Friday, November 13, 2015

October ECAB Decisions

The ECAB decisions for the month of October have been posted and I noticed something of concern.

Not all that long ago, some of the judges at the ECAB changed.

When the ECAB issues a decision they either affirm OWCP's decision which means they agree with OWCP and agree that the decision OWCP issued was correct. In other words, the claimant has lost their ECAB appeal.

They can remand OWCP's decision which means that something was wrong with OWCP's decision and the Board is sending it back to OWCP to correct whatever it is that the Board determined was wrong. Once OWCP has done that, OWCP issues a new decision.

A case can be remanded back to OWCP for a lot of different reasons such as OWCP didn't consider all the evidence, there's an outstanding medical conflict, a claimant has multiple claims that weren't combined, the case requires further development, etc... With a remand, the claimant hasn't lost, but hasn't won yet either because OWCP will be issuing a new decision.

Or the ECAB can reverse OWCP's decision. This means OWCP's decision was not correct or was inaccurate and the Board reverses it. This is a full-blown win for the claimant.

138 decisions are posted for October 2015. Of those, 27 were remanded back to OWCP. 111 were affirmed and ZERO were reversed.

Only 27 of the 138 were remanded and none were reversed. 111 were affirmed which is a pretty high percentage. Not a single claimant won their appeal in front of the ECAB in October. Not one.

I've been doing this a long time and I have never seen a month of ECAB decisions where there wasn't at least one reversal. I find this extremely concerning since this means the ECAB didn't find a single case where OWCP issued an inaccurate decision and I find that very hard to believe.


Wednesday, November 4, 2015

Schedule Awards-New Lie

In the latest liar, liar pants on fire files, OWCP is telling claimants in certain situations that they have no claim to a schedule award. I’ve been hearing this story more and more lately.

Claimants entitled to a schedule award are filing their CA-7’s and impairment ratings only to get a letter from OWCP which states the claimant is not entitled to a schedule award because they have not reached Maximum Medical Improvement, (MMI) because they are not working and they are receiving OWCP wage-loss compensation.

This letter states that a schedule award cannot be paid concurrently with wage-loss compensation or if the claimant is still receiving treatment. The letter ends by telling the claimant no further action will be taken to process their schedule award.

While it is true that a claimant cannot receive payment for wage-loss compensation and a schedule award at the same time (concurrently), a claimant can be at MMI and file for and receive a schedule award if they are not working and are still receiving treatment.

OWCP regulations indicate that if a claimant is not working and is receiving wage-loss compensation, the wage-loss compensation will be suspended while the schedule award pays out and when the schedule award is paid, the wage-loss compensation will be resumed.

Personally, I believe this is just the latest tactic of lying to claimants so that claimants will give up on their schedule awards. If you receive this letter, know that this information is not true.

These are the regulations that should be brought to OWCP’s attention should you receive this letter. I’ve written them below in letter form so that if necessary, you can copy and paste into your letter to OWCP.

If you have to write this letter to OWCP bringing the regulations to their attention, you should also ask for written confirmation that OWCP is in fact going to properly process your schedule award.

These are the regulations that apply:

There is no provision under the Act that hinders a claim for a schedule award if a claimant still requires treatment for their injuries. A claimant can be rated for permanent impairment on the current findings. The FECA manual states:

“A schedule award may be payable based on contemporaneous medical evidence of record showing a peak or plateau in the claimant's recovery status, even if the claimant's condition is likely to deteriorate. Payment of an increased award based on additional impairment may be considered at a later date.” See FECA manual part three at 3-0700-3(b).

There is no provision under the Act that indicates a claimant is required to be released back to work in order to claim a schedule award. In point of fact, the FECA manual states:
“If payment for TTD is interrupted to pay a schedule award, such TTD payments must be resumed at the end of the schedule if the claimant has not been reemployed or rated for LWEC at the time the award ends. See FECA manual part two at 2-0808-7(5) and Goldie Washington, 31 ECAB 239 (1979).

A schedule award is not payable concurrently with wage-loss compensation, however a schedule award is payable consecutively with wage-loss compensation. The FECA manual states:

“A schedule award is payable consecutively but not concurrently with an award for wage loss for disability for the same injury. See FECA manual part two at 2-0808-4(3). 


Tuesday, October 6, 2015

Filing A Schedule Award

I get contacted a lot by claimants who want information about how to file for a schedule award.

Most of these claimants have already hired someone who is going to take a percentage of the schedule award to “help” them but even after hiring them, they’re having trouble getting the answers they need.

Anyone who has read me, emailed me or talked to me knows how much I hate this practice. So once again let me stress the fact that an attorney or representative is not allowed under the Act to take a percentage of a schedule award or a percentage of anything related to your OWCP claim.

A contingency fee or a percentage is not allowed under OWCP for any reason.

Should you be looking for an attorney or representative to hire for any reason and they offer to relieve you of a percentage of your compensation or schedule award-that’s a clue that the attorney or representative isn’t on the up and up and doesn’t play by the rules. That might be a clue that maybe they’re not the right attorney or representative for you.

Even if you’ve signed a contract agreeing to a percentage, you do not have to abide by that contract since a percentage is not allowed under the Act.

Another thing that really bothers me about this is that the attorney or representative who is taking a percentage of a schedule award isn’t doing any work to receive that percentage.

It is actually simple to file for a schedule award by yourself. You only need two things:

One is an impairment rating under the 6th Edition of the Guides to Permanent Impairment.

A physician does this, so the attorney or representative has nothing to do with the impairment rating. They don’t do ANY work on the impairment rating…the physician does.

The second thing you need is a CA-7 with the portions relating to a schedule award completed.

Again, an attorney or representative doesn’t do ANY work for this. You can easily complete your name, address, claim number, date of injury, etc…You don’t need to pay someone thousands, sometimes tens of thousands of dollars to complete a few sections of a CA-7.

If you are still employed by your agency, you submit the CA-7 to your agency and the employer’s section is completed by the agency (remember to get a signed copy).

If you are not employed by your agency, you send the completed CA-7 to OWCP along with your impairment rating.

That’s it! That’s all there is to filing for a schedule award.

I get contacted all the time if a claimant has a question about completing the CA-7. I’m sure some of those people are reading this now. I’ve never charged anyone to help them complete a CA-7 for a schedule award. That’s because it only takes about five minutes of my time.

Obviously, I’m not against being paid for the work we do, but I am against those who illegally take a percentage of a claimant’s schedule award and/or compensation and make a really good living at it while claimants struggle with financial hardship.

If OWCP denies the schedule award or reduces the percentage, there are options and even if you need or want to hire help, you still should not pay a percentage of your schedule award.

I would love to see a trend where claimants file their own schedule award paperwork and keep the payout for themselves. After all, the claimant is the one with the permanent impairment they’ll have to live with, why should attorneys or representatives get a percentage of what is rightfully the claimant’s especially when they do nothing to ‘earn’ that illegal percentage?

Jesse Slade: owcpslayer@gmail.com

Wednesday, September 30, 2015

ICD-10 Codes

ICD-10 codes go into effect on 10/01/2015. OWCP will no longer accept ICD-9 codes for diagnoses. All diagnoses now need to include an ICD-10 code.

Monday, September 21, 2015

Team Work Ready

According to the Department of Justice, after an investigation by the USPS Office of Inspector General, The Department of Labor Office of Inspector General, Department of Veterans Affairs Office of Inspector General, Department of Homeland Security Office of Inspector General and IRS Criminal Investigations, Team Work Ready, a Houston, TX based company is the latest to be charged in a conspiracy involving health care fraud, money laundering and OWCP.
On June 30, 2015 a 20-count indictment was unsealed alleging that between January 2011 and June 2015, Team Work Ready submitted at least $6,787,058.00 in false and fraudulent claims to OWCP and received $5,656,778.00 in payment for those claims.
The indictment also alleges that Jeffrey Rose the CEO and Pamela Rose the CFO conspired to conceal approximately $700,000.00 in payments from OWCP when federal search warrants were executed on Team Work Ready clinics in July 2013.
Those indicted allegedly submitted claims for one-on-one physical therapy when patients were playing Nintendo Wii™, sitting in electronic massage chairs, playing water volleyball and/or watching television. 
While Team Work Ready advertises their facilities provide treatment rooms with state-of-the-art equipment designed for effective results with all therapeutic services performed and supervised on site by certified and licensed medical professionals, it would appear by this indictment that wasn't the case. 
The indictment also alleges the defendants received payments for sending patients to physicians and providers of diagnostic services.
Those currently indicted include Jeffrey Rose the CEO, Pamela Rose the CFO, Hugo Jaime the rehabilitation director and Frankie Sanders the vice president of operations.
Team Work Ready claimed it was a full-service clinic specializing in work-related injuries with 10 locations in five States including Texas and New Orleans and advertised they are a full-service multi-specialty clinic specializing in work-related injury, rehabilitation and therapeutic services for injured state and federal employees.
Team Work Ready continues to have an active Facebook page, but it appears their website has gone off line.
Once again, those that take advantage of injured workers are being paid exorbitant amounts of money while claimants suffer the consequences of being under the stigma of providers who allegedly falsified their bills.

Jesse can be reached at: owcpslayer@gmail.com

Wednesday, September 16, 2015

Tuesday, September 1, 2015

Lenin "Lenny" Perez

It never seems to end...

As if being harassed by OWCP or the agency you worked for, as if being hurt on the job or having to constantly prove your injuries wasn’t enough to deal with, now the people who claim to be on your side to help you are also taking advantage.

It’s no secret how I feel about attorneys and representatives who advertise their willingness to help claimants, but actually don't. Sure, there are some good ones out there, but more and more I’m hearing about how these same people are abusing claimants too.

It’s becoming common for attorneys and representatives to charge a claimant a percentage of their schedule award, even though OWCP does not allow that. They get away with it because claimants don’t know it’s not allowed.

This bothers me. First because it’s the claimant that was hurt, it’s the claimant that has a permanent impairment they have to live with and it’s the claimant that’s entitled to their schedule award money. For an attorney or representative to take a chunk of that just seems wrong to me.

Second, schedule awards aren’t that hard. The doctor does the impairment rating, so an attorney or representative doesn’t have to do any work there-the doctor does. The CA-7 is easy enough to complete. For a schedule award, the CA-7 is just a couple of sections. The attorney or representative isn’t working hard on that either. If they complete it for a claimant, it shouldn’t take more than 10 minutes of their day.

