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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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diannedawn  
#1 Posted : Thursday, April 18, 2019 3:49:03 PM(UTC)

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I filed for a reconsideration on the denial of a schedule award on March 14. Someone on here said I could expect a decision in 45-90 days if I “stayed on top of them”...
But who would I even call to question them about it?
A reconsideration is done by people not associated with your case...
So calling my CE or the Supervisor is not going to do squat. They’ll just say we have no idea.
Kind of like when the DMA had my file and did not make a decision for over 2 months. LoL

So can those here who have filed for a reconsideration tell me how long it was for you to get a answer?

Thanks in advance.
edalder  
#2 Posted : Sunday, April 21, 2019 3:25:43 PM(UTC)

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The OWCP computer system should reflect which senior Claims Examiner was assigned the reconsideration request. Your CE may not be able to access that list, but a senior CE and/or supervisor probably can. So, if you want to call, call your CE and let him or her refer your call to his/her SR CE or supervisor. That person should route your call to the assigned recon examiner.

How long it will take you to get an answer depends upon many factors. Did you submit an additional medical report with your request? If so, the recon examiner likely would ask for another DMA review. That process could easily take 30 days from the point at which the Recon examiner makes the referral. But if the review is favorable, you will probably have your decision within 90 days.

The stated goal of OWCP is to decide 80% of recon requests within 90 days. 20% are allowed to slide to 180 days, to accommodate the possibility that an IME may need to be scheduled, etc. Sometimes, of course, the recon examiner misses that goal, but it is not that common. Scheduled awards are not that complex. If you submitted a medical report from an appropriate specialist using the correct edition of the AMA Guides, you probably will hear within 90 days. However, 60 would be very optimist for a scheduled award case that needs another DMA review.

IF the recon examiner decides that an IME needs to be scheduled, you probably will be told that will occur. But IME's tend to be a time consuming process within OWCP. Most recon examiners do not like to see that step become necessary as the process might take longer than the remainaing time to 180 days and that can reflect badly on their individual performance stats. There actually will be a bias in favor of accepting that new medical evidence as definitive, as long as the medical report is reasonably good.

IF you did not submit any additional medical evidence, you probably will get your decision fairly promptly. You just are not likely to be happy with it.
Kivi
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