Tuesday, December 27, 2016

Schedule Awards-Do It Yourself

Most attorneys and representatives charge a percentage (a contingency fee) to handle the filing of a schedule award. Contingency fees are not allowed at anytime in OWCP but OWCP doesn't stop this practice and a lot of claimants aren't aware contingency fees aren't allowed so attorneys and representatives get away with taking a hunk of your schedule award.

Most claimants believe that filing for a schedule award is difficult and complicated...but it's not.

A schedule award pays for the permanent loss of use of a covered body part. Think about that for a minute...Permanent Loss of Use. It's unconscionable to me that if a claimant has a permanent loss of use because they were injured at work, that someone would take advantage of that for a percentage of the award.

The thing is, of all the things an attorney or representative might have to do, filing a schedule award takes the least amount of work.

In order to file for a schedule award you need to have reached Maximum Medical Improvement, (MMI) and have an impairment to a covered body part. If that criteria is met, then you need a proper impairment rating and a completed CA-7. That's it. That's all it takes to file for a schedule award with OWCP.

Almost every claimant with an accepted OWCP claim has completed a CA-7 at some point. It's not complicated and it's not hard to do. Even if you needed help, it wouldn't take more than 10 minutes for someone to walk you through completing a CA-7.

The physician does all the work for the impairment rating, so there's nothing there that requires professional help from an attorney or representative.

The most important part of a schedule award is is not an attorney or representative, it's the choice of rating physician. You want someone who has experience and knowledge dealing with OWCP impairment ratings and does it properly.

Once OWCP receives the rating report and CA-7, they begin to process the claim. First, they send the rating report to the District Medical Adviser, (DMA). The DMA checks the rating and calculations. The DMA has three choices; agree with the rating, increase the rating or lower the rating. The DMA then supplies the Claims Examiner, (CE) with a report that provides their calculations and discusses their reasoning.

Normally, the CE will use the DMA's rating percentage and notifies you of the outcome.

You can accept the rating OWCP approves even if it's lower than the rating your doctor gave you. If you do this, you receive payments for the percentage OWCP has approved.

One year after the start date of your schedule award (or last exposure) you can be re-rated if your conditions have worsened or there's a greater percentage of loss, which is pretty common.

If the new rating is higher than the rating you received, you would be entitled to the difference. For instance, if OWCP approved and paid 10% and later you were re-rated at 15% and OWCP accepted the 15%, you would receive the additional 5% (15%-10% previously paid=5% owed).

There are times with a schedule award when an appeal is necessary, but these appeals are usually based on medical evidence. Medical evidence comes from a physician not an attorney or representative and is something YOU would obtain-the attorney or representative doesn't obtain medical evidence on your behalf, you have to get it from a physician.

When OWCP decides on the percentage they'll accept, it's not easy to change their mind so the appeal process can take up to a year or more. If you check ECAB decisions, you'll see that even with an attorney, a high percentage of the appeals are denied. Why pay someone to go through the appeals process when you can submit new medical evidence on your own if an appeal is necessary.

A less frustrating and cheaper way to handle this is to accept the percentage OWCP has approved and submit an increased rating after a year.

There are a lot of times that you might need professional help with your OWCP claim but filing your claim for a schedule award shouldn't be one of them. If you hire an attorney or representative, most will take 10%-30% of your award.

I'm not saying don't hire professional help if you need it or want it, but if you do make sure you don't agree to give a percentage of your schedule award away. Why give away a percentage when you don't have to? That payment belongs in your pocket, not an attorney's, after all, you're the one with the permanent loss of use.

For more on increased schedule awards, see FECA Manual part two at 2-0808-9: