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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.


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GreenTurtlez  
#1 Posted : Wednesday, January 19, 2011 4:59:02 PM(UTC)
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On the CQS site "compensation payment tracking" my submitted CA7 changed from code (81-not payable-lwop)  to  (11-developed-lwop)     what does this mean?
carteropr  
#2 Posted : Thursday, January 20, 2011 1:37:50 AM(UTC)
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I do have the same code (11-developed-Lwop).
runningman1  
#3 Posted : Thursday, January 20, 2011 1:49:24 AM(UTC)
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any one have a list of codes and meanings?
runningman12011-02-23 10:17:21
redfox38  
#4 Posted : Thursday, January 20, 2011 1:50:25 AM(UTC)
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I believe it means they are reviewing your case, paperwork, ect.   They take their time, believe me.
carteropr  
#5 Posted : Thursday, January 20, 2011 2:40:05 AM(UTC)
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Thanks
Gfro  
#6 Posted : Thursday, January 20, 2011 2:44:35 AM(UTC)
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"take their time" hah!  still waiting for my husband's death claim to get ANY decision at all.
carteropr  
#7 Posted : Thursday, January 20, 2011 3:51:50 AM(UTC)
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sorry to hear that.
 
 
edalder  
#8 Posted : Thursday, January 20, 2011 7:56:30 AM(UTC)
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You'll probably get a letter from OWCP asking for some info.
 
Your agency may get one as well. Judging from your other post, apparently your agency has "taken issue" with your claim.
Kivi
GreenTurtlez  
#9 Posted : Thursday, January 20, 2011 8:23:24 AM(UTC)
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edalder wrote:
You'll probably get a letter from OWCP asking for some info.
 
Your agency may get one as well. Judging from your other post, apparently your agency has "taken issue" with your claim.

I know that my claim examiner was waiting on a Medical narrative from my doctor..  I just received the Medical Narrative today and it was an "outstanding" narrative.  My doctor put everything in the letter, my diagnosis, treatments, explanation of diagnoses, additional treatments, medication, etc...  He then precisely explained his assessment of the injury and how it relates to my job...  I am very impressed with how my doctor took the time to thorough and accurate.    Anyway I tried faxing the medical narrative to my claim examiner at owcp but the fax line was down all day- the fax line was busy or it just would ring with no answer (yes it was the right fax number)...    I went to the US post office and had it overnighted to owcp (hopefully it gets there in the morning).   I will try to fax again later tonight...   After owcp receives this medical narrative there should be no doubt as to the medical evidence in my case.

PS.. I do think I remember seeing "developed" status in my first claim before my CA-7 was approved for compensation.  If the CA-7 was being reviewed you would think it would say something along the lines of "processing" or "reviewing" "under review"...  Im thinking "developed" is creating new claim or pay approval....     however, I could be completely wrong... lol



GreenTurtlez2011-01-20 16:32:02
jesse slade  
#10 Posted : Thursday, January 20, 2011 8:43:55 AM(UTC)
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Developed means that OWCP has received medical evidence or lack thereof. The evidence is "Developed" The next step is for OWCP to issue a formal decision accepting or rejecting your claim.
GreenTurtlez  
#11 Posted : Thursday, January 20, 2011 9:44:54 AM(UTC)
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jesse slade wrote:
Developed means that OWCP has received medical evidence or lack thereof. The evidence is "Developed" The next step is for OWCP to issue a formal decision accepting or rejecting your claim.

I hope Owcp didnt make a decision because of what I had just stated earlier in that I just received the medical narrative from my doctor.  

Before they issue a decision will they notify the claimant if they need additional medical evidence.  The only thing I was able to submit early with my Ca-2a was my statements of injury, CA20, form 5c from doctor and then my manangement's challenge of claim.
jesse slade  
#12 Posted : Thursday, January 20, 2011 11:36:14 AM(UTC)
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Requesting medical evidence should have already been done. You should have received a standard letter saying that the information they have isn't enough and give you 30 days to provide the information. If they did this and you didn't respond or didn't submit everything, they don't care. The decision will be made based on the information you provided in response to their request.
 