OWCP could deny the schedule award and the attorney or representative may have to appeal. Yes, this would make them have to work. But other claimant’s without schedule awards require appeals too, do the attorneys and representatives charge tens of thousands of dollars for those appeals? No. If they did, they’d be out of business.

So what justifies taking a percentage from 10%-30% of a claimant’s schedule award that can end up to be tens of thousands of dollars in the attorney’s or representative’s pocket for the same appeal? Why should a claimant with a schedule award have to pay so much more?

If you’re reading this, please understand that there are other attorneys, representatives and advocates that can help you without taking a percentage of your schedule award.

Which brings me to Lenin "Lenny" Perez. Mr. Perez and his company claim they are advocates for injured employees. Which would lead a person to believe they’re on the injured worker’s side. It’s true they charge a reasonable monthly fee, but they also take a percentage (10%) of a claimant’s schedule award.

In addition, Mr. Perez has now been arrested for a SECOND time for allegedly taking 15%-20% kickbacks for his referrals of injured workers to specific doctors/clinics. This time it’s being reported that Mr. Perez made more than $250,000.00 from these kickbacks.

Their website claims Mr. Perez is the leading consultant/advocate in the field. You’d think the leading consultant/advocate would at least know what is and isn’t legal especially when he was arrested for the same thing, plead guilty in 2006 and did jail time.

You’d think the leading consultant/advocate would know OWCP doesn’t allow him or his firm to take a percentage of a claimant’s schedule award.

You'd think the leading consultant/advocate would have a better win record.

You'd think the leading consultant/advocate wouldn't risk tarnishing claimants by association.

Sometimes a claimant needs help with their claim. If you do, my advice is to make sure the person you hire is not only on YOUR side but conducts their business in an ethical way. To know that they will fight for you and not just cash your checks.

And anyone who wants a percentage of your schedule award is outside the regulations of OWCP. If they’re willing to go outside the regulations on your schedule award, what else might they do that isn’t in your best interest?

Update: on 10/18/2016 Mr. Perez died at the Pinellas County jail while awaiting sentencing.

From the Tampa Tribune:

Appeal of Mr. Perez’ first sentence:


Monday, August 3, 2015

OUTRAGE-OWCP's "Special" Provisions for the DEA's Confidential Informants

While legitimately injured workers have to fight to receive benefits, the Drug Enforcement Agency, (DEA) is supplying benefits under the Federal Employees’ Compensation Act, (FECA) to its confidential informants.

In a report by the Office of Inspector General, (OIG) released in July 2015, they learned that the DEA paid at least 17 confidential sources or their dependents FECA benefits totaling $1.034 million dollars. However, this amount is not accurate which can be determined just by reading OIG's report.

The recipients of these FECA benefits did not have to prove their “claims” with OWCP or even prove they were eligible for the benefits or fight for benefits the same way you, the injured worker have had to do. They did not have to provide OWCP with any proof they were entitled to FECA benefits the way you have had to do. 

This is because OWCP has a “special” method for processing and administering these cases.

The following are portions taken directly from the OIG’s report on its findings. While you read this, consider WHO works for the DEA as a confidential informant. While you read this, consider that these informants will never have to prove their claim, will never have to attend an OWCP-directed examination and will never face a proposed termination, will never have to provide OWCP with any report of earnings, will never have to provide OWCP ANY the proof you have had to provide:

Between July 1, 2013, and June 30, 2014, it appears that the DEA paid approximately $1,034,000 for FECA benefits to 17 confidential sources or their dependents. In some cases, the DEA has been paying FECA benefits since 1974, but we could not determine the total historical cost because the DEA and DOL do not track payments to confidential sources receiving FECA benefits.

In one particular case we reviewed, the confidential source was killed in July 1989 and his surviving family, which included a widow and dependents, began receiving FECA payments of $4,287 every 4 weeks. At the time of her death in 2012, the widow’s 4-week payment amount had increased to $6,311. Therefore, this family alone received over $1.3 million in FECA benefits since 1989.

As authority for the proposition that confidential sources may be categorized as non-federal law enforcement officers, the Personnel Manual cites Section 886 of 21 U.S.C. However, 21 U.S.C. § 886 merely discusses, among other things, the Attorney General’s authority to pay confidential sources from DEA funds; it has no relationship to FECA nor does it characterize confidential sources as non-federal law enforcement officers for any purpose.

Although FECA does, in some instances, extend availability for benefits to eligible law enforcement officers not employed by the United States, 5 U.S.C. § 8191, the implementing regulation defines eligible non-federal law enforcement officers only as law enforcement officers of state or local governments or governments of U.S. possessions and territories, and certain officers eligible for pensions under the D.C. Policemen and Firemen's Retirement and Disability Act. Confidential sources are none of these. 

We also found that a number of key DEA offices lacked knowledge about its confidential source FECA activities and expenditures. For example, DEA officials with whom we spoke from the Office of Human Resources and the Office of Operations Management, in particular officials from the Confidential Source Unit were all unaware that confidential sources were receiving FECA benefits. After numerous attempts and coordinating with entities external to the DEA, we identified two people in DEA’s Office of Safety and Worker’s Compensation who were aware that confidential sources were receiving FECA benefits.

