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Wednesday, November 30, 2011

Questions

I've been getting a lot of comments with questions. This blog doesn't allow me to answer direct questions.

If you have a question you'd like to ask, go to: http://theowcpclassroom.freeforums.org You can post your questions there.

Saturday, August 20, 2011

Physician Resource?

A lot of Claimant's are having trouble finding a physician that can handle their OWCP claim requirements. In addition to that, there are a lot of physician's who will no longer accept an OWCP Claimant simply because of OWCP's requirements.

I received an E-mail about a new company that is advertising physician's just for Claimant's in the OWCP system. According to the web site, this is an independently owned and operated company that have physicians that can document an OWCP claim and/or meet the medical report requirements. The web site states that the physicians have knowledge and understanding of OWCP and FECA procedures. They state they are Nationwide.

I know nothing of this company. I am not affiliated with them in any way. However, finding a physician that is aware of the OWCP requirements is not easy. If the statements on this web site are true, this could be a very useful tool for OWCP Claimant's and I thought it was worth passing on.

If anyone uses this company or has experience with their physicians and quality of their reports...please let me know.

Here's the information:

The company is called: FedDoctors.Com

http://www.feddoctor.com/ The web site has a search by zip code bar.

Telephone: 1-855-333-3627

Monday, August 1, 2011

Attorney's and Representatives revisited...contingency fees

I've been asked a lot recently about OWCP and representative's charging a contingency fee. Although I've written on this topic before, I'm revisiting it because of the amount of chatter I'm hearing recently.

As I wrote earlier; an attorney or representative for an OWCP claim cannot charge you a contingency fee, which is a percentage of your compensation and/or schedule award.

Although I don't know for sure, I think an attorney or representative gets away with charging a contingency fee because Claimant's aren't bringing this practice to the attention of OWCP or they're just not aware the representative isn't allowed to charge on a contingency basis. My guess would be the Claimant thinks THEY will get in trouble. That seems reasonable since Claimant's are always getting the fuzzy end of the lollipop in OWCPland. Well, I'm here to tell you, this is one of those rare instances that you should not get in trouble if you bring this issue to the attention of OWCP.

Even if a Claimant signs a contingency fee contract with an attorney or representative, the Claimant is not held responsible if contingency fees are brought to the attention of OWCP. Why? Because OWCP will not approve ANY contingency fee and like everything else in OWCPland, OWCP makes the final decision. If there is a contingency fee agreement, OWCP should determine that contract null and void, again because OWCP does not recognize or approve contingency fees. The Claimant should then be charged an hourly rate for the work performed on their claim.

Because OWCP makes the final decision, an attorney or representative can't sue you because of fees. Like everything else, what OWCP says goes unless the decision is overturned on appeal. So don't freak out if an attorney or representative says they're going to sue you, because they can't. An OWCP appeal is their only recourse...just like you.

The Code of Federal Regulations, which was recently updated in the Federal Register, shows Section 10.703 was amended to make it clear that OWCP can only approve representative's fees for services that have been performed before OWCP. This means you can only be charged for work on your OWCP case.

This section states; the Employees' Compensation Appeals Board , (the ECAB or the Board) must approve fees for services performed in from of the ECAB. This means that if you appeal to the ECAB, your attorney/representative fees must be approved by the ECAB not OWCP.

This section (10.703) of the Code of Federal Regulations has also been clarified that contingency fees will not be approved FOR ANY REASON. If the fee is disputed, OWCP/ECAB will consider the customary local charge for a representative with similar qualifications in considering what constitutes a reasonable fee. In other words, OWCP/ECAB will convert the fee into an hourly rate using the average rate of attorneys/representatives in your area. This applies to ALL disputed attorney/representative fees not just contingency fees.

Here's the link showing the amendments. Scroll down to 10.703: http://webapps.dol.gov/FederalRegister/HtmlDisplay.aspx?DocId=24143&AgencyId=13

This information is also in OWCP's regulations. You can find OWCP's regulations on representative fees at http://www.dol.gov/owcp/dfec/regs/compliance/DFECfolio/CA-810.pdf Scroll down to Chapter 4 and you'll find it at 4-1(d).

So again, if you've been charged a percentage of your compensation and/or schedule award by an attorney or representative and you think an hourly rate is more beneficial to you, don't be afraid to tell OWCP about it. As you can see from the regulations, this issue falls squarely on the attorney's and representative's shoulders, not the Claimant's.

Unfortunately, if it's been a long time since your agreement with the attorney/representative, you may not get anywhere, but it doesn't hurt to try it. If you were billed under a contingency agreement, that agreement was not valid. The amount of time that's gone by shouldn't matter...if it's wrong, it's wrong. If it's been a while, the worst they could say is no.

Saturday, July 30, 2011

Bad Diagnostic Films

Sometimes a Claimant gets a diagnostic study such as an MRI, CT Scan, X-Ray, etc...that differs significantly from previous tests or the diagnostic report doesn't revel what the physician expected it to revel or you had a test such as an MRI and that MRI showed abnormalities and the current MRI report shows 'normal'.

A bad diagnostic test report can be just as damaging to your OWCP claim as a bad physician's report and if you've received one, you should challenge the report.
If you've received a questionable radiological report, you can have your own independent second opinion performed on those results.

One of the companies that provides such second opinions is Radiia *Radiia has changed their name to Metis MD . To be clear, I have no affiliation with Radiia and am not connected with them in any way. I'm sure research would show there are other facilities that also provide this service. If anyone knows of good ones, let me know and I'll post them.

Radiia will provide you a comprehensive independent second opinion report on your films. Their physicians are all Board Certified with at least ten years experience. Their reports are detailed and explain where the information they provide comes from. In addition, if they do find something, Radiia will provide not only where the information came from, but pictures of the films with the abnormalities circled. I was impressed enough with the quality of their report, to recommend them here. With the pictures of the films included in the report and the abnormalities circled, it should be easy enough for even OWCP to comprehend.

If you need an independent reading of your films, I can recommend Radiia for this service. However, as I said, I'm sure there are other facilities that provide this service and you can certainly choose one of those. The bottom line is, you don't have to settle for an inaccurate reading of your diagnostic films.

Here's Metis MD's information for anyone who wants it...

Phone: 800-695-8191
FAX: 800-419-6976
Email: info@metismd.com

Mailing Address: 415 North LaSalle Street
Suite #502
Chicago, IL 60654

http://www.metismd.com/

Their charges are $200.00 for MRI, CT, Mammogram and $100.00 for X-Ray, Ultra Sound. Radiia also indicates they can have your independent second opinion delivered within 24-48 hours and they did meet that time frame.

Friday, July 29, 2011

More on Medical Narratives

The requirements of an OWCP medical report are so complicated, that physician's and Claimant's are often frustrated because they're constantly being told the report isn't good enough, requiring more and more from the Claimant's physician.

This sort of report isn't required every time you see your doctor, but it is required anytime a Claimant files for benefits or when OWCP has proposed termination of benefits for medical reasons, etc... A complete medical narrative should also be sent to OWCP at least once per year. Personally, I think every 4-6 months is better since you can never have too much good medical evidence in your file.


Once the initial report is written, any future medical treatment that occurs can be added. That way the physician just has to add any new information, include current examination results and include the examination date. S/he doesn't have to re-write the entire report.

Physician Assistants, physical therapists, registered nurses, etc…are not considered physicians under FECA and their reports will be of no value as a medical narrative.

Chiropractor reports will only be considered if Subluxation is diagnosed and confirmed by diagnostic testing.

The medical narrative must be on the physician’s letterhead and must be signed by the physician and must include the date of the examination.

Medical reports that contain phrases such as; might be, could be, probably will be given no value by OWCP. For example, the physician can't say the patient probably has a broken leg. The patient might have a bulging disc. The physician must say the patient has a broken leg. The patient shows symptoms of a bulging disc.

The OWCP recognizes the Merck Manuals. The Merck Manuals can be cited and/or quoted in the medical report. If the physician uses the Merck Manuals to enforce his/her medical opinion, it should be stated in the medical report the information came from the Merck Manuals. The link for the Merck Manuals is on the "Links" page.

The physician should be as specific as possible in his/her report.

A medical narrative must contain the following information:

The claim number and date of injury. The patient’s name, age and/or date of birth and hand dominance.

The Agency the patient is employed by, the job title of the patient and how long the patient has been working for the Federal Government.


If previous Federal jobs have been held, each additional Federal job should be listed (this includes military service).

The physical requirements of the patient’s job must be included in the medical narrative. Other factors of physical requirements should also include:
  • Some Federal jobs, such as military personnel, law enforcement, postal workers, etc…are more physical than the average job. If this is the case, it should be stated in the report
  • If the job is repetitious and/or has heavy lifting requirements, it should be stated in the report
  • If physical training is required, this should be stated along with an explanation of the training required and how often the training is required (such as military or law enforcement)
  • If the patient is required to work outside in all types of weather and/or on uneven terrain, this should be stated. Extremes in weather should be noted, such as it gets very hot and/or snow/ice.
  • Overtime requirements or overtime worked (if any) should be stated
  • If any previous Federal position was held and the physical requirements were above average (such as military service), this should be included in the report if these requirements contributed to the current condition(s)
The patient may supply the physician with the official job duties and physical requirements for reference. If the physician attaches a copy of the job duties, it must be stated in the report that the physician reviewed the job duties and a copy of the job duties reviewed is attached to the report. Otherwise, the physician must include a description of the job duties in the report.

