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Sunday, March 4, 2012

Statement of Accepted Facts, (SOAF)


OWCP is not a game. Unfortunately for Claimant’s, no one told OWCP. So if you want to conquer the OWCP system, you need to treat it like a game. When OWCP makes a move, you make a counter move. If you know what’s required of OWCP (the ‘Rules’ of the game), you can make sure you get documentation into your file so that if OWCP doesn’t follow its own rules and regulations, not only can you bring that up, but you’ve got documentation in your file that is accurate and outweighs theirs.


One of the places you can anticipate is the SOAF. At some point in the life of your claim, an SOAF will be prepared. That’s a fact. So if we know that, why not get your own version of your SOAF into your file?
When you’re sent to an OWCP-directed examination, the physician is given the SOAF with your medical records. The SOAF is the ONLY framework the physician is supposed to use as the SOAF is exactly that, the facts that are accepted in your claim. If the OWCP physician goes outside what’s in the SOAF, you can use that to get the report thrown out.
The SOAF is required to contain specific information, a topic I’ve covered before, and these requirements can be found in the FECA Manual part two at 2-0809. Here’s the link: 

http://www.dol.gov/owcp/dfec/regs/compliance/DFECfolio/FECA-PT2/group3.htm#20809 
First and foremost, if an OWCP-directed physician agrees with your physician, in other words the report is in your favor, even if the report is flawed, inaccurate or basically the only correct information is your name, you DO NOT want to bring this up to OWCP as they’ll go back to the physician for clarification which could end up with a report that is now against you or they’ll just send you out to another OWCP physician to do another report. My theory is, that’s their problem not yours. You’ve got enough to deal with, why go after what is essentially in your favor even if it is an inaccurate waste of paper?
Here’s another thing. Let’s say you’re sent to an OWCP-directed exam and the report is in your favor but your SOAF is flawed. You DO NOT want to bring this to your CE’s attention either. Why? Because sooner or later you’ll be sent to another OWCP-directed exam and CE’s for the most part will just slap on a new date and a couple of updates and send the SOAF out again. If it was flawed before, it will more than likely be flawed the next time. You go into the next OWCP-directed exam knowing the SOAF is flawed and you already have a weapon against the report if it goes against you.
In most claims, the treating physician never sees your SOAF. So your physician has more leeway than an OWCP-directed physician because they can go outside the framework of the SOAF. Why not use that to your advantage?
The bottom line is if your SOAF is inaccurate or missing information, this is the basis to get your second opinion or Independent Medical Evaluation, (IME or Referee physician) thrown out. An inaccurate SOAF equals an inaccurate medical report. If there are other flaws in the medical report (and there usually are), this is an excellent one two punch for the Claimant.
For example, let’s say that you have accepted conditions on two (or more) separate claims. It’s common for OWCP to conveniently forget to mention one of the claims and/or accepted conditions. If only one claim is mentioned in your SOAF, then your SOAF is not accurate and this can be brought up to fight the medical report. If all the accepted conditions aren’t listed, the SOAF is not accurate.

