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Monday, May 14, 2018

OWCP-Washington, D.C.


I have returned from my whirlwind Washington trip where I spent four days talking about OWCP and changes that could be made to help claimants.

I concentrated on changes that I believe would be effective, but avoided talking about ‘reform’ which is a scary and daunting thought to most people and let’s face it, reform probably wouldn't work anyway.

My theory is OWCP doesn’t follow its own regulations now, so even with the best reform in the world, unless OWCP followed those new regulations, the same adversarial system would exist.

So instead I discussed changes I believe would help level the playing field and give claimants a chance against the system. Since time is limited when meeting with a Senator or staff member (sometimes only a few minutes), I started with what I believe would make the most difference to claimants.

The three things I believe would make a difference are:

1)   Putting a cap on what OWCP physicians can receive for an exam. In my opinion, this takes away the financial incentive to provide a report against a claimant and would eliminate some of the biased doctors who are only in it for the money.

When these biased doctors leave because they can’t get millions a year, it also forces OWCP to bring in new doctors who may not be as biased.

If nothing else, this would save the American taxpayers millions of wasted dollars a year.

2)   Allowing every OWCP-directed exam to be recorded by the claimant.

This would provide the claimant with proof of what did or did not happen in the exam, what exam was or was not performed and give a claimant proof should OWCP use a negative report against a claimant giving the claimant a leg to stand on.

3)   Update the FECA manuals to specifically explain ‘Medical Rationale’.

It is obvious that the medical community and OWCP have differing opinions of what medical rationale is. OWCP only says it’s a “reasoned” or “rationalized” medical opinion.

But when a claimant’s physician includes a “reasoned” or “rationalized” medical opinion, OWCP still denies a claim due to a lack of medical rationale without explaining what the doctor didn’t provide.

I discussed that OWCP should have to update the FECA manuals to specifically explain what they consider to be medical rationale and provide one example of what they would accept as medical rationale and one example of what they will not accept as medical rationale.

This way a claimant can provide their physician with this section of the FECA manual and the physician can provide exactly what OWCP requires. This would lessen the need to repeatedly go to a physician for another report (and another and another) and significantly shorten the acceptance process ending the need for multiple appeals.

As a side effect, this change may bring more physicians willing to take an OWCP patient because they’ll know exactly what OWCP needs from them.

I spoke with three Senators and more staff members than I can count and also pitched these same ideas to NARFE's vice president of advocacy. 

Obviously not everyone was interested in what I had to say, but I am encouraged that there were several that did listen, took notes, asked questions and seemed interested in what I was saying.

Since it is the staff members who will be able to bring these issues to the Senators and/or Congresspeople, I will follow-up with those that were interested and hopefully form relationships with them and with a little luck, these changes will be made and that will help claimants fight against a system that seems so set against them. 

While I don't expect things to change overnight, I am hopeful that I can forge relationships and get the right people interested in making these simple, yet important changes.

I will continue the fight.

*A huge thank you to Mark who made my Washington meetings possible. I couldn't have done it without him and am forever grateful for his time and infinite wisdom.


6 comments:

  1. thank you thank you thank you

    ReplyDelete
  2. Thanks a lot for being our lecturer on this matter.
    I actually enjoyed your article a lot and most of all favored how you handled
    the aspect I widely known as controversial.
    You are always incredibly kind towards readers really like me and let me in my
    existence. Thank you.

    ReplyDelete
  3. I agree many things need to change. The hardest thing in my area is getting a doctor to accept a patient. Some of the workers travel over 100 miles just to get initial treatment and that may take weeks! I see how frustrated doctors get and I feel all of your points are valid and I personally am grateful for your effort. Thank you.

    ReplyDelete
  4. Jesse you are the greatest I believe in you and what you say thank you from the bottom of my heart for doing what your doing for all of use it feels so hood to be able to trust someone like you going up against owcp is a scary thing and just course one word was said wrong can cost you you case the Lord put the right person for Use thank you lord for sending us Jesse ruben yglesias

    ReplyDelete