Mechanism of injury:
It is not enough for the physician to state, for example, the patient fell off a ladder and broke their leg. For OWCP, the physician must be as specific as possible. For example, the physician must specifically state that the patient was in performance of their assigned duties, during an 8 hour day while having no medical problems (or list what medical problems they were having)when they fell off an 8’ ladder landing on the concrete floor. The force of falling 8' combined with landing on the concrete floor caused the patient’s leg to break. Any known reasons why the patient fell off the 8’ ladder should also be stated.

The physician must state what work-related activities caused or contributed to the medical condition(s). In our example above, hitting the concrete floor after an 8' fall caused the broken leg.

In the case of a consequential injury, the physician must indicate how the consequential injury is related to the original injury. For example, if the patient has an accepted knee condition and the instability of the accepted knee causes the patient to fall and injure themselves, the physician must relate the current fall to the instability of the accepted injuries. In other words, the patient would not have fallen if not for the instability of the knee. The instability of the knee comes from the accepted conditions. If the patient had never been injured originally, the current fall would not have happened. It is the original accepted injuries that caused the instability.


In the case of a fall, the physician should state any effects and/or residuals of the fall and what, if any, medical treatment was or is required because of the fall.

The physician needs to explain if any of the original accepted conditions progressed into new conditions, such as an accepted spinal disorder that causes Myelopathy or Osteophytes, medications that cause serious side effects, surgical complications from an approved surgery causing new medical conditions, an accepted psychological or physical condition that causes a sleep disorder, etc…


In the case of injuries that occur over time (Occupational injuries), the cumulative trauma should be described in detail. If the patient has repetitious or extremely physical job requirements over a long period of employment, it should be explained how the years of repetition or physical requirements caused or contributed to the patient’s current medical condition(s).


In the case of pre-existing conditions, the physician must state in detail what the pre-existing condition is/was, what symptoms it caused and explain what work-related events exacerbated, precipitated or accelerated the pre-existing condition.


The physician must relate how the injuries occurred in the course of the patient’s employment.

Medical rationale:
OWCP requires that the physician give a medical opinion and explain in detail how s/he arrived at their medical opinion and diagnosis. The physician also needs to explain why they believe or know the diagnosis is accurate.

What OWCP needs to know is exactly how the physician arrived at his/her medical opinion. How the physician knows his/her diagnosis is accurate. This is usually through examination, medical records, medical knowledge, experience and/or diagnostic test results.
The medical report also requires:

  • Physical examination results
  • Diagnostic test results
  • Treatment received, including the name and address the treatment was received and whether or not the treatment was beneficial
  • A complete diagnosis of the medical conditions. The diagnosis must include ICD-9 codes. In the case of psychological conditions, DSM codes should be used
  • Medications with dosage and side effects (if any)
  • Recommended treatment
  • Recommended diagnostic testing (if any)
  • Recommended surgical procedures (if any) with an explanation as to why the procedure is recommended and how the procedure might cure or give the patient relief from their medical condition(s)
  • Specialist referrals (if any)
The information should be listed in chronological order.


It is helpful and saves time if you list out the information about treatment, medications, physical therapy, etc...to save the physician time. The physician can check your medical records for accuracy and then transfer the information to his/her report. This is especially helpful if there has been a lot of treatment.


Here's another Jesse Slade tip...If you were required to take a pre-employment physical for your Federal employment, you should request a copy from your Agency, it should be in included in your personnel file.


If you can get a copy of your pre-employment physical, you can provide a copy to your doctor for incorporation into your narrative report. This pre-employment exam reports your physical condition prior to your Federal service and employment injuries. This can be especially useful for long term employees with extremely physical job requirements. It's a great tool for Occupational Disease (CA-2) claims.

Thursday, July 28, 2011

Functional Capacity Evaluation, (FCE) update

Recently the FECA Manuals have been updated and revised. There is now a section of the FECA Manual that covers the topic of the Functional Capacity Evaluations, (FCE's).

If you have been scheduled for or have attended an FCE, I highly recommend you read the portion of the FECA Manual that applies to FCE's so that, 1) you know the 'rules' and 2) that the 'rules' have been applied to you.

You can find the section on FCE's in part three at 3-0201-15. As always, you can find the FECA Manuals on the "Links" page of this blog.

Knowledge is power and only you can be responsible for making sure everyone involved in your case is acting according to the rules and regulations under FECA.

Friday, July 22, 2011

Rant, Ahoy...

Today, I'm on a rant about the outrageous absurdity, the disturbing thinking of our friends at OWCP and a couple of their current decisions.

We have two parties involved, the Claims Examiner, (CE) and a "Reconsideration Specialist". Now, I would love nothing more than to name these two by name, but in the interest of keeping this blog online and protecting the Claimant's identity, let's call the CE Ms. Cheaterson and the reconsideration specialist, Ms. Liesalot.

It starts with Ms. Cheaterson the CE, as most OWCP tales do. Ms. Cheaterson denied the Claimant consequential injuries. Ms. Cheaterson's decision said she relied on the "comprehensive medical report" of the OWCP'S District Medical Advisor, (DMA). Seems reasonable, until you actually use the facts.

So let's first look at the DMA and the comprehensiveness of not one, but two medical reports. The two reports together, yes, I said combined, constitute three paragraphs. My first question to you is, what is wrong with this? The answer is; a "Comprehensive Medical Report" will absolutely contain more than three paragraphs even if it's your first day in OWCPland. So we can be pretty sure something's amiss based on the DMA's economy of words.

Next, we're looking for what the three anorexic paragraphs boil down to. What is the medical opinion? Here, it is this one sentence:
"At this time I do NOT feel that OWCP should expand the accepted conditions in this case."
Ms. Cheaterson then assigned weight of medical evidence to the DMA's reports and denied the consequential injuries. Yes folks, when the report is on the side of OWCP, weight of medical evidence can be placed on three paragraphs that boil down to their physician's 'feeling'. Show of hands; how many of you out there think this would fly if it was the Claimant's physician's 'feeling'?? Anyone?

But wait, there's more. The DMA stated in both reports that the Claimant had established that bulging discs were in fact work related. Now wouldn't you know, bulging discs were one of the consequential injuries the Claimant was asking for. Wow, what a coincidence. Break it down and the DMA says bulging discs are established yet he doesn't 'feel' any conditions should be accepted. So which is it? Are they consequential or not? Are they established or not? We don't know because the DMA didn't tell us...which they are required to do.

So, what should a Claimant do if this is also their situation? Well, let me ask you this, is a feeling now considered a medical opinion? No, it is not. First, what kind of feeling is it? The doctor doesn't provide any explanation of why he has this feeling or what feeling it was. How do we know he isn't just hungry? Maybe it's gas. We don't know because he didn't explain why he was feeling whatever it was he was feeling and what caused the feeling he was having.

Also, there is no medical rationale connected to this sort of statement. When a physician declares that medical conditions are not consequential, they must explain how the injuries could NOT be related to the original injuries. The doctor has to state what intervened to break the chain of causation. No physician can make a statement about a Claimant's medical conditions without explaining in detail how they arrived at that specific medical opinion and what evidence they based the opinion on.

Then of course there's the contradictions....the Claimant and her physicians indicate the Claimant has bulging discs related to her original accepted conditions. OWCP then sent the Claimant to a second opinion. OWCP's second opinion physician agreed that all of the Claimant's claimed conditions were not only consequential but indicated that each of the conditions was permanent. OWCP then added three of the consequential injuries, but ignored the rest. OWCP cannot use a medical report to accept some of the conditions and not all the conditions. They can't just cherry-pick what they want, especially when it's THEIR doctor saying it. Once they use a report to accept one condition if that report indicates other conditions are work-related, OWCP has to accept those conditions as well.

On the Claimant's side we've got the treating physician, one of OWCP's own secops and diagnostic tests. On OWCP's side we've got a physician with a feeling who states the Claimant established bulging discs but then goes on to say no conditions should be accepted. Ms. Cheaterson then assigns weight of medical evidence to the DMA, the single opinion that denies the consequential injuries...sound familar? Well, I'm getting sick of it. It does nothing but waste everyone's time and taxpayer money. They know they're wrong, but they just can't bring themselves to admit it.

If you read an OWCP medical report and can ask yourself; which is it? the medical opinion is contradictory. If you're thinking; hey, make up your mind...it's contradictory and an OWCP medical report cannot be contradictory. Your doctor can't do it and either can OWCP's doctors. What applies to you applies to them, even if they haven't figured that out yet.

A three paragraph report does not even cover the history of most claims. So if your OWCP medical report is short, that's an indication it's not proper. They can't say I reviewed the file. They have to say what they reviewed. They can't just review OWCP's doctor reports, they have to consider ALL the evidence, including any evidence they receive on the date of the decision.

As our saga continues, Ms. Cheaterson then issued the formal decision denying the consequential injuries. Shocking. Of course, the Claimant appealed the decision.

Enter Ms. Liesalot, the so called "Reconsideration Specialist". All I can say is, after reading Ms. Liesalot's decision, I can say for sure and for certain there is nothing special about her and she should relinquish her 'specialist' title. Her decision is a blatant violation of FECA policy.

First Ms. Liesalot says that bulging discs have been accepted by the Office. Then goes on to explain that bulging discs aren't going to be accepted. I know, right? Where do they get this stuff?

She then discounts the Claimant's argument against the DMA by suddenly promoting him to the District Medical Director. These are two very different jobs. She also declared the DMA's reports, "Qualified Medical Opinions" Of course, these errors are easily proven, but that requires another appeal which means another delay to the Claimant, which I'm pretty sure is the point.

Ms. Liesalot then states that the consequential injuries that are being requested are already accepted. Again, an easily proven error since there would have been no appeal if the consequential injuries had previously been accepted. Duh.