These DEA officials stated that the DEA does not keep any files for these FECA cases and relies solely on DOL to administer and oversee the cases. These individuals elaborated that there is almost no review of these FECA cases by any DEA headquarters officials.

We were told that the field office staff forwards these cases to DEA’s Office of Safety and Worker’s Compensation, which reviews the forms only for clerical errors and then submits them to DOL. According to these DEA officials, after the DEA forwards the FECA case to DOL, neither the DEA field office nor headquarters is notified of DOL’s acceptance or denial of the case or any other interaction between DOL and the claimant.
A DOL Office of Workers Compensation Programs (OWCP) official stated that DOL does not follow normal procedures for processing the DEA’s confidential source FECA cases. This lead DOL official, who is currently responsible for handling these DEA cases, stated that DOL identifies these FECA cases as “secure” cases and does not perform an in-depth review of these FECA applications.

Further, DOL does not process any related claims through its electronic system and instead uses a labor intensive manual process that requires a very small staff to complete the review process, maintain hard copy files, and oversee the payment transactions for all “secure” files.

According to this DOL official, DOL established this structure a long time ago to accommodate the DEA’s concerns regarding the sensitivity of confidential source FECA cases. We requested documentation to substantiate this statement, but neither the DOL official nor the DEA were able to provide any information to the OIG.

We discussed confidential source eligibility with DEA and DOL officials and neither agency accepted responsibility for determining whether DEA confidential source FECA applicants met the criteria.

Officials from the DEA’s Office of Safety and Worker’s Compensation stated that DOL is responsible for determining who is eligible for FECA benefits, while the DOL official who currently manages the DEA’s confidential source FECA files stated that DOL has relied upon the DEA for the underlying determination of whether confidential sources are eligible to receive FECA benefits in accordance with the special procedure that it adopted to address DEA’s concerns about the sensitivity of confidential source cases.

DOL’s Division of Federal Employees’ Compensation clarified that DOL is the agency that determines FECA eligibility, but reiterated that, once the employing agency has identified the injured individual as a confidential source, DOL considers the definition of “employee” to have been satisfied for purposes of providing workers’ compensation benefits.

DOL relies on DEA and performs no independent analysis to test “employee” status. In addition, when we discussed with the Criminal Division’s Deputy Assistant Attorney General the provision of FECA benefits to DEA confidential sources, he stated that he was unaware that this was occurring. However, he indicated that if the DEA is providing FECA benefits to its confidential sources, then a prosecutor needs to know this information because it creates a financial relationship (potentially a dependent one) between the DEA and the confidential source. 

Based upon this DOJ official being unaware of the DEA’s FECA activities related to confidential sources as well as the fact that relevant DEA officials were also generally unaware of confidential sources receiving FECA benefits, it appears that the DEA has not evaluated, or asked the Department to evaluate, how a determination that confidential sources could qualify as civil employees and receive FECA benefits might either increase the disclosure obligations of federal prosecutors in criminal cases or impact other Department equities.

In multiple cases, we could not verify or validate that DEA confidential sources were receiving FECA benefits for claims involving injuries or deaths that happened while the confidential sources were performing services directly for the DEA because the file contained insufficient information regarding the triggering event to make that determination.

In fact, in one of the FECA cases that we reviewed, the FECA application included a statement from a DEA official indicating that the injury sustained by the confidential source was possibly due to the source’s carelessness and that at the time of the injury the confidential source was not being directed by DEA personnel.

The following are some other examples of these types of cases.

· The DEA submitted and DOL accepted a claim for a DEA confidential source who was shot and injured in 1984, but there is no indication of where and how the shooting occurred. In addition, a document in the file indicates that the confidential source “claimed” that a narcotics trafficker committed the act. We could not find any information in the file that would support that DEA officials were present when the source was injured, how they confirmed the source’s claim to have been shot by a narcotics trafficker, or the basis for believing that the shooting resulted from the source’s cooperation with DEA.

· The DEA submitted and DOL accepted a claim for a confidential source who was presumably killed overseas in 1991. However, according to the file, there were no witnesses to the confidential source’s death and the source’s body had not been recovered. The file contained no details describing how or why the DEA believed that the source was killed as a result of cooperation with the DEA.

· The DEA submitted and DOL accepted a claim for a confidential source who was shot and injured while traveling to work in 1997. This incident occurred 1 day after the DEA activated the individual as a confidential source. Further, DOL’s FECA file clearly indicates that DEA officials stated that the source’s injury did not happen while performing DEA-related activities. The file also indicates that the DEA had evidence that the shooting was related to 29 the source’s involvement with the DEA, but this evidence is not recounted in the DOL file nor is there an indication that the evidence was verified.

· The DOL accepted a claim that was submitted by the DEA more than 2 years after a confidential source was shot and killed at home in 1999. According to the information in the file, no DEA officials were present when the incident occurred. There was no other information in the file to indicate that the shooting occurred as a result of the confidential source’s involvement with the DEA.

· The DEA submitted and DOL accepted a claim for a confidential source who was shot and injured at home in 2002. However, the file indicates that there were no witnesses to the shooting and the file contained no evidence of a link between the shooting and the individual’s status as a DEA source. Inconsistent Benefits Determination In addition to the absence of procedures for determining eligibility of DEA confidential sources for FECA benefits, we found that there were no formal standards or policies for determining the source’s “existing pay rate” at the time of the event.

According to DOL policy, when a recipient of FECA benefits does not receive a standard salary, DOL calculates FECA benefits using the average annual earnings for an individual who performed similar work in the previous year. Given that the services that confidential sources provide to the DEA are often irregular, sporadic, and unique in nature, the DEA’s confidential sources are not paid standard amounts and there is a wide range of payments provided to confidential sources while they are active with the DEA.

Therefore, in some of the FECA files we reviewed, DOL requested that the DEA provide additional information to establish the source’s “existing pay rate” at the time of the injury.
However, in general, we found that there was a lack of consistency in the determination of pay rates and the resulting compensation benefits determination. The following examples illustrate these inconsistencies.

· One case file indicated that a confidential source had been injured in 1994. According to the case file, the DEA provided information that the source had received approximately $10,868 in that year. DOL used that amount to establish the existing annual pay rate for the claimant. Because this amount was below DOL’s established minimum compensation amount, DOL used its minimum allowable amount in establishing the recurring FECA compensation benefits for the confidential source.

· One case file indicated that a cooperating witness was killed 2 days prior to the sentencing of defendants in a DEA-related drug case in 1990. This individual had not yet received any payments from the DEA at the time of the death, but the DEA later paid the surviving family member an award payment of $10,000. 

To determine the existing pay rate for the deceased, DOL asked the local DEA field office to provide payment totals for its three highest paid confidential sources in the year prior to confidential source’s death. The DEA provided the amounts ($174,000, $44,000, and $22,000) and recommended that the median amount be used to determine benefits. DOL agreed with the recommendation and determined the recurring FECA compensation benefit amount based upon the second highest paid DEA confidential source in the local area.

· As previously identified, the DEA filed a FECA claim for a confidential source who, 1 day after being activated as a confidential source, was shot and injured while traveling to work in 1997. Without a history of payments to this new confidential source, the DEA asked DOL to establish the source’s existing pay rate by using the federal government’s General Schedule (GS) pay rate for a GS-7 federal employee. DOL agreed and FECA benefits were determined based on the GS-7 pay rate.

· One case file indicated that a DEA confidential source was killed in 1991. DOL case files contain information from the DEA indicating that this source had received over $500,000 from the DEA in the prior 2 years. According to DOL, FECA benefits are capped at the maximum federal employee salary on the General Schedule, which equates to the annual pay rate for a GS-15, Step 10 employee. The file indicates that after reviewing the available information, the DOL determined that the surviving family members should receive the maximum benefit allowable, and the amount awarded at that time (1991) was $6,661 every 4 weeks.

In other files there was insufficient information related to the basis for the benefit amount. While in some cases it was clear that the responsible DEA field office was involved in the pay rate determination, there was little evidence to indicate that DEA headquarters personnel were providing any input or oversight in this area.

The purpose of FECA for injured workers is to compensate qualified individuals who are injured on the job during the time they cannot perform their duties. FECA regulations require agencies to provide assistance to injured individuals to return them to work as quickly as possible. When an employee is well enough that he or she can perform the duties that were performed prior to the injury, the individual should no longer receive FECA benefits.

· For one confidential source who was injured in 1997, our review of DEA’s confidential source file indicated that the DEA not only paid for this individual’s housing expenses, but also provided payments for information and an award payment of over $1 million between the date of his injury and 2012. At the same time, the individual was also receiving FECA disability benefits, which amounted to approximately $2,000 every 4 weeks. The source was deactivated in 2012 because he could no longer provide useful information. He last received a source payment from DEA in October 2012. Based on DEA and DOL documentation, we estimate that between 1997 and 2012, the DEA paid this individual a total of $2,186,813, comprised of $353,075 in FECA benefits and $1,833,738 in confidential source service and award payments.

· One confidential source was receiving full FECA disability benefits resulting from an incident that occurred during a March 1986 DEA operation. However, the DEA’s records indicate that the confidential source was deactivated in December 1985 and not reactivated until September 1996. DEA documentation also revealed that the DEA field office continued to pay this deactivated confidential source for information and services within months of submitting the FECA claim. One of the payments, in the amount of $1,000, was paid just 4 days after the purported injury for which the confidential source was deemed fully disabled and qualified for FECA benefits.

The DEA eventually reactivated this confidential source in 1996 and as of November 2014, this individual was still an active confidential source receiving DEA payments for cooperation as well as full FECA disability benefits. From our review of the DEA’s confidential source files and DOL’s FECA files it did not appear that the DEA had informed DOL of the individuals’ continued use and earning as a source, or that DEA was concerned about the individuals’ receiving dual benefits.

FECA policy requires individuals receiving compensation for partial or total disability to advise OWCP immediately of any return to work, either part-time or full-time. Individuals receiving FECA benefits are also required to submit an annual report of earnings from any employment. If an individual knowingly omits or understates his or her compensation, that individual forfeits their right to benefits.

As a result of DEA’s lack of substantive involvement and record keeping, as well as the atypical manual process DOL told us that it used for these cases at the request of DEA, we could not specifically determine how much money each recipient had been paid in FECA benefits or if the payments to the confidential sources or their families were ongoing.