Here's a couple of ECAB decisions that were ordered back to OWCP to combine the cases:
http://www.dol.gov/ecab/decisions/2012/Jan/11-0779_O.htm
http://www.dol.gov/ecab/decisions/2012/Jan/11-1208_O.htm
You may have medical conditions that cover more than one part of the body. For instance, you may have an accepted orthopedic condition and an accepted mental condition. If OWCP sends you to an Orthopedist and your SOAF only lists the orthopedic conditions, the SOAF is still not accurate. Why? Because you’re a whole person, you are not a list of broken parts.
By the same token, if an Orthopedist discusses your mental conditions and doesn’t have the medical degree to do so, then the Orthopedist isn’t qualified to determine residual effects of your mental condition(s) are they?
In this example, OWCP would be required to send you to an Orthopedist and a Psychiatrist.
Also, mental conditions require a different set of requirements in your SOAF, such as accepted employment factors. Again, this information is readily available in the FECA Manuals.
Some positions require a physical examination prior to being hired. If this is the case, you should request (in writing) a copy of your personnel file from your Agency. This file should contain a copy of the physical examination and should prove that you were in good health prior to beginning your employment since we know you weren’t hired if you were already busted up.
Your physician can discuss the results of the entrance exam and include a copy with his/her report. Entrance physical exams are a great tool to show your good health when you began your employment and in some cases show the extreme nature of your medical conditions by comparing your current test/exam results with the entrance exam results. This is especially true if you’ve been Federally employed for decades…young and spry going in, not so much after on the job injuries.
One item usually lacking on your SOAF is a description of your physical duties. Most SOAF’s list the job title and a couple of physical activities, like Letter Carriers drive a Postal vehicle and deliver mail. Law Enforcement Officers, (LEO) arrest people and carry a firearm. An Assistant types. A nurse administers medication. Their descriptions hardly make known the actual physical duties of any given job.
So today, I’m giving you a couple of examples of how your physician should list your physical duties. The majority of people I deal with are Postal employees and LEOs, so here examples of physical duties for Letter Carriers and Law Enforcement Officers, (LEO). But this can be tailored to fit any job title at any Agency. Just list out what you do, what you lift, carry, etc...I’ve used these two descriptions many times with good results.
The accepted conditions should be listed with their corresponding ICD-9 Codes. You can type this out for your physician. If s/he puts it on his/her letterhead and/or includes it in his/her report it becomes part of your medical evidence to support your claim. This is best when used in conjunction with a medical narrative.
For newbies, in order to get your claim accepted, your physician needs to include a physical description of your job in a medical narrative.
For Letter Carriers:
Insert your name, date of birth 00/00/0000 began working for the United States Postal Service, (USPS) as a full time city letter carrier beginning 00/00/0000. S/he is right/left hand dominant.
Letter carriers are regularly required to lift and carry 10 pounds continuously and 70 pounds intermittently from floor to waist height or higher as often as required on a daily basis up to 8 hours per day and a maximum of 12 hours per day.
Simple grasping and fine manipulation are required up to 8 hours or more per day, driving, sitting, standing, walking up to 6 hours or more per day, twisting up to 4 hours per day, climbing, kneeling, bending, stooping, pushing, pulling, reaching above the shoulder up to 2 hours or more per day.
On average, letter carriers spend 1 ½-2 ½ hours per day in the office casing mail which requires continuous standing, twisting, turning and reaching above the shoulder. Mail is loaded into trays and/or tubs which can weigh as much as 35 pounds or more each. All office duties require continuous twisting, turning, bending, lifting and stooping.
Street duty may last up to 6 hours or much longer. Letter carriers work in all types of weather on terrain from concrete to sand to mud, from hilly to flat grounds, rugged rock filled paths or downtown street sidewalks. Letter carriers may be exposed to snow or ice covered terrain as well as rain soaked ground cover 8 hours or more per day. Street duties require constant bending, twisting, stooping lifting and climbing of stairs or hills. The job of a city letter carrier is physically demanding employment which exposes the letter carrier’s body to constant pressure upon feet and knees and upper and lower body.
If this applies, it should be included as well:
As a city letter carrier, insert your name worked walking routes and was required to carry a satchel weight 35 pounds or more on his/her right/left shoulder. This can be especially useful if you have a shoulder injury.
Frequent heavy lifting and carrying combined with constant twisting, turning, reaching, reaching above the shoulder, bending and stooping makes the physical requirements of a letter carrier more strenuous than those of the general population.
_______________________________________________________________________________
For our LEO example, we’ll use a Criminal Investigator with the Department of Homeland Security, (DHS). You should change the information to fit your job title/duties:
Insert your name has been employed by the Federal government as a Criminal Investigator for the past 15 years (15) with the Drug Enforcement Administration (DEA) and currently with the Department of Homeland Security, (DHS). S/he is ?? years old and right/left hand dominant.
If you had military service as well, a short statement should be included.
In addition to civilian service, insert your name served in the insert military branch which included a tour as insert military title deployed in combat operations insert where you were deployed. 
In the course of fifteen (15) years of Federal service, insert your name completed two rigorous law enforcement training academies. Insert your name completed basic special agent training at the DEA Academy in Quantico, Virginia. Insert your name also completed the Criminal Investigators Course at the Federal Law Enforcement Training Center in Glynco, Georgia. 
During his/her training, insert your name was required to complete extensive amounts of firearm training, including extensive use of shoulder fired weapons. S/he was also required to complete physical training, including distance running, sprints, obstacle courses, push-ups, sit-ups, weightlifting including bench pressing; defensive tactics that included strikes to the brachial plexus; boxing and grappling.
Some of insert your name required training included the vehicle pit maneuver which entailed motor vehicle collisions at approximately 30 miles per hour. These maneuvers were required both as driver and passenger. 
As a insert job title (Border Patrol Agent, Criminal Investigator, etc…) insert your name has been on numerous searches and arrest warrants. S/he has had to wrestle suspects on the ground, has had to tackle suspects, and navigated various obstacles, both on foot and in vehicles, in pursuit of subjects, inflicting great strain on his/her body.  Over the course of the last fifteen (15) years, insert your name participated in hundreds of operations and arrests, working in some of the nation’s most violent and dangerous communities. 
For LEOs, I suggest you include your three most physical incidents in your career, especially those that resulted in any injuries or any previous OWCP claims. For example having to tackle a suspect to the ground, an intense foot chase, a suspect that resisted arrest or if you’ve ever been shot at, etc…
The details should be short and state just the facts.
The job of a insert job title is physically demanding employment which exposed insert your name to constant pressure upon feet and knees and upper and lower body.
The physical requirements of a law enforcement officer are more strenuous than those of the general population.

8 comments:

  1. You may want to wash that Prozac down with some Mylanta.
    You stated:

    "Here’s another thing. Let’s say you’re sent to an OWCP-directed exam and the report is in your favor but your SOAF is flawed. You DO NOT want to bring this to your CE’s attention either."

    So you encourage people to omit whaever as long as it is in their favor. That is why claimant's have difficulty, unfortunately they are all painted with the same wide brush.

    and comments have to be approved by you. That is also one-sided. You don't agree with me so no-one can see your post. What a phoney.

    ReplyDelete
  2. Well, Mr. Anonymous I'd like to know what criteria you used to diagnose me. I'm going to continue to rant and give claimants every trick I know or learn to help them with OWCP and that includes the Claims Evaders, (CE's). I've got a suggestion for you, remove my site from your Favorites bar and quit reading me if I upset you so much. It's pretty simple...you don't like it...don't read it. And by the way, I love the irony of you calling me a phoney, Mr. Anonymous.

    ReplyDelete
  3. any suggestions on how to get soaf corrected? Been 10 years still can't get owcp to correct injuries from ca2.

    ReplyDelete
  4. An SOAF is normally used for an OWCP physician. If it is in error, OWCP should be notified of the errors and a corrected copy should be made.

    If the accepted conditions do not match the diagnosis, a medical narrative from the claimant's physician is needed to connect the diagnosis to the required work.

    ReplyDelete
  5. If the SOAF is incorrect, and the OWCP exam is not favorable. Do you any have any suggestions on how to get soaf corrected? Been 10 years still can't get owcp to correct injuries from ca2. Now going to referee- SOAF was requested prior to exam was not received any recourse? Referee exam not favorable.

    Thank you for all of this information, put into an easily unstandable format!

    ReplyDelete
  6. To correct the SOAF, the claimant should put the errors in writing and send it to the CE. The claimant should give the CE a time limit (30 days) to respond.

    If you go to: http://theowcpclassroom.freeforums.org/test-forum-1-f2.html

    we can discuss the issue

    ReplyDelete
    Replies
    1. Thanks, the 2nd opin was not in my favor, a referee exam has been made. Is now the time to submit errors in 2nd opin exam? Or should I wait till referee exam is done?

      Delete
  7. I would do it now. That way your file has something in writing before the referee appointment.

    ReplyDelete