Ms. Liesalot's decision was so utterly pathetic, that of the four arguments made by the Claimant, she didn't actually address any of them. Really, if you could read it, it's just a bunch of stuff made up, without even one ECAB citing to back her up. If they can't cite an ECAB case to back them up, that's an indication your arguments are sound. If it wasn't so pathetic, it might be comical.

Sometimes, you get a really bad decision and there's not one thing you can do about that except appeal. Obviously, this Claimant isn't going to get anywhere in her District. The decisions speak for themselves in the lack of knowledge of the FECA Manuals, ECAB precedent and Larson's on Workers' Compensation Law. The Claimant now has an appeal on its way to the ECAB and I expect it will be kicked back in the Claimant's favor.

The behavior just disgusts me. It's all a game with people's lives hanging in the balance. It's not enough that your mental status has changed because your physical status has changed. No, they have to add the stress of bogus decisions that they know are wrong. Is it so awful for them to just adhere to the rules and regulations governing the system? Some appeals are not so cut and dry and sometimes you have to make a couple of runs at it before you get everything you need. But other times it's obvious there were errors, it's obvious the Claimant has proved their case beyond a shadow of a doubt. When that happens, they should at LEAST have to cowboy up and approve the Claimant's claim.

Sure, everyone is concerned with their own OWCP case, but think about how many of these decisions are being written every day, five days a week in 12 Districts. How many Claimant's are out there struggling with this system. All Claimant's are asking for is what they're entitled to by the written rules, but OWCP refuses to play fair. This is why no matter how beaten you feel, you must fight back and remember that there are others out there just like you. Feeling the same way you are. You can't let them get away with it, because that's exactly what they want.

Can anyone reading this explain how this system is still being called non-adversarial? It does make me wonder though...is the waste of time, effort and money to both Claimant's and the taxpayers due to ignorance or just plain obstinate? And when is someone going to pay attention to this behavior?

Sunday, July 10, 2011

Attorneys and Representatives

We're lucky, we're living in the information age. I can't imagine how hard it was to handle an OWCP claim without the Internet. This is interesting to me since I fought technology for so long, I didn't even have a computer when my OWCP saga started.

Maybe you find yourself in a position where you need or want help with your OWCP claim. There are several attorneys out there that do nothing but OWCP claims and you may or may not have heard their names. In an OWCP claim, you don't have to hire an attorney, you can hire anyone to represent you. In addition to attorneys, there are also representatives that handle OWCP claims. Representatives usually come about by starting with their own claims. Through time and effort, these Claimants become "experts" in OWCP. Somewhere out there now is a Claimant on their way to becoming another OWCP expert.

In the very beginning, since I knew absolutely nothing, I found myself in a position to need representation. I hired an attorney and paid the $5,000.00 retainer. I hired this particular attorney because a fellow employee was using him and he had successfully battled OWCP with his own claim and had been doing it ever since, more than twenty years.

It only took a few weeks for my retainer to be spent. One of the things my attorney did was file an appeal with the ECAB. Within just a few weeks a response came back that the appeal could not be filed because there had been no formal decision from OWCP. It was at that moment I began to question the abilities of my attorney. I had just learned the hard way my attorney didn't know the basic facts of OWCP procedure. Unfortunately, what I didn't know then was a lot.

It was then I caved in to technology and found the magic of the Internet. I Googled my attorney and what I found was that he had in fact been an attorney up until the California Bar Association suspended his license (several years earlier) for financial abuse against ten of his OWCP Claimants. He never got his attorney's license back, yet still called himself an attorney and last I saw, still advertises as an attorney.

I guess the moral of the story is, check with your State Bar Association and make sure your attorney has a valid license. Google your attorney and see what's there.

Just because an attorney or representative has been doing OWCP cases for years, decades even, it doesn't mean they're any good at it. Likewise, someone who's only been doing OWCP cases a few years might be great at it. For example, there are two attorneys that are pretty good at Schedule Award claims, but not great in other areas. There's an attorney who only wins 1-5% of the time, yet somehow gets a lot of Claimants to sign on with him. There are rumors of representatives who illegally charge on a contingency basis.

So how do you know if your attorney is any good at OWCP cases? That's an excellent question. The only way that I know of is the ECAB decision web sites (links to both are on the "LINKS" page). On the site by month and year, you can go to any month and year and by looking at all the decisions that month, you can see how many appeals the attorney or representative filed and what the win, lose or remand record is for the month. By going to the searchable ECAB site, you can type the attorney's name into the search bar and see what comes up.

There is a problem with this limited information. First, it doesn't have anything to do with the win/loss record on any other appeal such as a reconsideration, review of the written record or a hearing. We can only assume any prior appeal was lost, as most people consider the ECAB the last resort. Second, the attorney or representative may not have many or any appeals in front of the ECAB, so you may not find any record. A lack of ECAB appeals could indicate the representative has a better win record and doesn't need to constantly appeal to the ECAB.

Hiring an attorney or representative is an important decision. I suggest researching and talking to the person. Will they talk to you? Do they charge a fee for talking to you? Will they answer your questions? Do they know what they're talking about? I suggest having a few questions ready that you know the answer to. If the person can't answer those questions accurately, move on to someone who can.

If you find yourself in this position, these are the FECA rules governing attorney and representatives fees, which can be found in the FECA Manual part 2 at 2-1200...

Under FECA part 2 at 2-1200-2, A Federal employee may act as a representative only on behalf of an immediate family member or while acting as a Union representative. In both cases, no fee or gratuity can be charged.

Under FECA part 2 at 2-1200-4, A Claimant is solely responsible for the fees of their representative, however, fees must be approved by OWCP prior to the fees being paid. Collecting fees without OWCP approval is a misdemeanor under 18 U.S.C. 292. OWCP DOES NOT pay the fee, the Claimant is solely responsible for the payment of fees, but OWCP must approve the fees.

Fees with no relation to your claim will not be approved by OWCP.

Time spent in preparing the request for fees, writing letters, holding conferences, or any other activity connected with the preparation of the representatives bill may not be considered.

Fees for work in front of other areas, such as the ECAB must be approved by the ECAB and not the OWCP under 20 C.F.R. 501.11.

Mailing, copying, messenger services, travel costs and the like should not be included in your bill. These are services OWCP has determined to be "Administrative" costs between the representative and his/her client. However, secretarial services, paralegal, legal assistant and legal intern can be included in your bill.

Any retainer or pre-paid fees must be held in an escrow account by the representative and cannot be removed until OWCP approves the fees.

Your bill must include an itemized statement showing the representatives hourly rate, the number of hours worked, a description of the specific work performed and the total charge less administrative costs. A statement with the amount charged must be signed by the Claimant. This statement must also include an acknowledgement that the Claimant is aware that s/he has to pay the fee. If any of this information is missing, OWCP should return the bill to the representative advising them to submit a corrected bill.

OWCP does not recognize any contract or agreement between representatives and clients for payment of a fee for services on a contingency basis. In other words, a representative cannot collect a percentage of your compensation or your Schedule Award. Any contingency contract or agreement will not be considered. In Angelea M. Sanden the ECAB ruled that the representatives contingency fee arrangement was illegal. The ECAB determined the contingency contract null and void and the representative had to calculate the money owed on an hourly basis. Here's the link to the Sanden case http://www.dol.gov/ecab/decisions/2004/Sep/04-1632.htm

Since this is what I do for a living now, obviously I'm not saying don't hire someone if you need them. I'm saying make sure you make an informed decision on the subject because in OWCPland, whatever your representative says on your behalf is counted by OWCP as coming from the Claimant. So you want to make sure you see anything before it's submitted to OWCP to check it for accuracy. It's easy for a representative to get dates, places or events wrong. The Claimant knows their case better than anyone and has a vested interest in the outcome of OWCP's decisions. You might need help, but you have the right to know what's being said or done on your behalf.

Remember, your representative fees can be challenged. If the rules above are not being followed, you believe you're being overcharged or you don't agree with the fees, write to OWCP, quoting the FECA Manual and/or Angelea M. Sanden and challenge your fees. At some point OWCP will have to make a formal decision on the subject and you'll get appeal rights. If you're right, the fees can be reduced or eliminated by OWCP.

Saturday, July 9, 2011

Standard Operating Procedure, (SOP)

Today's topic is what has become standard operating procedure but in reality should be classified as 'scare tactics' commonly used in OWCPland by both OWCP and your Agency. Let's take them one at a time...

First, your Agency. When Claimant's are first thrown  into the OWCP system, they believe that their injuries will be properly attended to without having to fight tooth and nail for proper medical care and treatment. You were injured while working, why wouldn't you think it would be taken care of? Unfortunately, most Claimant's find out the hard way just how wrong they are about that. Your injuries should be properly attended to, but sadly, the system really doesn't work that way.

Many Claimant's speak to their Agency for advice with their OWCP claim. Most Agencies are required to help a Claimant with their claim. To be honest at the very least. Well, if you're reading this, you may have already figured out your Agency will lie to both OWCP and you. Or you're constantly being told, 'I don't know'. When it comes to a choice between believing you or believing your Agency, OWCP will most likely side with your Agency. So you want to counter anything mis-stated.

I've said it before and I'll say it again. Anyone reading this should also spread the word...your Agency will lie to you so verify EVERYTHING you're told by your Agency. Don't just blindly believe what you're told and if you're new and have been blindly following your Agency...stop now.

My experience is the more Agency lies or erroneous information you can prove, the better you can use it to your advantage. It's a credibility argument that you can make. You are honest...they are not. Depending on what/where they lie, there are laws you can cite.

Suggestion number one; Get it in writing. This applies to everything that involves your OWCP claim. Proof is the name of the game and believe me, you may be pleasantly surprised by what some people will put in writing that you can use later. If you have a telephone conversation, get the Who, What, When, Where, Why and How. Take notes and then type those notes up and send a copy to OWCP. Now your side of the story is in your file.

