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.


  1. I hear you Jesse. It's so convenient that Mr. Steiber, or whatever his name was, and Mr. OIG, whoever he is, conveniently omit this tad bit of information from the Oversight Committee.

    They're all nothing but a bunch of chislers, not the injured federal employees. It just makes me sick.

    I really enjoy this website and it's filled with so much useful info. Thank you.

  2. Jesse-
    This is the type of news that needs to get out there. Just what you posted to the big newspapers, the director of OWCP and the legislators looking to reform OWCP.