-5b  Work Capacity Evaluation Cardiovascular/Pulmonary Conditions

OWCP-5c  Work Capacity Evaluation Musculoskeletal Conditions

OWCP-915  Claim for Medical Reimbursement

OWCP-957  Medical Travel Refund Request

There are many more forms that may be used during the course of a federal employees workers compensation claim and you can find the full list and links to these forms here.

If your doctor is not familiar with these forms, share this information with them. It is vitally important to all federal employees with ongoing OWCP workers compensation claims that their doctor understands how to help them keep their ligament claim alive! This again is why FedDoctor.com exists. To help connect injured federal employees with doctors who understand OWCP.

 

 

Orthopedic Surgeon in Beverly Hills Helps Federal Employees!

Wednesday, May 9th, 2012

 

Great news for Southern California… Dr. Steven Meier at the Center for Progressive Sports Medicine and Orthopedic Surgery helps federal employees! FedDoctor.com is very proud to help connect injured federal employees with Dr. Steven Meier and his wonderful team.

Dr. Meier’s office is located on the famous Wilshire Boulevard in Beverly Hills, California. His focus is on injures and he is dedicated to providing each patient with highest quality of care possible.

Dr. Meier is a Board Certified Orthopedic Surgeon and offers multiple treatment options including therapy, exercise programs, rehabilitation and minimally invasive surgical options. When surgery is necessary, the most current technologies are used which result in less postoperative pain and a faster recovery.

OWCP Federal Workers Compensation claimants are welcome! Dr. Meier has years of experience in helping individuals with work related injuries. He is also familiar with the AMA Guides 6th edition and can help you with your impairment rating examination for your OWCP schedule award.

Visit Dr. Meier’s website at www.ProgressiveSportsMedicine.com or contact his office directly at (310) 777-7845.

 

 

Arizona Injury Medical Associates

Monday, April 30th, 2012

Dr. Adarmes and the whole team over at Arizona Injury Medical Associates are doing an outstanding job for Federal Employees.  FedDoctor.com is very proud to help more Federal Employees connect with their office.

 

 

AIMA offers full service pain management, EMG and NCV Studies, second opinion consultations, disability evaluations and comprehensive medical case management.

AIMA also specializes in impairment ratings for all federal employees with OWCP claims from all around the country. The staff and doctors at Arizona Injury Medical Associates care about your physical and emotional well being. With their friendly staff and Double Board Certified Doctors who are experts in injured workers and personal injury victims, you will be in good hands.

Click Here to learn more about their office or go visit their brand new website at www.arizonaima.com!

 

 

Dr. Benson has 3 locations in Texas to Help Federal Employees!

Friday, April 27th, 2012

Dr. Les Benson has been treating and helping injured and disabled federal employees for several years.  All federal employees in Texas need to become familiar with Dr. Benson and his excellent team.  FedDoctor.com is very proud to help more federal employees connect with such a great doctor!

 

When you are an injured federal employee with an accepted OWCP claim, you know if can be very difficult to establish a treating physician.  And it is almost impossible to find one that will “go to bat” for you against the OWCP.  Dr. Benson understands this and can help you. Dr. Benson offers treatment, rehabilitation services, in-house physical therapy, disability and impairment rating examinations, and more.

Dr. Benson currently has offices in Temple, Waco, and Fort Worth.

Learn more about Dr. Benson and how he can help you!

 

 

FedDoctor is growing!

Thursday, November 17th, 2011

FedDoctor has been growing! We continue to scour the nation for great medical providers that understand how to deal with the federal workers compensation office.

Don’t fight the OWCP on your own! They can be difficult to understand and require complex medical paperwork just to open your claim. Let an experienced doctor who understands the forms take control of the OWCP paperwork.

This is an opportunity for you to get the treatment and benefits that are supposed to be a part of the federal workers compensation system. We are looking to add more doctors in new areas and provide every federal employee with a quality medical option for treatment and evaluations.

Sign up for our newsletter, subscribe to our blogs, Like our Facebook page or follow our Twitter feed to stay up to date. Be the leader of your local union! This information can change one your friends lives. Sharing FedDoctor.com is a way you can help federal employees from all federal agencies across the country!

Stay tuned, FedDoctor is on the move…

The American Medical Association 6th Edition Guidelines and the OWCP

Friday, November 4th, 2011

Everyone who has ever filed for schedule award benefit from the OWCP is familiar with the AMA Guides to Rating a Permanent Impairment.

On May 1, 2009 the OWCP switched to the newest form of the book, the 6th Edition. This significantly changed the way doctors rate your permanent impairment.

Previously, under the 5th edition of the guides, most impairment was based on the loss of range of motion. The 6th edition changed to a more predominately diagnosis based impairment.

This can significantly change the way that your schedule award will be calculated. Remember that the federal government workers compensation office asks that the impairment ratings be done differently than almost every state law workers compensation. It is important that when it comes time to have your injury rated, that you get a doctor who is qualified and has experience working with the OWCP.

FedDoctor.com members understand the process and how to do 6th edition AMA ratings on your OWCP accepted injury. Getting the calculation right is important, but they understand how to properly document and assign your impairment under your claim.

Remember that every doctor charges for these services differently, so make sure you call their office and request the cost of the report. This report will determine how much money you get for you injury. Even if it is out of pocket, it may be well worth your while to pay for this report.

Find your new impairment rating doctor here and get started on your recovery.

Pelham in the Bronx is the newest member of FedDoctor.com!

Tuesday, October 4th, 2011

Pelham Physical Medicine Inc. is FedDoctor.com’s newest member provider.

Pelham has in house diagnostics such as EMG/NCV. With OWCP requiring 6th Edition AMA Guides reports, those types of objective tests can be the difference in having a schedule award accepted or denied. Pelham also specializes in physical medicine and rehab.

Pelham Physical Medicine has years of experience working with the Department of Labor and completing the required forms and documents to satisfy the OWCP. With their knowledge of the federal workers compensation system and the doctors on staff to care for your injuries, Pelham will be able to serve the New York City metro area for the treatment of their federal injury claims.

Welcome aboard, Pelham!

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