Telephone conversations are supposed to be put on a form called a CA-110. When you get copies of your file, you get copies of the CA-110's. Once you see them, you may notice that OWCP's version of your telephone conversations are quite different that what actually took place, so it's always good to get your side in your file.

Federal Agencies run on policy, procedure and regulations. So if your Agency tells you anything you must do or anything they cannot do, ask for it in writing with the corresponding policy, procedure or regulation. Then you can look it up yourself and see if what you're being told is true. Or you may find that policy, procedure or regulation doesn't apply to you or isn't accurate to the situation.

Second, your Claims Examiner, (CE)/OWCP; we could cover this topic for weeks, months even and not be done talking about it. The main thing I want to bring up here is intimidation tactics. Sometimes, your CE will threaten to send you to an OWCP second opinion physician. This is often used simply as a scare tactic. If your CE uses this tactic, simply don't respond to it. They're going to do what they're going to do and you have no control over that. It doesn't take long in the system to learn about OWCP's physicians. There is absolutely nothing a claimant can do if a CE schedules a second opinion except go to the appointment. So there's no use in being in a panic over it. The examination is not the important part, it is the report that's important and I've discussed before what to look for in an OWCP medical report.

Even if you don't do it yourself, there are people out there that know what to look for, how to challenge an OWCP medical report.

Another common scare tactic is to threaten to cut off your compensation. Again, make sure you get it in writing. If the CE won't put it in writing, there's a good chance it's an intimidation tactic. It's simply meant to scare you. It's much better for your Agency and OWCP to have you afraid. It makes it easier for them to control you.

Suggestion number two; Don't Show Fear or Emotion. Really, this should be a rule and it should be number one. Being injured and then thrown into this wacky system is extremely emotional. You're banged up, the future seems scary and unknown, and Bam, the crazy train stops in OWCPland and drops you off. Those running the system rely on that fear and emotion. OWCP actually refers to this system as non-adversarial. Personally, I don't think that word means what OWCP thinks it means. I don't know about you, but I find the system extremely adversarial.

Suggestion number three; Whatever you put in writing to OWCP read it over and remove anything emotional....Just stick to the facts. Same goes for telephone conversations. Scream bloody murder and curse all you want...curl up in the closet and cry like a little baby, AFTER you hang up the phone. AFTER you type up your correspondence to OWCP or your Agency.

If the CE will put their scare tactic in writing, did the CE use the proper regulation? For instance, CE's love to confuse Field Nurses and Vocational Rehabilitation Counselors. They send one Claimant after another letters threatening to suspend their compensation. They do this because under the Vocational Rehabilitation process, your compensation CAN be suspended for non-cooperation. The Field Nurse program is voluntary and OWCP CANNOT suspend your compensation for non-cooperation. It doesn't stop the CE from threatening you, but using the FECA Manual and cited regulation, you can prove you are right and OWCP is wrong and your benefits can't be suspended.

These are just two common tactics used. The bottom line is, for every move OWCP makes, there is a counter move for the Claimant. All is not lost. CE's and Agencies often don't seem to understand their own rules and regulations or purposely mis-quote or mis-cite them. Use that to your advantage. If you can get lies and inaccuracies in writing, consider yourself lucky. And remember, you don't have to live in fear, because there are counter moves and they might just be trying to scare you. Remember, it works to their advantage if you are afraid, if you don't know the 'rules'.

The sad fact is, no one is coming to the rescue of an injured Federal employee. You have to take responsibility for your own claim...which you can do. An educated Claimant is a powerful Claimant.

Friday, June 17, 2011

Who Wants to Know a Secret?

If you are an OWCP claimant, receiving compensation, and you find yourself being harassed by creditiors, here's a little known fact...OWCP compensation is exempt from the claims of creditors. However, payments garnished for alimony and child support do not fall under this catagory.

So if you're being harassed by creditors and you're receiving OWCP compensation, you can site 33 U.S.C. subsection 916 which states:

33 U.S.C. § 916 : US Code - Section 916: Assignment and exemption from claims of creditors:
"No assignment, release, or commutation of compensation or
benefits due or payable under this chapter, except as provided by
this chapter, shall be valid, and such compensation and benefits
shall be exempt from all claims of creditors and from levy,
execution, and attachment or other remedy for recovery or
collection of a debt, which exemption may not be waived."

So if you find yourself in this situation and are tired of being harassed, write a letter to your creditor(s) trying to collect the debt and cite the U.S.C. above.

Wednesday, May 11, 2011

New OWCP Survey

The Department of Labor has published a new survey, go to the link below and Let Your Voice Be Heard.

Take the survey and let's start letting OWCP know what we think of them. The survey can be completed by both Claimant's and Providers. If your physician, physicial therapist, surgeon, diagnostic testing facility, or any other Provider has had trouble with OWCP, they can take the survey as well. Everyone  should be encouraged to complete the survey if they've had issues with OWCP.

http://www.dol.gov/owcp/OWCPSurveyLetter.pdf

Sunday, May 1, 2011

Suspension of Benefits

Today, we're going to talk about suspension of benefits for obstruction of or failure to attend an OWCP directed medical examination. An OWCP medical examination can be a second opinion examination, an Independent Medical Evaluation, (IME), Functional Capacity Evaluation, (FCE) or any other medical examination scheduled by OWCP on your behalf.

The legal provisions OWCP uses to suspend your benefits can be found at 5 U.S.C. 8123(d), which states:
"If an employee refuses to submit to or obstructs an examination, his right to compensation under this subchapter is suspended until the refusal or obstruction stops. Compensation is not payable while a refusal or obstruction continues, and the period of refusal or obstruction is deducted from the period for which compensation is paid."
When scheduling you for a medical examination, OWCP's only requirement is reasonableness. OWCP can send you to medical examinations as frequently as they determine is reasonable and at the times and places it determines.

It is OWCP that determines what is reasonable for OWCP to do and I can tell you OWCP rarely finds themselves unreasonable. So even if OWCP sends you to one examination after another, even if OWCP does engage in doctor shopping, or seeks a specific opinion, you still must attend the appointments or face suspension of your benefits.

Doctor shopping is when OWCP sends you to multiple physicians in an attempt to obtain a specific opinion. There are very few instances where OWCP and/or the ECAB finds that OWCP was in fact involved in doctor shopping. The precedent was set in the case of Carlton L. Owens 36 ECAB 608 (1985) and there is a decision where the Board found OWCP did engage in doctor shopping. That case is: http://www.dol.gov/ecab/decisions/2000/May/98-0726.htm In this case the OWCP sent the Claimant to multiple second opinion physicians and the Board found the OWCP engaged in doctor shopping.

On the other side of the coin is the case http://www.dol.gov/ecab/decisions/2005/Dec/05-0116.htm In this case, the Claimant was sent by OWCP to multiple physicians and the Board found that OWCP was NOT involved in doctor shopping.

It's extremely hard to prove a case of doctor shopping. Not only do you need for OWCP to send you to multiple physicians, but it also seems OWCP must also have sent leading questions to the physician(s).

An inaccurate Statement of Accepted Facts, (SOAF) is not a valid reason for not attending an OWCP directed medical examination. See the decision: http://www.dol.gov/ecab/decisions/2008/Aug/07-2283.htm

If OWCP has scheduled an appointment that is far away from you, and they often do, the distance you must travel is not a legitimate excuse for not attending the appointment unless you have medical documentation. Your medical documentation must explain WHY, medically, you cannot travel the distance. You can notify OWCP and inform them that you require transportation to the examination. Transportation to/from a medical examination must have prior authorization by OWCP or the cost of the transportation will be denied.

Under 20 C.F.R 10.323 any actions by a Claimant's representative will be considered the actions of the employee for the purpose of determining whether a Claimant refused to submit to, or in any way obstructed, an examination required by the OWCP.

This means that whoever is hired to represent you acts on your behalf and your representative's comments and actions are considered to be your comments and actions. It will not be the representative that has to deal with the results of those actions, it will fall on the Claimant.

This decision is the perfect example of the effects of a representative's actions having a negitive impact on the Claimant: http://www.dol.gov/ecab/decisions/2003/Jun/03-0354.htm In this decision the Board concluded that the Claimant's representative obstructed the medical appointment through intimidation by writing to the physician. The moral of the story is, be aware of what your representative is submitting on your behalf.

When an FCE is performed, the person administering the FCE may include comments regarding the extent of your cooperation and the validity of the test results. OWCP can use these comments to determine non-cooperation and consider your actions obstruction and suspend your compensation. You can find more information about FCE's under the post: "Functional Capacity Evaluation, (FCE) Reports"

In order for OWCP to invoke the provisions of the law and suspend your compensation, the CE must ensure that you have been properly notified of your responsibilities. When you receive a letter notifying you of the scheduled examination, OWCP should include a paragraph explaining the consequences of not attending the examination. This paragraph should also include the information under 5 U.S.C 8123(d). If this information is not sent to you, you have not been properly notified.

In addition, if you don't attend the scheduled appointment, OWCP must give you time to object to the choice of physician and an opportunity to provide an explanation for not attending the appointment. This comes in the form of another letter from OWCP giving you 14 days to provide an explanation as to why you didn't attend the appointment. OWCP cannot suspend your compensation until after it meets these requirements.

Even if you receive notice of a scheduled examination and even if you inform OWCP you refuse to attend the appointment, OWCP cannot suspend your benefits until after the time limits of the letter giving you 14 days to provide an explanation have expired.

In order to have your compensation restored, you must notify OWCP of your willingness to cooperate. This should be done by letter and should specifically state you're willing to cooperate and you will attend the medical examination. If a replacement appointment hasn't been made, you should specifically request OWCP schedule another examination.

