FedDoctor.com

For an injured federal employee, it is vital to understand the importance of going to see a federal workers compensation doctor. The federal workers comp process is confusing, and not all doctors understand the system or even take DOL or OWCP cases. If your normal doctor does not understand how to help you file for your OWCP claim, you might not receive all of the benefits that you are entitled to. Even worse, your claim might be denied altogether if it is filed incorrectly or poorly.

At FedDoctor.com, our doctors focus a portion of their practice entirely on seeing injured federal employees and helping them with their claims and paperwork. Our OWCP doctors can help you fairly and justifiably attain the benefits that you deserve, and if they find out that you have some kind of functional impairment, most of our doctors can even help you file for and receive a schedule award under the AMA 6th Edition system.

So where does your union fit into this? Your co-workers and fellow union members look to your union for support and information. When people get injured, they will ask around, seeking information on what to do next. And that’s why we want your union to be familiar with FedDoctor.com. It’s completely free to use the website to find an OWCP doctor, and if your union is directing people to go to FedDoctor.com, your inured fellow co-workers will be that much closer to getting their benefits.

So talk to your union today about FedDoctor.com, so that they can help spread the word. We want all federal employees to know how to find an OWCP doctor when needed.

Federal employees live and work in every part of our country. Some work at desks, processing all sorts of paperwork while others are on the front lines of protecting our national security. One constant is that all of them work with varying levels of injury risk and are sometimes injured as a result of their employment.

When a federal employee is injured on the job, they must file a workers compensation claim with the Department of Labor’s Office of Workers Compensation Programs (OWCP). They are assigned a claim number and a claims examiner makes a determination on the merits of the file and either accepts or denies the claim. If the claim is accepted, the injured federal employee is allowed to get medical care under the OWCP claim and all medical expenses that arise in connection with the approved injury are covered by the federal government. If the injury is severe and the claimant needs to miss work as a result, they are eligible to file for Lost Wage Compensation and be paid while they are off. Payments are made tax free at the rate of 75% is the worker has dependents and 66% if they do not.

If the claim is denied, the claimant can appeal the decision and submit more compelling medical documentation that supports their claim.

At FedDoctor, we try to help injured federal employees find doctors who understand what the OWCP requires to accept a claim, and then treat the injured worker and provide the types of reports and documentation to help them secure the federal workers compensation benefits that they are entitled to.

Your doctor plays one of, if not the most important roles in your claim. Every benefit you want, need, or are entitled to must come on the basis of medical rationale. If the medical file doesn’t warrant the treatments or payments, it will usually not get approved. If your doctor doesn’t understand the federal system, they often get frustrated and lose interest in working with you and your claims examiner. Finding a doctor that does understand can make all of the difference.

If you are looking for a good doctor to help you, consider using our search tool at FedDoctor. We do our best to find doctors all over the country that take a special interest in treating federal employees with OWCP claims. You can find them for an impairment rating under the 6th Edition of the AMA Guides, or switch to them as your primary care for the at-work injury.

We are actively searching the nation for more doctors that can help you. Please subscribe to our blog or like our Facebook or Follow our Twitter account. We update and post information that is useful to injured federal employees as well as announce new doctors on our site. Our goal is to have a FedDoctor member near every federal employee in the country. Let us know if you have heard of a doctor who helps federal employees or if you see one yourself.

… Continued from Part 3…

Hopefully now, you have had an independent medical evaluation by a quality federal doctor (hopefully FedDoctor was helpful!). Once you get your report back, it is time to go to work.

In order to get a good handle on how to calculate what your award might be, the next step is to understand what the OWCP List of Scheduled Members looks like. The federal workers compensation office uses this list of body parts to value each individual section of your body based on its importance to the whole body. Remember, this is very different from Whole Person Impairment (WPI) but uses the same type of principles.

For instance, an entire leg is valued at 288 weeks of compensation. A toe (other than great toe) is only worth 16 weeks. Here is a list of the other body parts and their corresponding weeks of compensation:

Arm 312 weeks
Fourth Finger 15 weeks
Leg 288 weeks
Hearing (1 ear) 52 weeks
Hand 244 weeks
Hearing (both) 200 weeks
Foot 205 weeks
Breast 52 weeks
Eye 160 weeks
Kidney (1) 156 weeks
Thumb 75 weeks
Larynx 160 weeks
First Finger 46 weeks
Lung (1) 156 weeks
Great Toe 38 weeks
Penis/Female Sex Organs 205 weeks
Second Finger 30 weeks
Testicle/Ovary (1) 52 weeks
Third Finger 25 weeks
Tongue 160 weeks
Toe (other) 16 weeks

The new impairment rating that your doctor provided to you is multiplied by the body part’s number of weeks of compensation. If your doctor assigned a 10% impairment to your leg, that would correspond to 28.8 weeks of compensation.

Your compensation rate is the same as your lost wage reimbursement rate. 75% of pay if you have dependents, and 66% if you do not. Multiply that weekly comp rate by the number of weeks of compensation from your impairment rating and body part and voila! You have your schedule award amount.

Now comes the hard part, submitting your claim to OWCP and hoping it is approved for the full amount! A good doctor, like the ones on this site, will be helpful. The stronger the report, the better your chances are of getting the claim approved for the highest amount of impairment.

Good luck, and don’t be afraid to ask an attorney for help. This is not legal advice, but it may be a good idea to get some!

… Continued from Part 2…

In the 6th edition, it specifically requires you to be at MMI before the impairment can be rated. Have patience! Getting the rating appointment with a good doctor could be a waste of time if you haven’t allowed an adequate amount of healing time to elapse.

Federal workers compensation is difficult enough without having to redo your work or take more time to see a doctor. It is important to try to get it as right as you can on the first try. Once the fight begins, you will benefit from having all of your ducks in a row.

FedDoctor is the only place online to find quality federal doctors all over the country that help the federal employee! Using this resource and sharing it with your friends and co-workers can net you more money when it comes time to file the schedule award claim.

So now that you have reached MMI, schedule your visit with a qualified doctor to have your impairment rated. You can use your treating physician, but make sure that they fully understand the type of report they are generating.

As we discussed previously, the rating must be done in accordance with the AMA Guides 6th edition. Not all doctors know how to use this version as most states have chosen not to adopt this version. In addition to being done using the 6th edition, federal workers compensation schedule awards are not done using Whole Person Impairment (WPI), but rather stay at the local level using Regional Impairment.

To explain the difference, here is an example. If you have a 10% loss of use to your upper extremity (UE) that may equate to a 2% loss of the whole person. The difference is clear: 2% WPI vs. 10% UE.

OWCP does not accept WPI ratings at all. If your report is done using WPI, you have a significant chance of having the entire report thrown out by the district medical advisor in your OWCP regional office.

Your impairment rating should be left in the regional format. In addition, it is generally not helpful to have your doctor rate additional parts of your body that are not included on that claim number. If you have multiple claims, have separate reports done. OWCP often has different claims examiners responsible for different claims and they won’t necessarily both get a copy of the report. This seems like a minor detail, but it can cause confusion and delay or ruin your schedule award claim.

To be continued…

… Continued from Part 1…

So if your physician is not a federal doctor (a doctor who simply understands the differences between federal and state workers compensation law), it is important that you know and understand schedule award calculations.

Now that you understand that you are not going to forfeit any future compensation benefit rights, it is now time to understand when and why a schedule award may be the next logical step in your claim process.

Federal workers compensation laws require that you reach Maximum Medical Improvement (MMI) before you get your impairment rated by a doctor (Read more about Maximum Medical Improvement here). MMI is determined when your physician determines that your recovery has plateaued. This doesn’t mean that you will never, ever get any better, simply that you are unlikely to substantially improve over the next twelve months.

If you are about to have surgery, MMI is usually not reached until approximately one year has elapsed after the operation, especially if the nature of your injury is neurological.

The rules that doctors follow when evaluating an impairment are laid out by the American Medical Association. The AMA Guidelines to Rating a Permanent Impairment 6th Edition are the most recent version of those rules and are the ones adopted by the OWCP (read more about the AMA 6th Ed. here).

These are likely different than the version used in your home state, another reason why FedDoctor is so helpful to injured federal employees. We help you locate federal doctors around the country that understand the 6th edition and how it relates to your schedule award. There may be one in your back yard!

OWCP claimants are allowed to travel to see a doctor to have their impairment rated for a schedule award claim. While OWCP may not reimburse you for travel expenses, you are allowed to have a one time visit with for an independent medical evaluation without preauthorization and without having to change treating physicians.

To be continued…

There is often a lot of confusion about the difference in a federal doctor from an OWCP doctor, a District Medical Advisor, and a second opinion or referee doctor. Hopefully, this article will shed some light on the differences and help you understand why having a doctor that understands how the OWCP works to treat you is so important.

The terms ‘federal doctor’ and ‘OWCP doctor’ do not actually define how a doctor practices medicine. They are terms used by people within the federal community to denote a physician that has special understanding or familiarity with the Office of Workers Compensation Programs and their procedures. Those terms help you know which doctors might be helpful with your injury claim.

However, it is important to be careful and understand that sometimes the term ‘OWCP doctor’ might insinuate that the doctor works for the federal government. The OWCP does not directly employ any physicians that actually examine claimants. However, some doctors are occasionally contracted to see a federal claimant for a second opinion or referee exam.

When the medical evidence in you federal workers compensation claim are not sufficient to make a decision on the case, the claims examiner may schedule an appointment for you to see one of those contract doctors. Often those doctors do not establish a patient/doctor relationship and simply render an opinion based on the questions asked by the claims examiner. This is not your doctor. Some may be helpful, but often they are making a determination on the merits of your case with a 1o minute exam and may not be able to give your case the time that it deserves.

Similarly, a referee doctor is used as a third and final say when two doctors have a disagreement about your medical file. They may choose to side with your treating doctor, or the second opinion doctor. Sometimes they even come up with their own opinion that is different entirely.

Understanding the differences between these terms is important for any federal employee that has an ongoing workers comp file. FedDoctor is always looking to find doctors that understand the federal workers compensation system and can help you get the treatment and documentation that you need. Keep checking back and share this information with your fellow federal employees. We want the federal employee to be informed on their medical care rights and understand that their health care choices make a difference when it comes to a workers compensation claim.