In addition, neither the DEA nor DOL has accepted responsibility for judging the eligibility of FECA cases originating from confidential sources. We believe that confidential sources have been awarded FECA benefits without adequate review to verify that these individuals are legally entitled to benefits as described in the FECA statute and implementing regulations.

We believe that the absence of a thorough eligibility review significantly increases the risk that taxpayer dollars will be used inappropriately. It also appears that taxpayer dollars are at risk through the DEA’s existing inconsistent process for determining an established pay rate and compensation benefits for confidential sources seeking disability payments.
In some cases, FECA payment amounts were calculated based on arbitrarily selected amounts, wholly unrelated to amounts paid for any services provided by the confidential source.

The DEA’s poor oversight of its FECA activities relating to confidential sources has also resulted in the DEA inappropriately continuing to use and pay confidential sources who are receiving full disability payments through FECA and should be reporting all income to DOL.
The lack of DEA policies in this area means that Special Agents in the field are left unaware of the legal and financial implications of FECA cases. In fact, one DOL case file that we reviewed contained a statement from the DEA that: “there was a lack of prescribed procedures the DEA agents are to follow in such cases, and the Special Agent had limited understanding that ‘these employees’ are covered under the same ‘death insurance’.”

Read the full report: https://oig.justice.gov/reports/2015/a1528.pdf

I strongly urge any of you who have had to fight to get your OWCP benefits or fight to keep your OWCP benefits write you Congressperson and express your outrage at the ease in which the DEA’s confidential informants receive what could be life-time benefits they may not be entitled to.

Express your outrage and demand that Congress take an active role in the DEA's practice of providing full FECA benefits to people who do not have to abide by the same rules and regulations that you have to abide by.

If OWCP and the DEA will not supply the OIG with the actual facts and figures of these "special" claims, urge your Congressperson to demand the information be turned over to Congress.

Monday, June 22, 2015

Help For Those That Need It

Do you need help with your OWCP claim but just can’t afford the attorney or representative’s costly retainer and hourly rate? 

I can drastically minimize those fees by ghostwriting whatever you require, helping you with a strategy, review your documents and/or do the research for you to help you help yourself.

From a simple letter to an appeal, no job is too large or too small and my fees are a fraction of what you’ll be charged by an attorney or representative because I charge based on what you need. 

It doesn't matter if you need help with one issue or multiple issues, I can supply what you need to help you resolve your claim issues at a reasonable fee.

For those who cannot afford the high price of a full-service attorney or representative, contact OWCP advocate Jesse Slade for a more budget minded approach to help with your OWCP claim and get the help you need at an affordable price.

Jesse Slade is the alternative to high-priced attorneys and representatives. 

Contact Jesse at: owcpslayer@gmail.com

Thursday, March 26, 2015

Pain...In Your Report

Most physicians don't understand OWCP's requirements when writing a report for them. This is a topic we have discussed before.

Most physicians will write the reports they're used to writing. These reports work in just about any other system, so unless the physician understands OWCP, they believe the same report is good enough for OWCP.

As a lot of you know, this is not the case and a lot of times you, as the claimant must educate your physician on what OWCP requires from him or her. One of the biggest reasons I see for discounting your physician's report is the use of the word-PAIN.

Of course you have pain, you've been injured. Of course you tell your physician about your pain, s/he's your doctor. Of course your doctor is going to tell OWCP about your pain. Your doctor might say you can't work because of the pain. The problem is, OWCP has determined pain is a symptom. As far as OWCP is concerned, your pain is your problem not theirs.

OWCP will not accept claims where your physician only discusses your pain, even if there's a diagnosis. OWCP will not accept pain as a reason for not working. OWCP will not accept pain as a reason because your pain is your problem...it's a Symptom not a medical diagnosis.

The Employees Compensation Appeals Board, (ECAB or the Board) backs OWCP on this topic which means OWCP has every right to deny your claim based on a report that revolves around pain.

Your physician can certainly discuss your pain, but more important is for the physician to discuss the source of your pain. Where the pain is coming from. What is causing your pain. Why you have pain.

In most cases, this is not difficult to do, most claimant's know where their pain is coming from, what's causing the pain, so it isn't difficult for a physician to relate why you have pain (again-in most cases). It's just that the physician doesn't know that's what OWCP requires.

Too many claimants are having a difficult time finding and keeping physicians that are willing to deal with OWCP's stringent requirements. Many physicians become frustrated with OWCP. Many quit or say they'll never take another OWCP claimant.

Claimants need to keep the physicians they've got. So help your physician by letting them know what OWCP requires.

This is especially important when it comes to the requirements of medical reports, so let your physician know that while s/he can discuss pain, it's important to let OWCP know where the pain is coming from. What is causing your pain. Why do you have pain. What is the diagnosis that causes your pain.

For more on medical report requirements, see these articles:


Thursday, February 26, 2015

Calculating A Schedule Award

You've had your impairment rating, submitted your rating and your CA-7 and OWCP has approved your percentage of loss...so how much will your schedule award pay you?

First, use the chart below to determine the maximum number of weeks allowed for the impaired body part. 