Once you have attended the medical examination, your compensation may be payable retroactively to the date in which you notified OWCP you would attend the appointment. In other words, the date of your letter to OWCP indicating you will be cooperative and attend the appointment. In order for your compensation to be retroactively paid, you must not only notify OWCP but you must then attend the scheduled medical appointment.

The bottom line is that if OWCP schedules you for a medical examination, you should attend or you're risking the suspension of your compensation and it can take months or longer to have your compensation restored.

Policy regarding suspension and restoration of benefits can be found in the FECA Manual part two at 2-0810-13.

Here's a few ECAB decision regarding suspension of benefits for failure to attend an OWCP directed medical appointment:
http://www.dol.gov/ecab/decisions/2011/Feb/10-1205.htm http://www.dol.gov/ecab/decisions/2010/Aug/10-0246.htmhttp://www.dol.gov/ecab/decisions/2010/Feb/091597P.htm http://www.dol.govv/ecab/decisions/2010/Feb/09-1195.htm#_ftn7


The Code of Federal Regulations, (C.F.R.), United States Code, (U.S.C.) and Federal Employees Compensation Act, (FECA) Manual part two can be found on the "Links" page. Employees Compensation Appeals Board decisions regarding leading questions can be found on the "Useful Stuff" page.

Saturday, April 30, 2011

The Mailbox Rule

The Mailbox Rule is another one sided rule used by OWCP. The Mailbox Rule is simply this:
"In absence of evidence to the contrary a letter properly addressed and mailed in the due course of business, such as in the course of the Office's daily activities, is presumed to have arrived at the mailing address in due course"
What this means for Claimant's is all OWCP has to do is show that there is a letter and that letter was properly addressed. OWCP does NOT have to prove the letter was actually mailed to you. If you cannot prove this is inaccurate, then as far as OWCP goes, you got the letter whether you actually got it or not.

That's how it works for OWCP, but Claimant's have to be able to prove they mailed their items. A Claimant can do this in two ways...
1) You can locate the document(s) in question in your OWCP file. This is all well and good unless OWCP conveniently removes the document(s) from your file. In this case, you have no proof the document(s) were actually mailed and received by OWCP. Where OWCP simply has to show there is a letter and that letter has your last known address on it, a Claimant has to prove the letter was actually mailed.

2) A Claimant can prove they actually mailed document(s) by sending everything that goes to OWCP either delivery confirmation or certified mail. This is the cheapest way to track your OWCP correspondence. Delivery confirmation is slightly cheaper than certified mail, but either one will do.

In addition to sending your OWCP correspondence via delivery confirmation or certified mail, you should also write the tracking number on the document(s) you're sending. This way the document is identified by a specific tracking number. When I write to OWCP, I type the delivery confirmation number in the 'footer' of each page.

You don't have to use a separate tracking number for every document. If you're sending several documents, you can send them under the same tracking number, just make sure that tracking number is on every page you're sending so the documents can be identified later.

If you don't write the number on the document(s), then OWCP can simply say we didn't receive those items. OWCP can say something was sent delivery confirmation or certified mail, but it wasn't the document you say it was. Unless the tracking number is written on the document(s) OWCP can simply deny, deny, deny.

Once you mail your items, keep an eye on the tracking number and when the item is received by OWCP, print out a receipt showing it was received. You can track your items through the postal services Track and Confirm website. I usually staple the original receipt onto the track and confirm receipt so that I can easily make a copy of both on one page if I need to. You can find Track and Confirm on the "Links" page.

You can pick up a stack of delivery confirmation or certified mail receipts at your post office along with Priority Mail envelopes. If you keep a stack around the house, then you'll always have them when you need to send OWCP any correspondence.

I cannot tell you how many times a tracking number with proof of receipt put OWCP back in its place and proved the documents were actually mailed and received by OWCP. I'm always able to prove that I did in fact send the document(s) and exactly when OWCP received document(s) because I don't send anything to OWCP without a tracking number on it.

You can find more information about the Mailbox Rule at 20 C.F.R. 10.127 and in the following ECAB decisions:

http://www.dol.gov/ecab/decisions/2008/May/08-0202P.htm
http://www.dol.gov/ecab/decisions/2003/March/02-0713.htm

I've put a link for the Code of Federal Regulations, (CFR) on the "Links" page.

Wednesday, April 20, 2011

I Feel A Rant Coming On

How many people out there reading this have noticed the exorbitant amount of money OWCP pays for its nurses, District Medical Advisors, (DMA), vocational rehabilitation counselors and physician's?

An OWCP field nurse will receive a minimum of $5,000.00 for their services. I've seen a nurse paid up to $20,000.00 for their so called services. This amount might be reasonable if the nurses actually did anything other than bill for services they do not or cannot render. A vocational rehabilitation counselor can spend an hour on your case and charge $1,000.00-$1,500.00 for their time and no one at OWCP questions the bill.

It seems to me that any claimant in vocational rehabilitation who is asked what job they want to do could respond that they want to be a vocational rehabilitation counselor. You don't have to do much and you get paid an extreme amount of money.

Recently, I saw a DMA report that consisted of one and a half pages and the DMA charged $225.00 for it. When OWCP went back for clarification, the same DMA charged an additional $225.00 for one paragraph of clarification. $450.00 for two pages. And as usual, the finished report was thrown out due to inaccuracies, inconsistencies and policy violations.

Then there's OWCP hired gun physicians. A second opinion physician can charge as much as $1,000.00 or more for a report and the Independent Medical Evaluation, (IME) physicians can charge $4,000.00 or more for their reports and receive it. Not only do they receive the full amount they charge, they get paid by "Prompt Pay" which means they get their money paid quicker than anyone else.

I'm working with a claimant right now who was sent to a second opinion and an IME. I expect both reports to be thrown out on appeal since neither is accurate or complete and neither report actually addresses the issues OWCP requested. As with any OWCP medical report, neither are up to OWCP's standards, yet OWCP has determined they carry the weight of medical evidence. One claimant, two reports with a cost of $4,900.00. And again, I expect that money will have been paid for nothing since the reports should be thrown out on appeal.

This particular IME boasts he has done 10,500 IME examinations for one company. He charged OWCP $4,250.00 for one report. If my math is right, that's $4,462,500.00 for writing medical reports that are easy to get thrown out. And remember, that's just for one company.

Think about how many medical reports are thrown out on appeal. How much money wasted for the cost of those reports only to determine later the report wasn't up to OWCP's standards. If we knew the actual figures, the amount of wasted money is in the multi-millions.

If you were a doctor, why wouldn't you exclusively write these types of reports? The money is better than a physician in private practice and you don't have to deal with those pesky patients. Of course the four million dollar price tag doesn't include the physician going to court as an expert witness or any of the reports written for other companies or the reports s/he may write for State workers' compensation, Social Security, etc...Factor in the 10 minutes to half an hour the physician spends doing his 'exam' and the profit margin to the physician really becomes clear.

Just for a minute imagine what would happen if a claimant's physician charged $650.00-$4,000.00 for one report. If it was a claimant's physician, I can almost guarantee OWCP would come after the physician for fraud, but they don't blink an eye if the physician is one of their hired guns. A claimant's physician can write a complete, thorough report and charge $200.00-$300.00 and not receive the full amount charged because OWCP determines the cost is too high. Yet OWCP's physicians seem to be able to charge any amount and receive that amount promptly and in full without any questions whatsoever.

The problem for claimant's is when a physician does these sort of reports as their exclusive way of making a living, they come to rely on the money and in order to continue on the gravy train, they must produce reports against claimants or risk OWCP dropping them in favor of a physician that will write the reports OWCP wants. The physician becomes biased. That's not my opinion, it's a fact that can be verified by searching the physicians through Employees Compensation Appeals Board, (ECAB). If you look, every physician that works regularly for OWCP consistently writes reports against claimants. In a lot of cases, the reports are contrary to all the medical evidence in the file and yet are accepted as factual by OWCP and given weight of medical evidence.

It's no wonder these people work exclusively for OWCP. Why wouldn't they? The money is way more than any amount you could make in the 'real' world. It's more than any other person in their field can make for doing the same job.

In light of the recent comments from OWCP's current Director about the cost of caring for claimant's, and how OWCP needs to cut benefits and services to claimant's because claimants receive too much, it seems the obvious choice for saving money is through OWCP's own medical personnel.

Before OWCP decides claimant's are receiving too many benefits at too high a cost, their own medical personnel should be put under the microscope and caps on their fees should be put in place. Not only would that save OWCP more money than cutting services for claimants, it just might eliminate physicians, nurses and vocational rehabilitation counselors that only work for the big bucks OWCP will pay them.

All of us have to start writing to OWCP with our complaints against the fees OWCP's medical personnel receive. We have to write complaints against the physicians, nurses, vocational rehabilitation counselors and DMA's who regularly work for OWCP and consistently go against claimant's no matter what the evidence shows. If we continue to sit back and do nothing then we will change nothing.

Tuesday, April 19, 2011

Causal Relationship; What's the Difference?

In order for your claim to be accepted, you must prove causal relationship. Causal relationship means the relationship between you, your work and the injuries you claim.

There are four ways your medical conditions can be related to your employment:

1. Direct Causation is shown through a natural and unbroken sequence resulting in the condition claimed. If you broke a bone after a fall, the broken bone is caused by the fall. If you were injured in a motor vehicle accident, the accident is the cause of the injuries. If you were attacked by a dog, the dog attack is the cause of the injuries, etc...

An unbroken sequence means that nothing interferes with the sequence of events. Nothing saves you from falling. Nothing keeps you from being in an accident. Nothing stops the dog from attacking you. An unbroken sequence means that from start to finish the events lead to injury.