As a side note, when OWCP issues a formal decision, they have to consider the evidence received up to and including the date of the decision.
 
If you just received the narrative report then OWCP didn't consider it because they haven't received it. Check the ACS website and under billing, see if there is a "Promp pay". Check the bills in process and the bills paid and denied. The "Prompt pay" designation is used whenever an OWCP doctor/facility has billed. If you have a "Promp pay" for a doctor you don't reconize on a date you didn't see a doctor, this is probably the bill of a District Medical Advisor, (DMA) also known as a consultant. If the DMA has billed, OWCP sent medical records to the DMA for the medical opinion and I can almost guarantee they will stand by the DMA's opinion. Just like any other OWCP hired gun, the DMA tends to write reports completely on the side of OWCP. Most DMA's are well known to those who pay attention to such things.
 
Before you can proceed, you need to known what's been done. There's no way to advise you without the facts. Right now, your claim is developed, you over nighted the narrative, until OWCP takes the next step, there's no way to know what step you should take.
jesse slade2011-01-20 19:43:05
GreenTurtlez  
#13 Posted : Thursday, January 20, 2011 12:25:02 PM(UTC)
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jesse slade wrote:
Requesting medical evidence should have already been done. You should have received a standard letter saying that the information they have isn't enough and give you 30 days to provide the information. If they did this and you didn't respond or didn't submit everything, they don't care. The decision will be made based on the information you provided in response to their request.
 
As a side note, when OWCP issues a formal decision, they have to consider the evidence received up to and including the date of the decision.
 
If you just received the narrative report then OWCP didn't consider it because they haven't received it. Check the ACS website and under billing, see if there is a "Promp pay". Check the bills in process and the bills paid and denied. The "Prompt pay" designation is used whenever an OWCP doctor/facility has billed. If you have a "Promp pay" for a doctor you don't reconize on a date you didn't see a doctor, this is probably the bill of a District Medical Advisor, (DMA) also known as a consultant. If the DMA has billed, OWCP sent medical records to the DMA for the medical opinion and I can almost guarantee they will stand by the DMA's opinion. Just like any other OWCP hired gun, the DMA tends to write reports completely on the side of OWCP. Most DMA's are well known to those who pay attention to such things.
 
Before you can proceed, you need to known what's been done. There's no way to advise you without the facts. Right now, your claim is developed, you over nighted the narrative, until OWCP takes the next step, there's no way to know what step you should take.

wow, thanks jesse for the detailed response...

to answer your question... NO.. I never received any standard letter from Owcp in regards to the recent recurrence claim that I had recently submitted 3 weeks ago.  I did receive a letter from them stating that my Ca-7 wasnt payable because I needed to submit a reason for work stoppage, but this was before I even submitted the actual CA-2a claim (I was hoping to keep the work stoppage on my old claim).   As i said I overnighted the medical narrative earlier today (its thursday now so hopefully it gets there early friday).  I also tried faxing a copy of the medical narrative today but something is wrong with OWCP's fax.  I am looking for alternate fax number...   but thats where I am at right now.

GreenTurtlez2011-01-20 20:30:30
GreenTurtlez  
#14 Posted : Thursday, January 20, 2011 12:26:50 PM(UTC)
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GreenTurtlez wrote:


jesse slade wrote:
Requesting medical evidence should have already been done. You should have received a standard letter saying that the information they have isn't enough and give you 30 days to provide the information. If they did this and you didn't respond or didn't submit everything, they don't care. The decision will be made based on the information you provided in response to their request.
 
As a side note, when OWCP issues a formal decision, they have to consider the evidence received up to and including the date of the decision.
 
If you just received the narrative report then OWCP didn't consider it because they haven't received it. Check the ACS website and under billing, see if there is a "Promp pay". Check the bills in process and the bills paid and denied. The "Prompt pay" designation is used whenever an OWCP doctor/facility has billed. If you have a "Promp pay" for a doctor you don't reconize on a date you didn't see a doctor, this is probably the bill of a District Medical Advisor, (DMA) also known as a consultant. If the DMA has billed, OWCP sent medical records to the DMA for the medical opinion and I can almost guarantee they will stand by the DMA's opinion. Just like any other OWCP hired gun, the DMA tends to write reports completely on the side of OWCP. Most DMA's are well known to those who pay attention to such things.
 
Before you can proceed, you need to known what's been done. There's no way to advise you without the facts. Right now, your claim is developed, you over nighted the narrative, until OWCP takes the next step, there's no way to know what step you should take.

wow, thanks jesse for the detailed response...

to answer your question... NO.. I never received any standard letter from Owcp in regards to the recent recurrence claim that I had recently submitted 3 weeks ago.  I did receive a letter from them stating that my Ca-7 wasnt payable because I needed to submit a reason for work stoppage, but this was before I even submitted the actual CA-2a claim (I submitted the CA-7 referencing my old "original" injury claim).   As i said I overnighted the medical narrative earlier today (its thursday now so hopefully it gets there early friday).  I also tried faxing a copy of the medical narrative today but something is wrong with OWCP's fax.  I am looking for alternate fax number...   but thats where I am at right now.


jesse slade  
#15 Posted : Thursday, January 20, 2011 1:41:16 PM(UTC)
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Just so you're aware, a recurrence is extremely hard to get accepted by OWCP. In order to qualify for a recurrence your condition needs to have a spontaneous change. Added to your problem is your agency controverting your claim. Good Luck.
GreenTurtlez  
#16 Posted : Thursday, January 20, 2011 2:04:32 PM(UTC)
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jesse slade wrote:
Just so you're aware, a recurrence is extremely hard to get accepted by OWCP. In order to qualify for a recurrence your condition needs to have a spontaneous change. Added to your problem is your agency controverting your claim. Good Luck.

I have heard that as well.  When I spoke to my claims examiner prior to submitting the recurrence claim, the claim examiner told me on the phone that if the injury claim and medical evidence fell into another category she would convert the claim appropriately.  Further, the workman comp manager for my agency directed me to file a recurrence claim (I have the email sent to me by him directing i submit CA-2a).  If by for some reason my claim gets denied and is not converted, I will submit CA-2 occupational immediately.  
GreenTurtlez  
#17 Posted : Saturday, January 22, 2011 1:42:24 PM(UTC)
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jesse slade wrote:
You should have received a standard letter saying that the information they have isn't enough and give you 30 days to provide the information. If they did this and you didn't respond or didn't submit everything, they don't care. The decision will be made based on the information you provided in response to their request.
 
As a side note, when OWCP issues a formal decision, they have to consider the evidence received up to and including the date of the decision.

Well everything you said was correct!  Today I received a letter from Owcp stating that they needed a medical narrative from my doctor with dates, treatments, diagnosis, tests/exams and to explain the casual relationship of injury to recurrence.  Luckily, the letter I submitted the day before addresses all of this and more.....    good lookin out ... you were right....   thnx, turtle....
carteropr  
#18 Posted : Thursday, February 10, 2011 5:39:42 AM(UTC)
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 Today Checking on my case in the CQS page,   I have found that they approved my case and also say on the current case status:   Payment on Daily Roll   and   on the bottom part Compesation Payment Tracking say   11/03/2010 - 01/28/2011      51-2011-02-09-Entitled-LWOP-Certified   what would this means.
leftylouie  
#19 Posted : Thursday, February 10, 2011 5:53:21 AM(UTC)
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carteropr - means your getting $$$ for the period stated.  Daily rolls means you must continue to submit a CA7 every payperiod for compensation until OWCP sends you a letter telling you different.
Just want to be free....
carteropr  
#20 Posted : Thursday, February 10, 2011 6:29:51 AM(UTC)
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Thanks Leftylouie, for the Info. Thats good news, these guys almost brought me to Bankruptcy....
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