Schedule awards are paid at your compensation rate of either 66 2/3% (no dependents) or 75% (with dependents). 

To calculate the schedule award payment, multiply your actual percentage of impairment of the affected body part by the maximum number of weeks from the chart below. This will determine the number of weeks you're entitled to.

Then multiply the number of weeks you're entitled to by your weekly pay rate and multiply that result by your compensation rate of either 66 2/3% (no dependents) or 75% (dependents). This will give you the approximate amount of your schedule award.


In this example there is a 10% impairment rating of the hand with a 75% compensation rate and a weekly pay rate of $500.00:

10% (your actual percentage of impairment) X 244 weeks (100% loss of use of the hand) = 24.4 weeks

24.4 weeks X $500.00 (weekly pay rate) X 75% (compensation rate) = $7,320.00

In this example there is a 15% impairment rating of the arm with a 66 2/3% compensation rate and a weekly pay rate of $500.00:

15% (your actual percentage of impairment) X 312 weeks (100% loss of use of the arm) = 46.8 weeks

46.8 weeks X $500.00 (weekly pay rate) X 66 2/3% (compensation rate) = $15,600.00

*When the compensation rate is 66 2/3% multiply the compensation rate by 66.666666667%


  • Arm 312 weeks
  • Leg 288 weeks
  • Eye 160 weeks
  • Hearing (one ear) 52 weeks
  • Hearing (both ears) 200 weeks
  • Hand 244 weeks
  • Thumb 75 weeks
  • 1st Finger 46 weeks
  • 2nd Finger 30 weeks
  • 3rd Finger (ring finger) 25 weeks
  • 4th Finger (pinky finger) 15 weeks
  • Foot 205 weeks
  • Great Toe 38 weeks
  • Toe (other than great toe) 16 weeks
  • Vulva-Vagina-Uterus-Cervix 205 weeks
  • Breast 52 weeks
  • Ovary (includes Fallopian tubes) 52 weeks
  • Penis 205 weeks
  • Testicle 52 weeks
  • Larynx-Tongue 160 weeks
  • Kidney 156 weeks
  • Lung 156 weeks
  • Skin 205 weeks

Even if your accepted injuries are not on this list, you may still be entitled to a schedule award if the accepted injury caused impairment to a covered body part. For instance if you have a spinal injury which is not a covered member, you may have nerve damage caused by the spinal injury that affects your arm(s) and/or leg(s). The nerve damage could entitle you to a schedule award under the hand, fingers, arm, leg, foot and/or toes. The same would be true for a brain injury or other body parts that are not covered for a schedule award. 

You may not collect both a schedule award and OWCP compensation at the same time if the compensation and the schedule award are for the same body part and/or extremity. For example if you are collecting OWCP compensation due to a right shoulder injury you cannot collect a schedule award for an impairment to the right hand since it is the same extremity-the right arm. 

In this case, OWCP will suspend (stop) compensation until the schedule award is paid and then compensation will resume.

Your actual schedule award payment may vary slightly but this method gives you an idea of what payment to expect from your schedule award.

Thursday, February 5, 2015

Representative Rant

While I was doing some research, I stumbled onto a website by accident. Normally, if this happens I just go back to my research but something about the material I was reading on this website caught my attention. Imagine my surprise when a couple of paragraphs in I realized I was reading my own work!

Turned out a husband and wife (who I will call Mr. and Mrs. X out of Dallas, Texas) who are in business representing claimants with their OWCP claims had stolen articles from this blog and were pawning them off as their own work. Their website even claims their material is copyrighted which is ironic since at least some of their articles were stolen from me over a year ago. I shouldn't have been surprised since it turns out Mr. X, the one who is identified as the person who posted the articles, states he is a retired claims examiner.

After reading through all ten articles posted on the website, it became clear that they stole my material for half their posted articles in their attempt to get your business. 

I immediately sent an email to them and demanded they remove the material they stole from this blog.

Over the next two days I went back and forth with Mrs. X. In response to my demand to remove my material from their website, the first email I received stated; “Would you kindly advise me what material you are talking about and I will remove immediately.” This is a telling statement. Had I received this demand I would have told the person where to go since I know with certainty I have written all of my own material with the exception of one guest article. Yet Mrs. X was quick to state as soon as I identified the material it would be removed.

Then, in typical claims examiner fashion, the opinion reversed itself. I received an email that stated in part; Mr. X “nor myself have ever knowingly stolen material from any website.” Which I again found ironic since half their articles were stolen from this blog and were nearly word-for-word what I’d written years before they posted it to their website.

If they didn't knowingly steal my work, where did it come from? Did it just appear by magic on their website? Did internet fairies put it there when Mr. and Mrs. X weren't looking? Are they saying they don’t know what is posted to their website or that it might be stolen? Are they saying they’re not aware of who posts on their website? Are they saying it was a mistake that Mr. X took credit for posting the articles? 

And if they've never “knowingly” stolen from another website, why was the first response that they would remove the material? Ultimately, what is posted on a business website is the responsibility of the business owner and most business websites have a limited number of people who can post written material without the business owner’s knowledge. Obviously, I didn't believe Mrs. X.

The new email also stated I would need to provide comparisons of all the material I believed was "close" in content to mine. Since most of what they had stolen was word-for-word, cut and pasted, obviously we weren't talking "close" in content, we were talking blatantly plagiarized.