Occupational injuries fall under direct causation, but are also known as "proximately caused" and the medical evidence to prove your occupational injury more than likely will require greater medical rationale in order to have your claim accepted.

Medical rationale is the HOW of the injury. For example; you fell from a height and landed on a concrete floor. When you hit the concrete floor, you broke your leg. Falling from a height and landing hard on concrete caused your leg to break. The broken leg required immediate medical attention. If you had not fallen from a height and had not landed on concrete, you would not have broken your leg and would not have required medical attention.

When it comes to medical rationale, your doctor must be specific. What is obvious to claimants and their physician's is not obvious to OWCP. There should be no question where you were, who you were working for and exactly how the injury occurred. Again, although obvious, it is not enough for your doctor to say you fell off a ladder at work and broke your leg.

Once accepted, there is no limitation on the duration or severity of the condition. As long as the medical evidence shows disability and/or the need for medical treatment, there is no time limit on how long compensation and/or medical treatment will be paid.

2. Aggravation occurs if you have a pre-existing condition and that condition is worsened, either temporarily or permanently by an injury arising in the course of your employment. For example, you have a heart condition and your heart condition is aggravated by your employment. You have degenerative disc disease and you sustain a traumatic injury which aggravates your degenerative disc disease. You have a respiratory condition and dust aggravates your condition.

A temporary aggravation involves a temporary (or limited) period of medical treatment and/or disability after which you return to your previous physical status.Compensation is payable only during the period of time the aggravation lasts. When the aggravation ends, compensation and/or medical treatment is no longer payable. A temporary aggravation involves only the aggravation and not the underlying disease. Benefits are paid only for the aggravation that made your condition worse, not the condition itself.

OWCP must determine through medical evidence a temporary aggravation has resolved. Your benefits cannot be terminated without notification and proper medical evidence. Normally, OWCP does this through one of its medical examinations.

A permanent aggravation occurs when a condition will persist indefinitely due to the effects of the work-related injury or when a condition is materially worsened and will not revert to its previous level of severity. For instance if you suffer from allergies and you were exposed to dust or fumes and the exposure to dust or fumes causes your allergy attacks to be more severe, that would be a permanent aggravation. If your spinal condition was aggravated and you lose range of motion that you don't recover, that would be a permanent aggravation. A permanent aggravation means that the worsening isn't expected to get better.

There is no additional benefit to you for a permanent aggravation, but OWCP does not like to accept permanent aggravations because it is easier for OWCP's physician's to say your temporary aggravation ended so OWCP can terminate your benefits. If your aggravation is permanent it's harder for OWCP's physician's to say there are no residuals of the aggravation. If your physician believes your medical condition was permanently aggravated, they should say so in every report.

3. Acceleration means that the injury or illness hastened the development of an underlying condition. An acceleration is when the speed in which your condition develops is faster than if you were not exposed to injury or illness. If you're young and you have a knee injury that results in a total knee replacement, your condition was probably accelerated because knee replacement is normally done when you're older. If a hectic, erratic work schedule prevents you from regular eating and your diabetes gets worse, your diabetes was accelerated by your employment. If you have a spinal injury and your degenerative disc disease which was not symptomatic, suddenly becomes severe, your degenerative disc disease may have been accelerated by your employment.

4. Precipitation is when your condition is latent and would not have developed without factors of your employment. If you have tuberculosis that is latent and you become symptomatic after an exposure at work, your tuberculosis was precipitated by the new exposure.

Like a temporary aggravation, only the work-related precipitation is compensable. Once the condition returns to a latent condition, your entitlement to benefits ends. If the condition does not return to its previous state, then there would be no limit on the duration of acceptance. In other words, as long as the condition is present, you're entitled to benefits.

You can find information about causal relationship in the FECA Manual part 2 at 2-0805-2.

Tuesday, April 12, 2011

Types of Claims; What's the Difference?

Some claimant's get confused over what type of claim they have. Today, we're going to discuss the different types of claims (except death claims, which are obvious). The type of claim you have depends on what caused the injury.

No matter what type of claim you file, you have the burden of establishing the claimed condition is causally related to the factors of your Federal employment and you must show sufficient cause for OWCP to proceed with processing and adjudicating a claim. In order to do this, you must submit medical evidence including a medical narrative and any diagnostic tests. OWCP's responsibility is to aid you in the process by giving detailed instructions for developing the required evidence.

Traumatic Injury: FECA Manual part 2 at 2-0807 describes a traumatic injury as:
"A condition of the body caused by a specific event or incident, or series of events or incidents, within a single workday or shift. Such condition must be caused by external force, including stress or strain, which is identifiable as to the time and place of occurrence and member or function of the body affected."
What this means is your injury occurs due to a specific event or series of events during one work shift. For instance a car accident, or you were hit by a car, something fell on you, a wrench hit you in the head, you lifted something and couldn't move or heard something pop, you sprained your ankle, you fell off a ladder or the wing of a plane, you broke a bone, a dog attacked you, you slipped on ice, etc...

For your claim to be a traumatic injury, you and your physician must be able to say; on this day, at approximately this time, this specific event occurred and you were injured because of it. If you can pinpoint the exact date and event or you require immediate medical care, your claim is traumatic.

A traumatic injury is filed using form CA-1.

Occupational Injury: The FECA Manual part 2 at 2-0800-2(d) describes an occupational injury as:
"A condition which is produced by continued or repeated exposure to elements of the work environment such as noxious substances or damaging noise levels over a period longer than one work day or shift"
This means your injury happens over time. For example, your job is repetitious which requires you to perform the same physical tasks everyday and over time a medical condition develops such as carpal tunnel syndrome, or a shoulder condition or a spinal condition or your job caused a pre-existing condition to worsen or become symptomatic.

An occupational injury is filed using form CA-2. You have three years from the date you first realized the injuries were work-related unless you were being exposed to something and you weren't aware you were being exposed, then the clock starts on the date of the last injurious exposure. Asbestos, toxic fumes, etc...fall under this category.

Recurrence of Disability (a work stoppage which occurs after an employee has returned to work after a period of disability: FECA Manual part 2 at 2-1500-3(b) describes a recurrence of disability as:
"(a) A spontaneous material change, demonstrated by objective findings, in the medical condition which resulted from a previous injury or occupational illness without an intervening injury or new exposure to factors causing the original illness;

(b) A return or increase of disability due to an accepted consequential injury; or

(c) Withdrawal of a light duty assignment made specifically to accommodate the claimant's condition die to the work-related injury. This withdrawal must have occurred for reasons other than misconduct or non-performance of job duties."
A recurrence injury claim is extremely difficult to prove because you need to show a spontaneous change in your condition. A spontaneous change means the condition developed without any apparent external influence, force or cause of treatment. This means if you were bending, pushing, pulling, reaching, lifting, etc.... and something happens, it is not a recurrence because the act of bending, pushing, pulling, reaching or lifting is an external force.

When you file a recurrence claim, you have to prove the spontaneous change. If you describe your injury by saying you were doing this or that and the injury occurred, this is NOT a recurrence because whatever you were doing is an external force.

Agencies often tell an employee to file for recurrence. Your Agency does not always accurately inform a claimant of which type of claim they have and what paperwork to file. To avoid complications later, do not listen to your agency without verifying the information is accurate.

A recurrence injury is filed using a CA-2a.

Consequential Injury: FECA Manual part 2 at 2-0805-6 describes a consequential injury as:
"This kind of injury occurs because of weakness or impairment caused by a work-related injury, and it may affect the same part of the body as the original injury or a different area altogether. For instance, a claimant with an accepted knee injury may fall at home because the weakened knee has buckled. This incident will constitute a consequential injury whether the affected part of the body is the knee or some other area, such as the back or arm. Or, a claimant with an injured eye may compensate for loss of functioning by overuse of the other eye, which may result in a consequential injury."
Consequential injuries happen because of a worsening or progression of your original conditions or because of your original injuries, another part of your body is affected. If your right knee was damaged and you develop a limp that causes hip problems, the hip conditions are consequential to the knee conditions. If Stenosis is accepted you may develop Myleopathy (spinal cord compression). The Myleopathy is consequential to the Stenosis. If you have an accepted shoulder condition and the other shoulder develops problems because of overuse, the new shoulder injuries are consequential to the original shoulder injuries.

Likewise, if you're sent to a Functional Capacity Evaluation, (FCE) and you're injured or your conditions worsen, those injuries are consequential. If you attend physical therapy for your accepted conditions and you're hurt or your conditions worsen during your physical therapy those injuries are consequential. If you're approved for surgery and any complications arise because of that surgery, those injuries are consequential. Any new injury or worsening of your original injuries because of any treatment you receive is a consequential injury.

The most common consequential injury is a psychological condition due to pain. When you're injured and in constant or chronic pain, or you can no longer do the things you used to do, it affects you psychologically. Both the chronic pain and the resulting psychological condition is consequential.

There is no specific form for consequential injuries. To request consequential injuries, send a letter with your medical narrative and request the consequential injuries be added to your files. You can also read the 04/03/2011 post titled "Consequential Injuries" for more information.

You will have to fight to get any additional conditions added to your claim. Just because your claim is denied, does not mean you should stop fighting to get your conditions accepted. With any denial of services or any claim, get a formal decision so you have appeal rights. If your CE does not provide a formal decision with appeal rights, send a letter to OWCP requesting the formal decision. If OWCP doesn't reply within 30 days, go up the "food chain" to the District Director.

If the District Director doesn't reply to your request send a letter to your Congress person requesting help in getting a formal decision.

Wednesday, April 6, 2011

Where's My CA-7?

