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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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#1 Posted : Monday, April 22, 2019 11:12:48 AM(UTC)

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I have 2 accepted claims L & R knees.
In Feb. I was sent to SECOP to determine if my bilat rotator cuff tears was a consequence of my accepted L knee injury. I tore both shoulders because I had to use crutches. The SECOP wouldn't connect the dots between crutch use for knee injury and torn RC! I had the surgeries and used my prvt insurance.

Now, I'm being sent to the same SECOP to evaluate whether my R knee warrants a conversion from a partial knee replacement (owcp authorized) to a TKR. My surgeon has been trying to get auth for nearly one year!

Does using the same Dr to evaluate more than one claim pass the smell test?

Separately, based on his findings for my L knee, this Dr claims I can work for 2 hrs with limitations! My L TKR was authorized a year ago ( this was also a conversion from an authorized partial replacement). I was never able to complete rehab on L knee d/t R knee failing and rotator cuff tears!

I was a RN and have since let my license lapse. Can I be offered a job, even though I retired d/t disability 2 yrs ago from my agency? I'll be 66 at the end of this year, had offset SS disability up to age 65. I am still collecting WC for my L knee. I returned to work and collected a SA after the partial replacement on my R knee.

It occurs to me that 2 things are being considered: Auth for R knee TKR, and throw me off the WC rolls for my L knee. Any help would be appreciated. WC has ruined my life!!!

Edited by user Monday, April 22, 2019 11:27:52 AM(UTC)  | Reason: Not specified

#2 Posted : Thursday, May 9, 2019 10:35:56 AM(UTC)

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For a second opinion on a different case, there is no requirement that the doctor be someone who was never ever involved in either OWCP Case. That would only be an issue with an IME to resolve a conflict in medical opinion. You are not there yet.

If you can only work two hours a day, I doubt that OWCP will pursue a job offer and the fact that your nursing license has lapsed also would have to be considered, if re-emplymet with the Federal agency is under consideration. . Moreover, all medical conditions, work related or not, have to be considered in a job offer.

As to what may or may not be under consideration, ask OWCP for a copy of the Statement of Accepted Facts (SOAF) and the questions posed to the doctor. Don't speculate about what OWCP is doing (as you are here). You can get a copy of the SOAF and Questions citing the Privacy Act.
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figtree on 5/9/2019(UTC)
#3 Posted : Thursday, May 9, 2019 12:11:01 PM(UTC)

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Well...as it turns out I did get SOAF for both exams as well as their questions.
Both exams were with same IME....my mistake thinking this was SECOP. The appointment request stated SECOP, the Dr stated he’s an IME.
On my first exam, ( L TKR) he said I’m at MMI
My second exam with him was to determine whether I needed TKR (revision) on my R knee. OWCP already authorized a partial replacement on my R knee.

Since he determined I was MMI for my L knee...what does this mean? Will I be kicked off the rolls? Can I continue to get treatments for that knee? My L knee rehab was interrupted because my R knee failed.
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