Welcome Guest! To enable all features please Login or Register.

Notification

Icon
Error

Federal Workers' Compensation

The Office of Workers' Compensation Programs administers four major disability compensation programs which provide wage replacement benefits, medical treatment, vocational rehabilitation and other benefits to certain workers or their dependents who experience work-related injury or occupational disease.

Here is a forum for members to share and exchange experiences regarding to workers' compensation related issues.


To read today's top news stories on federal employee pay, benefits, retirement, job rights and other workplace issues visit FederalDaily.com.
Options
Go to last post Go to first unread
pkeng  
#1 Posted : Monday, March 30, 2020 10:36:20 AM(UTC)
pkeng

Rank: Newbie

Groups: Registered
Joined: 10/31/2011(UTC)
Posts: 7

I had my third surgery on my accepted injury but OWCP LWECed me 12 months ago. Their secop doctor recommended surgery in July 2017 and I finally got it done in March 2020. I've now asked my CE twice why I have not been reinstated to 100% disability (they approved the knee replacement!). Both times I got an "I don't know" but I found out the answer in less than five minutes after the second IDK answer.

As per FECA regs, I apparently have to REQUEST a modification of the LWEC, my questions is: Is there a template or a good structure for me to complete the request. I'm very annoyed they are pulling the IDK card, but it is typical. Thank you.
OBE17  
#2 Posted : Monday, March 30, 2020 11:56:29 AM(UTC)
OBE17

Rank: Rookie

Groups: Registered
Joined: 7/4/2019(UTC)
Posts: 41
United States
Location: New Jersey

Was thanked: 2 time(s) in 2 post(s)
I don't know. Mostly, I answered to let you know "someone" is reading your post. It's disheartening to ask a question and have no one acknowledge you.
Maybe I can help get a discussion going for you: Is this the "form" you are speaking of? http://www.eeo21.com/fil..._appeal_request_form.pdf

You say you were "LWECed" 12 months ago. I suppose you mean your benefit was lowered down from 100%.
And at that time I suppose you were issued a formal decision letter?
Is what-you-need, a RECONSIDERATION? If so, it appears you have missed the deadline.

I'll be watching because I'm eager to learn how this is done.
pkeng  
#3 Posted : Monday, March 30, 2020 12:35:45 PM(UTC)
pkeng

Rank: Newbie

Groups: Registered
Joined: 10/31/2011(UTC)
Posts: 7

Thanks. I had an appeal for the LWEC and some things are pending with that, but they upheld the original (wrongly so) for multiple reasons. Here is what I found in the regs: https://www.dol.gov/owcp...ECA-PT2/group3.htm#21501

There is substantial section on requesting the modification. Because this is a change in my condition after the issuance of a decision, it falls outside of the regular appeal. I've formulated a letter and noted that *their* doc said I needed more surgery and after being bounced around for quite a while, finally got it done. The bottom line is that I cannot do any work, so the reduction from 100% disability should be reinstated and then reevaluated. Not only that, but my CE from last year (a senior person) told me that my status would revert back to 100% and that I would have to go through voc rehab all over again - even though they *knew* I needed more surgery. I mistakenly thought the change was automatic, the regs state I have to ask for it. :/ I am a dog with a bone and I found it very odd that two CEs said they didn't know when one told me last year what was supposed to happen. I have a new bone.

OBE17  
#4 Posted : Tuesday, March 31, 2020 5:25:33 AM(UTC)
OBE17

Rank: Rookie

Groups: Registered
Joined: 7/4/2019(UTC)
Posts: 41
United States
Location: New Jersey

Was thanked: 2 time(s) in 2 post(s)
I am no expert in dealing with OWCP, and as I have stated, I'm offering my thoughts mostly as questions, as opposed to declarations, because I too am seeking answers. I don't know how long you have been waging this fight with OWCP but I "sense" that you may have a need to better familiarize yourself with the terms used by OWCP and their meanings. I know I did!

100% disability and Permanently Totally Disabled are not interchangeable. The former is the way OWCP describes an IW undergoing VR but with an added disclaimer that it is for only that period of time the IW is undergoing VR. It is also the % of your salary you are paid while on Continuation of Pay (before a WEC is imposed)but the criteria for the latter is specifically laid-out by OWCP standards as the complete LOSS of the use of BOTH EYES, HANDS, or FEET, which is pretty horrific an injury! "Experts" have told me that there is almost no chance for an IW to be accepted as Permanently Totally Disable with anything less.

In my own case, OWCP imposed a WEC on me based on the fact that upon my recuperation (and ability to return to a Light Duty Status) I was forced out of federal gov't work and sent (through VR) to find a job (but one which paid 45% of the wage of my injury job) They imposed that 45% WEC on me and, to this day, have never been willing to reconsider that number. It has been with me for decades in spite of the fact that I have been unable (due to aging and progression of the injury) to work a job even at the 45% WEC. I don't know how they get-away with this but they do!



pkeng  
#5 Posted : Tuesday, March 31, 2020 9:56:25 AM(UTC)
pkeng

Rank: Newbie

Groups: Registered
Joined: 10/31/2011(UTC)
Posts: 7

I've been on OWCP since 2005 and was forced out of my job in 2008. After a six year battle, two ECAB wins (for me), I was finally put on 100% disability with an effective date of 2008. I was not removed from that until last year after a lame attempt at VR. I was docked by the LWEC and a very senior CE told me that it was highly unusual for 1) their secop doc to say I needed more surgery; 2) that OWCP would progress with VR knowing I needed more surgery; and 3) that once the surgery was done, I'd be back on 100% disability again and have to do VR all over again.

What I did not know was that I have to ask for the modification, which I have now formulated and am ready to send off to them. I can believe one person saying they didn't know, but not two people - this is their job. A total knee replacement is a very difficult surgery and one does not just bounce back. I could not drive for a few weeks, cannot walk properly, nor can I sit properly. I did not have a job, but that is really of no matter since the surgery was done to help me become more whole (which I never will be, but we keep trying).

Right now I am 100% totally disabled, by the physician's description. Good luck on your case - I will post a follow up when I receive notification. I suspect they will fight it but they have been on the losing end of my case for more than a decade. They keep trying but I keep fighting.
jesse slade  
#6 Posted : Thursday, April 2, 2020 11:02:53 PM(UTC)

Rank: Senior Member

Groups: Registered
Joined: 8/14/2008(UTC)
Posts: 2,007

Thanks: 1 times
Was thanked: 139 time(s) in 132 post(s)
Modification of an LWEC is only warranted where the party seeking modification establishes a material change in the nature and extent of the injury-related condition, the employee has been retrained or otherwise vocationally rehabilitated, or the original determination was, in fact, erroneous.

You would be seeking modification based on a material change.

To do this, you need a physician to lay out the history of the injuries and explain how the accepted conditions have changed to the point of total disability.

In your case, your doctor should indicate why you required surgery, that you had the surgery and OWCP approved the surgery.

Your doctor should indicate what job duties you cannot perform, why you can't perform those job duties and how it's related to the accepted conditions and/or surgical rehab.

Once you have this narrative, you'd send it with a letter to OWCP requesting the LWEC be modified based on a material change in the medical condition. OWCP would then need to evaluate the evidence and determine if modification is warranted.
Rss Feed  Atom Feed
Users browsing this topic
Guest
Forum Jump  
You cannot post new topics in this forum.
You cannot reply to topics in this forum.
You cannot delete your posts in this forum.
You cannot edit your posts in this forum.
You cannot create polls in this forum.
You cannot vote in polls in this forum.


This page was generated in 0.231 seconds.