I hear the same story over and over...claimant's who file a CA-7, Claim for Compensation are not getting their CA-7's properly submitted by their Agencies. I hear this story too often for the problem to be random, un-trained personnel. My personal opinion is that it's done on purpose.

When the processing of your CA-7 is delayed, your compensation is delayed, which in turn causes a financial hardship. By law, your Agency has five days to process your CA-7 and file it with OWCP. If you're having serious problems with your Agency processing your CA-7, I've found this works pretty well...

On your next trip out of the house, stop by your local Post Office and pick up some Delivery Confirmation or Certified Mail receipts (the choice is yours) and Priority Mail envelopes. Pick up a small stack, since it's handy to have them when you need them.

After you complete your CA-7 write the tracking number on the CA-7 you're submitting and using the Priority Mail envelope, submit the CA-7 as you normally would. If you know the name of the person you're sending your CA-7 to, make sure you put their name on both the tracking receipt AND the envelope. Make sure you write the same tracking number on each page you're submitting.

When you write the tracking number on the document, no one can come back later and say they didn't receive it, that wasn't the document submitted under that particular tracking number or that a different document was submitted under that tracking number. The tracking number now identifies the document.

After you mail the CA-7, track it online and once it's delivered, print out a copy of the delivery receipt. Now you have absolute proof, including the time, the CA-7 was received by your Agency. I've included the link to USPS Track and Confirm on the "Links" page.

If your CA-7 is not processed timely, write a letter to your Agency, but go up the "food chain". Address your letter to the supervisor, manager, department head, district director or whoever is above the person or department that processes your CA-7's. You can't expect the person or department that's creating the problem to fix the problem...so you should go above their head.

The laws that govern the processing of your CA-7 fall under The Code of Federal Regulations, known as C.F.R. and the United States Code, known as U.S.C. These are the C.F.R. and U.S.C. that apply to processing your CA-7:
"Upon receipt of Form CA-7 from the employee, or someone acting on his or her behalf, the employer shall complete the appropriate portions of the form. As soon as possible, but no more than five working days after receipt from the employee, the employer shall forward the completed Form CA-7 and any accompanying medical report to OWCP, 20 C.F.R section 10.111 Subpart B (c)."
"Whoever, being an officer or employee of the United States, charged with the responsibility for making the reports of the immediate superior specified by the FECA, 5 U.S.C. section 8120, who willfully fails, neglects, or refuses to make any of the reports, or knowing files a false report, or induces, compels, or directs an injured employee to forego filing of any claim for compensation or other benefits provided under sub-chapter I of chapter 81 of Title 5 or any extension or application thereof, or willfully retains any notice, report, claim, or paper which is required to be filed under that sub-chapter or any extension or application thereof, or regulations prescribed thereunder, shall be fined $500.00 under this title or imprisoned for not more than one (1) year, or both, 18 U.S.C. section 1922."
In your letter to the Agency, state the facts; the date the CA-7 was submitted, the date the CA-7 was received and the person the CA-7 was sent to for processing (if  known). Quote the C.F.R. and the U.S.C. and make a statement regarding the violation(s) your Agency has committed.

Include a copy of the CA-7 that shows the tracking number and the USPS track and confirm receipt showing the date and time the Agency received the CA-7. Send a copy of the letter, including the attachments to OWCP and the person (if known) who was in charge of processing your CA-7. Make sure all this information is included in your letter.

Every situation is different, but the body of your letter should go something like this:
On 00/00/0000 via Delivery Confirmation Number: 123-456-7890, I submitted a CA-7, Claim for Compensation to Ms. Jane Doe Injury Compensation Specialist for the period 00/00/0000 through and including 00/00/0000.
The attached USPS Track and Confirm receipt indicates the Agency received the CA-7 on 00/00/0000. It has now been eight (8) working days since the Agency received my CA-7 dated 00/00/0000 and yet the CA-7 has not been processed and sent to OWCP as required by law.
Quote the C.F.R. and U.S.C from above just as I've written them.
Immediately process my CA-7 dated 00/00/0000 or provide a legitimate, written explanation why my CA-7 Claim for Compensation will not be processed in a timely manner in violation of C.F.R section 10.111 Subpart B (c) and 18 U.S.C. Section 1922.
Sincerely,
Your Name
Your Address
Your Phone Number

Cc: Your Claims Examiners Name
       Name of the person who was supposed to process your CA-7 (if known)

Attached hereto and set forth as if fully incorporated herein:

1. CA-7 dated 00/00/0000; and
2. USPS Track and Confirm receipt, Delivery Confirmation Number: 123-456-7890
In my personal experience once I've sent this letter, the delays stop. If the problem persists, write to OWCP and request that OWCP inform your Agency of its responsibilities of processing your CA-7 and request you be able to submit your CA-7's directly to OWCP because your Agency continues to violate the C.F.R. and U.S.C. delaying your rightful compensation. 

Tuesday, April 5, 2011

The ECAB

If you've done any reading on the subject of OWCP, you've probably heard about the Employees Compensation Appeals Board, also known as the ECAB or the Board. You've probably heard you should read an ECAB decision or look up a decision in support of your case, but what do you do with it once you find it?

The ECAB is the highest authority in the OWCP system. What the Board says goes. The ECAB sets and holds precedent. If the ECAB says it and the precedent has held, then that's the law of OWCPLand.

The point of reading ECAB decisions, is that you become familiar with what the actual rules are as opposed to what OWCP tells you the rules are. So if, for instance, you have an issue with your Statement of Accepted Facts, (SOAF) and you read three or ten ECAB decisions, the Board will repeat the same policy, procedure or law that pertains to the situations of the SOAF.

Every case is different, but policy, procedure and law surrounding the issues are the same. Job offers, Loss of Wage Earning Capacity, (LWEC), vocational rehabilitation, fact of injury, consequential injuries, SOAF's, occupational injuries, recurrences, you name it, there's an ECAB decision about it. The more common the issue, the more plentiful the ECAB decisions on the subject.

If you need to respond to a letter or especially an appeal in support of your case, you need to back your claim up with citations from the FECA Manuals and the ECAB. It's not enough to tell OWCP they made an error or incorrect decision, you must show them. The OWCP MUST follow its own policies and procedures, but as we know, a lot of times they don't. It is your responsibility to point out where OWCP got it wrong, because let's face it, the OWCP isn't going to police itself.

Almost every topic that could come up regarding your claim is in the FECA Manuals and the same applies to ECAB decisions. When looking for an ECAB decision regarding a specific topic, use the ECAB by Topic link on the "Links" page. Once you get to the ECAB web site, type in your topic in the search bar on the left hand side of the screen. Check the Federal Employees Workers' Compensation box on the right hand side of the page. More than likely you will get results. If not, keep playing with it until you do.

An ECAB decision will tell the facts of the case and will then discuss the issue on appeal citing precedent cases on the topic. The Board will then make one of three decisions;
1. Affirmed, which means the claimant lost and the Board agrees with OWCP;
2. Remanded, which means something is missing or something else needs to be done so the file goes back to the OWCP to get the missing information; or
3. Reversed which means the claimant won and the Board reverses OWCP's decision
The Board will cite precedent setting cases in every decision. Those citings will be listed at the very end of every decision. When you're using ECAB decisions to support your claim, use appeals that are as similar as possible and have been reversed.

At the top of every ECAB appeal, there will be a Docket Number and the date of the decision. This is the information used to find an ECAB decision by Month and Year. Quote the ECAB decision that you're using in your argument(s) to OWCP and then cite the case where you found the information.

ECAB decisions aren't just for use when attempting to overturn an OWCP decision, you can actually learn from them. Read ECAB decisions on your topic and you'll learn what the specific requirements are. Even decisions that are affirmed are useful as learning tools. ECAB decisions lay out exactly where a claimant went wrong and exactly where a claimant went right. If you're attempting to get a claim accepted, ECAB decisions on your topic will lay out exactly what information is required from you.

For instance, if you're being sent to an Independent Medical Evaluation, (IME) and you read ECAB decisions regarding IME's, then you'll see over and over again that an IME is to be chosen at random according to strict guidelines. If you received an inaccurate Statement of Accepted Facts, (SOAF), you'll see over and over again that a medical report based on an inaccurate SOAF is of little or no value. If stale medical evidence was used, you'll see over and over again that the Board has held that medical evidence that is not contemporaneous (or current) is of no value. If you're trying to prove causal relationship, you'll see over and over that causal relationship must be established by rationalized medical opinion evidence.

If you want to learn what's required for any OWCP circumstance, try reading ECAB decisions. Quoting ECAB decisions to OWCP is also one of the best ways to rebut any OWCP decision, opinion or conclusion. OWCP cannot come back and say the ECAB is wrong.

As an example, we'll say that OWCP found a job offer suitable based on the stale medical evidence and as a result, the claimant was injured, but OWCP denies the claim. We would respond to OWCP like this:
The Board has recognized the importance of medical evidence being contemporaneous with a job offer in order to ensure that a claimant is medically capable of returning to work, Ruth Churchwell, Docket No. 02-0792 (2002), John Perez, Docket No. 99-0816 (2000).

The Office relied on stale medical evidence on which claimant's job offer is based. The Board has stated that, consistent with case precedent, stale medical evidence cannot form the basis for current evaluation of residual symptomology or disability determination, Diane M. James, Docket No. 90-1944 (February 13, 2006), Keith Hanselman, 42 ECAB 680 (1991), Ellen G. Trimmer, 32 ECAB 1878 (1981).

Claimant was provided an unsuitable job offer based on obsolete medical evidence. As a consequence, every injury and/or aggravation that arises from the inappropriate job offer is compensable and must be determined to be in performance of duty.
When you respond to OWCP by citing the ECAB, OWCP must then either reverse the decision or show where you and the ECAB are wrong, which they can't do since the ECAB out ranks OWCP.

OWCP relies on you not knowing what the "rules" are, they rely on you to believe whatever they tell you. Show them you do understand the "rules", that you won't put up with bad decisions and that you'll fight back by citing the FECA Manuals and the ECAB. If you do, you might find that suddenly they can make the right decisions.

Monday, April 4, 2011

Job Offers

At some point during your claim, you may be given a job offer by your employer. If you're given a job offer, you need to make sure all the proper procedures have been followed.
You can find information regarding job offers in part two of the FECA Manuals at 2-0814. I've posted a link to the FECA Manuals on the "Links" page.

The first thing you need to know about job offers is that they MUST be in writing. This means if your agency calls you on the phone and tells you to report to work without providing you a job offer IN WRITING, then it's not a suitable job offer. In that situation, you should tell your agency they must provide you a job offer in writing. Follow up any telephone conversation up with a letter to the agency and send a copy to OWCP. Your letter should state who you talked to, when you talked to them and what was said. You should state a suitable job offer must be in writing and cite the pertinent parts of the FECA Manual at 2-0814. If your employer stated on the phone that they will send you a written job offer, include that information in your letter by stating you're waiting for the agency's written job offer as stated by whoever you talked to.

In addition to the job offer being in writing, it MUST also contain a description of the duties to be performed. These are the job duties which are things like typing, filing, answering phones, casing mail, guarding the President, etc...

Your job offer MUST also include the specific physical requirements of the job. This is walking, bending, twisting, driving, reaching, lifting, pushing, pulling, etc...The physical requirements must be SPECIFIC, so your job offer needs to state how often you have to perform the duty, what the weight requirements for lifting, pushing and pulling are, if appropriate, whether the physical requirement is constant or intermittent.

Your job offer MUST also include any special demands of the workload and MUST also include any unusual working conditions, such as you'll be exposed to weather conditions, you'll be exposed to toxic chemicals, dust, etc...These items must also state the amount of time you'll be exposed to the unusual working condition(s) and what the special demands of the workload are.

Your job offer MUST include the organizational location and the geographical location of the job being offered. This means the agency location offering you the job and the actual address where you'll be performing the job (these two locations may be the same).

Your job offer MUST include the date the job becomes available and the date your response is required. As a side note to this, if your job offer has an end date in 90 days or less, it is not a suitable job offer. If you were a permanent employee when you were injured, you're entitled to a permanent job offer. Only employees that were temporary when they were injured get a temporary job offer. So if your job offer ends in less than 90 days, then the job offer is not suitable because it is considered a temporary job offer.

Your job offer should also include your pay rate. This is the rate of pay you'll be paid for the job in question.

Once the job offer is written it is supposed to be sent to your Claims Examiner, (CE) who should review it for suitability. If your agency doesn't provide OWCP a copy of the job offer, you should along with a letter stating the letter is your formal request for a determination of suitability. When the CE receives the job offer, the CE assesses the following information:

If a job offer involves less than four hours of work per day and the evidence shows you're capable of working for or more hours per day, the job offer is considered unsuitable.

A temporary job offer will be considered unsuitable (as described above).

If medical reports in your file document a condition that has arisen since your original injury, that disables you from the offered job, the job is considered unsuitable even if the subsequently-acquired condition(s) are NOT work related.
Once the CE has determined the job offer is suitable or not, you are to be notified by OWCP. If OWCP calls you, they must also follow that call up with a letter. If your CE calls you, you should follow that up with a letter stating, who you talked to, when you talked to them and what was said. If the CE stated they'll send you a letter confirming suitability, then make sure you put that in your letter as well. Remember to keep copies of your correspondence to OWCP for your records.

The letter the CE sends you should state that the job was found suitable, the job remains open and that you'll be paid the difference (if any) in compensation between the pay of the offered job and the pay you were receiving on the date of injury. In other words if the job is for four hours per day, OWCP will pay you 4 hours of compensation at your date of injury pay and your agency will pay you four hours at the rate of pay for the job offer position. The letter should give you 30 days from the date of the letter to either accept the job or provide written explanation of the reasons you're refusing it.

If you and/or your physician do not agree with OWCP, you must send your reasons to OWCP. No response from you is considered by OWCP as a refusal to accept the job offer. If you need to update your medical evidence, have your physician complete a new CA-17 and if necessary a narrative report. If the narrative report will take longer than 30 days, you can provide OWCP with the CA-17 and inform them that a narrative report is forthcoming and the approximate date you expect to have the medical report. You can find the CA-17 on the "Links" page using the Forms link.

If you accept the job, OWCP will terminate or reduce (as appropriate) your compensation benefits and you should receive a letter explaining the termination or reduction in your compensation benefits. You should receive a formal decision on the topic after 60 days of reemployment.
If you refuse the job after you receive your letter giving you 30 days and you provide OWCP with reasons for refusal, the CE must evaluate the evidence you submit and determine whether or not its valid. Some valid reasons are; the offered position was withdrawn, you found other work, your medical condition worsened and you are now disabled for the job in question, you provided evidence that your decision is based on your treating physician's advice, in other words, your physician told you you can't do the job or the job isn't suitable or within your restrictions.

If your reason is due to your physician or medical, you must have the physician provide medical reasoning in support of his/her opinion. So let's say your physician says s/he disagrees with the job offer because it requires you to reach and you have a no reaching restriction, that is not enough. Your physician must say why you can't reach. The physician needs to say that s/he disagrees that the job offer is suitable or within your restrictions and why. For instance; you have a no reaching restriction due to a full rotator cuff tear in your right shoulder which hinders your range of motion and ability to lift more than X pounds.  The rotator cuff tear restricts you from reaching due to loss of range of motion and the pain associated with the rotator cuff tear when you reach and lifting more than X pounds could damage the right shoulder further. Your physician gave you restrictions for a medical reason, s/he must state what those medical reasons are.

Your physician can't just say no way my patient can do that. They have to give a medical reason why you can't do it and your physician needs to be specific. Any test results that confirm what your physician is saying should be included in the narrative report as well as examination results.

Once a decision is made, OWCP will notify both you and your employer. If OWCP determines the job is unsuitable, you and the employer will be notified. If OWCP determines your reasons are not valid, they will issue a letter stating the job offer is suitable and remains open. This letter will give you 15 days to accept or refuse the job.

If you do not accept the job offer before the end of the 15 day period, OWCP will issue a formal decision for abandonment of job or refusing suitable employment and terminate your benefits. This includes your compensation and medical benefits and your right to any future schedule award.

The 30 day notice and the 15 day notice from OWCP is proper notification known as your Maggie Moore rights. OWCP is required to send you both the 30 day and 15 day notices before it can terminate or reduce your benefits.

It is very risky to refuse a job offer OWCP has determined as suitable. If you refuse OWCP will terminate benefits and with the appeals process it could take from months to years to get your benefits restored.

Even if OWCP determines the job offer is suitable, your employer has policy and procedure regarding job offers and you should read those policies to make sure your employer is following them. You should carefully read your job offer contract. Some job offer contracts indicate they're based on your treating physician's restrictions. If your job offer states this and the restrictions are based on a physician other than your treating physician, make the employer change the job offer to comply with your physician's restrictions.

Some job offer contracts state it is your responsibility to stay within your restrictions. If you accept the offer, even if it is not within your restrictions, you do not have to perform duties or physical requirements if those duties are outside your restrictions.

Anything you request from your employer, such as modifying the job offer to remain within your treating physician's restrictions should be in writing and a copy should be sent to OWCP.

Because of your employment injuries or a combination of employment related and non-employment related injuries, you may also qualify under the Federal Rehabilitation Act of 1973. You can be injured at work and be covered under OWCP and ALSO qualify under the Federal Rehabilitation Act. The Federal Rehabilitation Act is the Americans with Disabilities Act for Federal employees.

If you do qualify under the Federal Rehabilitation Act, that Act supersedes OWCP. In other words the Federal Rehabilitation Act is more powerful than OWCP. Again, every request under the Federal Rehabilitation Act should be in writing to your employer with a copy to OWCP. If the Federal Rehabilitation Act applies to you, I highly suggest you read the Act to understand your rights. I've posted the link for the Federal Rehabilitation Act of 1973 on the "Links" page.

You can sign your job offer under protest and/or duress. As an example, if your job offer does not remain within your treating physician's restrictions, you can sign it under protest for violating your treating physician's restrictions. If you're going to sign your job offer under protest or under duress, you should put that in writing and give a copy to your employer and send a copy to OWCP. State that you will be accepting the offer under protest or duress and the reasons why. Make sure the letter is signed, dated and that you keep a copy for yourself.

In addition, when you sign the job offer under or near your signature, you should write that you're signing under protest or under duress and the reason why.  This way, you've got a letter to both your employer and OWCP and the job offer contract also states you're signing under protest.

You only get one body in this life and the last thing you want to do is re-injure yourself or end up with new injuries because of an unsuitable job offer. When you put everything in writing, you have evidence to work with later if you need to appeal or fight a bad decision. The bottom line is, do not do anything your physician has declared you cannot do. It is your responsibility to stay within your physical restrictions both at work and at home. Your agency cannot force you outside your medical restrictions, if they attempt it, you should file the appropriate grievance or EEO complaint.

I've posted several ECAB decisions regarding job offers, including Maggie Moore rights, suitability, temporary, physical requirements and relocation. You can find these decisions under Job Offers on the "Useful Stuff" page.

Changes have been made to the FECA Manual regarding Job Offers here's the link to the new article:
http://theowcpclassroom.blogspot.com/2014/04/revisions-to-feca-manual-part-1-of-2.html