As if there wasn’t enough
to contend with, a new issue for claimants has come to my attention and it's getting more widespread. It is important that this information gets to ANY claimant who finds themselves with a nurse on their claim.
Agencies are assigning nurses to OWCP claims and in some cases, these
nurses are misrepresenting to a claimant and/or their providers that they were
assigned by OWCP or that they are contracted by OWCP.
In some cases, the agency
nurses are misrepresenting that even though employed by the agency, they have
the right to access your medical records and get involved with your providers because you were injured at work.
THIS IS NOT TRUE
In some cases, the agency
and/or its nurses are preventing an injured worker from seeing a qualified
physician by recommending a physician or telling the injured worker they have
to see a particular physician. You do NOT have to have an agency-recommended physician
as your treating physician.
In some cases, the agency and/or their nurses are directing claimants away from certain physicians, saying the physician is under investigation when they are not. This is currently most widespread in Arizona.
I’ve said it before and I’ll say it again, DO NOT believe your agency without proof what they’re saying is true. It’s hard enough to find a physician that will take an OWCP patient, now the agencies are trying to eliminate physicians, especially the good ones, that do accept OWCP claimants by telling lies about the physicians to scare claimants away.
For injured Border Patrol employees, there is at least one agency nurse in Arizona that is currently not licensed in the state of Arizona and is inappropriately inserting herself into claims as if she has a legitimate right.
In some cases, the agency
and/or their nurses are inappropriately obtaining your medical records from your medical providers. When
you’re injured, your agency does not receive or manage your medical records…OWCP does.
In some cases, the agency
and/or their nurses are contacting your providers in person or by telephone. The
agency and/or their nurse CANNOT contact your medical providers in person or by
telephone.
However, your agency can
contact your providers in writing. If any agency is contacting a provider, it
MUST be in writing and a copy of the letter must be provided to both you and
OWCP at the same time it’s sent to your provider. The agency can ask your provider about work limitations and possible job assignments.
If the agency writes your provider and the provider is going to respond, they should respond to OWCP. The doctor has no obligation to respond to the agency. Your agency is not involved in the decisions of your claim. Your agency doesn't review or weigh medical evidence. Your agency does not manage any part of your claim. Your obligation is to OWCP not your agency.
Your obligation to your agency is to notify them when you have been released to work and to provide any physical restrictions through a completed CA-17.
Your obligation to your agency is to notify them when you have been released to work and to provide any physical restrictions through a completed CA-17.
If the agency needs information, they can contact OWCP and if they are legally entitled to the information, OWCP will give it to them.
If your agency contacts you for medical reports, you should
send the reports to OWCP and NOT the agency, but you can and should provide the agency a
current CA-17.
The agencies and/or their nurses are inserting themselves into claims and asking providers for information such as billing codes. Legitimate OWCP Field Nurses don’t need to ask for billing codes. Since all your bills go through OWCP, they can easily find out what’s being billed. They don’t need ask your providers for billing codes.
The agencies and/or their nurses are inserting themselves into claims and asking providers for information such as billing codes. Legitimate OWCP Field Nurses don’t need to ask for billing codes. Since all your bills go through OWCP, they can easily find out what’s being billed. They don’t need ask your providers for billing codes.
Your agency and/or their
nurses CANNOT attend medical appointments, CANNOT participate in your treatment,
CANNOT make treatment recommendations, CANNOT schedule appointments and CANNOT discuss
your claim or your injuries with your medical providers.
Because of these new agency tactics, ANY nurse assigned to your claim should be properly identified as an OWCP Field Nurse.
When OWCP assigns a Field Nurse to your claim, you will be notified in writing. If you did not receive a letter from OWCP assigning a Field Nurse to your claim, there is a chance the nurse contacting you is not assigned by OWCP but is an agency nurse.
ALL claimants should ask their Field Nurse for the letter OWCP sent them and identification to confirm they are in fact the OWCP Field Nurse assigned and not an imposter sent by the agency to wrongfully obtain your medical information and documents.
Once you know the nurse's name, you should also confirm the nurse has a current and valid license in your state.
If an agency nurse inserts
themselves into your claim, I suggest you contact OWCP in writing and let them know the agency is acting outside its bounds of the Act. A copy should also be sent to your agency and the agency should be told to remove their nurse from your claim immediately. That the nurse is not to contact you or any of your providers again. And most important, your
providers need to be notified in writing that the agency nurse has no legal right to any information involving your claim.
If an agency nurse is or
has been assigned to your case and improperly obtained medical information, you can also file a complaint with your state’s
nursing board for improperly inserting themselves into your claim and/or directing the course
of medical treatment, possible Privacy Act and/or HIPAA violations and violating
20 CFR §10.506. You can also talk to your
union about filing a grievance.
You do NOT have to interact in any way with an agency nurse
or an OWCP Field Nurse for that matter.
It is not in your best interest to allow your agency access to your medical records or your providers. They are not
entitled to the information and if the agency requires information regarding
your claim, they should be told to contact OWCP.
A CA-17 indicating your physical restrictions is
all the medical documentation your agency should require. If they need anything
else, the agency should be told to contact OWCP.
Your agency has NO authority to insert themselves into your
claim. If the agency requires information about your claim, they should be told
to contact OWCP. If the agency is legally entitled to the information, OWCP will
provide it to the agency.
If I haven't said it enough: The agency should contact OWCP if they need information about your claim.
If I haven't said it enough: The agency should contact OWCP if they need information about your claim.
Also something to remember, Field Nurses are Voluntary. Even
if you’re assigned a Field Nurse by OWCP, you do not have to allow them access
to you, your home, your providers or your medical records.
Claimants unfortunately have to protect themselves and the
best way to do that is by knowing your rights. You are NOT required to cooperate
with an agency nurse in any way, shape or form and if one has inserted
themselves into your claim, you should immediately put a stop to it.