I wasted my time in preparing a side-by-side comparison of my article regarding medical narratives which I posted July 29, 2011 and their article which claimed to be posted by Mr. X on January 21, 2014. I sent this side-by-side comparison and also listed four other articles that were obviously stolen from me, but wasn't going to waste more time doing more side-by-side comparisons for them.

In response to the side-by-side comparison, I received an email which states; “The specific article you have sent by attachment will be removed within 48 hours.” It would appear that I proved my article was in fact plagiarized and posted to their website, otherwise why would they remove it?

After some more back and forth with Mrs. X, I received an email that stated; “I have requested that our website designer remove all articles for re-write.” Re-write? They certainly didn't write five of the articles in the first place...I did. Interesting, since I alerted them that five of their ten articles were stolen from me, why would they remove all of their articles? Makes me wonder where the other five came from. And they did remove them. As of February 05, 2015 the entire ‘article’ section disappeared from their website. But the damage was already done. How much revenue was generated for them by using material plagiarized from me?

When I made my displeasure known to Mrs. X and told her I would be blogging about the incident, the final email I received stated; “I would suggest that before you proceed to attempt to hurt our business, you carefully consider repercussions.”

Excuse me? Typical claims examiner thinking. They steal my work and claim it for their own, generate revenue for themselves by using my work, get caught in their lies and are now concerned I might harm their business? Apparently they didn't consider the harm they did to my business or the repercussions by using my material to advance their income and increase their business using my stolen material for more than a year.

Obviously, they don’t know me very well…because like any claims examiner, retired or not, their little threat didn't faze me, I had truth on my side and as proof of that, you’re now reading the article I said I’d write.

You'd think as a 'retired' claims examiner Mr. X would be knowledgeable enough to compose and write his own articles and wouldn't have to plagiarize them from me or anyone else. At the very least you’d think Mr. and Mrs. X would know where their articles came from if they didn't write them on their own. Makes me wonder if they write their own appeals. Makes me wonder what else might be stolen from someone with the skills they might not have.

You'd think they wouldn't need to steal my material in their attempt to gain your business. You'd think Mr. X would know more about OWCP policy, procedure and regulations than I could possibly ever know since he is a 'retired' claims examiner. A claims examiner who wrote how many formal decisions denying benefits to claimants? A 'retired' claims examiner who is now in business to take your money to overturn the decisions written by his fellow claims examiners.

It would seem my thinking is correct since Mr. X claims that as a retired claims examiner he has insider knowledge regarding the internal operations of OWCP. He is also adamant that a claims examiner is not your friend, another little tidbit of irony.

Well here’s my question, if a retired claims examiner has all that insight into the internal workings of OWCP why were my articles stolen in an attempt to get more business? He has insider knowledge so why can’t he write his own articles in his attempt to get more business? Also, if the claims examiner is not your friend while they’re working for OWCP, how does retiring turn the claims examiner into your friend?

I'm all for a person making a living and this blog proves I care about what happens to claimants under the broken OWCP system, but I am not okay with 'retired' claims examiners who were responsible for so many horrible decisions that affected claimant’s lives now out there trying to drum up business from those very same claimants and using my stolen articles to do it. To me, this amounts to claims examiners still taking advantage and getting paid for it…again.

Being the thorough person I am, and the fact that Mr. and Mrs. X stole their articles from me and made me mad, I wondered if there was more being sold to claimants by Mr. and Mrs. X.

Reading the website, Mr. X sounded proud of being a "retired" claims examiner, touting his vast experience and expertise of the inner workings of OWCPland. Twice on his website, Mr. X claims that he consistently wins cases at all three appeal levels. You would hope so since Mr. X is a retired claims examiner, who should know better on what is required to reverse a bad decision than an ex claims examiner? So, I searched the ECAB for any decisions where Mr. X served as a claimant’s representative. 

I found ten ECAB cases where Mr. X was the representative for the claimant. Out of these ten cases only ONE was a reversal which is an outright win for the claimant. There were also TWO that were sent back (remanded) to OWCP for further development, not quite a win but not a total loss, at least not yet. 

This left seven ECAB appeals that Mr. X lost (affirmed). That got me wondering what Mr. X considers consistently winning since in seven of the ten ECAB cases Mr. X lost the claimant's appeal at the ECAB level. I don't know about you, but I wouldn't call outright losing 70% of cases consistently winning at the ECAB level. And we may never know what happened to the two remanded cases sent back to OWCP. One reversal out of ten appeals a 10% actual win record is not consistently winning, at least not to me, but apparently it is to Mr. X and he wants you to believe it too. It's unfortunate there isn't a way to check the other forms of appeals to see what his actual win/loss record is on those levels. 

I've said it before and I’ll say it again, by the time a claimant is looking for help, they are in a very vulnerable situation and some people will take advantage of that. 

Bottom line, be careful who you hire. Not everyone is as honest as they claim to be. Not everyone is as knowledgeable as they claim to be. And for Mr. and Mrs. X, you can believe that I will be watching you from now on.

Since ECAB decisions are published and are not copyrighted material and are open to public viewing, here are the ten ECAB cases I’m talking about:

These were the five stolen articles: