OWCP Claims Guide: How to Win Federal Workers' Compensation Benefits

Chris and Gini host their final Wednesday night OWCP chat before a two-week break, covering essential workers' compensation topics in a Q&A format. They discuss claim approvals, denials, common supervisor violations, and upcoming training opportunities.Key AnnouncementsNational OWCP Convention: Sunday, November 16th, 3-6 PM Eastern (Facebook only)Upcoming Travel: Utah meetings and BYU vs. Utes game, followed by FOA National Convention in WisconsinWoodshed Night: October 29th - covering rules, laws, and regulations supervisors violateNew Leadership: Congratulations to Jonathan Smith, new APW National PresidentFIC Tallahassee: Opening December 1st (Dr. Stephick)Critical Statistics DiscussedOnly 6.78% of non-postal federal employees had accepted claims in 2023 (down from historical 14%)Federal Injury Centers maintains over 95% success rateMost denials are due to inadequate medical documentation, not claim examiner biasMajor Topics Covered1. Understanding Claim DenialsDenials happen due to inadequate medical narratives from doctorsYou DON'T need an attorney for denied claimsFile reconsideration with improved narrative addressing denial reasonsAttorneys are only necessary for: car wrecks on the job, federal disability, schedule awards with second opinion denials2. Essential Forms & ProcessesCA-10: What federal employees should do when injured (often hidden from workers)CA-16: Pays all medical bills for 60 days, must be issued within 4 hours of reported injuryCA-17: Limited duty form - supervisors cannot withhold until claim is approvedCA-7/CA-7A: Payment forms for intermittent time offCA-2A: Notice of recurrence (verify with doctor first that it's same injury)**3. The "Black Sharpie Method"When supervisors refuse to complete CA-17 side AWrite "Supervisor [name] refused to issue" in black SharpieSubmit to claims examiner to create accountabilityPrevents supervisor from ignoring medical restrictions**4. Common Supervisor ViolationsRefusing to issue CA-16 within 4 hoursWithholding CA-17 until claim approvalRetaliating against injured workers (federal crime: fines, imprisonment, or both)Sending workers home claiming "no work available" on restrictionsNot honoring limited duty assignments**5. Payment & BenefitsChoose COP (Continuation of Pay) over sick/annual leavePay based on current salary if working full-time, or pre-injury pay with blanket increasesMileage reimbursement limited to 100 miles round trip (get authorization for more)Lifetime medical coverage for accepted claimsSchedule awards available for permanent impairment6. Key Rules & RightsReport injuries NOW (within 7 days maximum, but immediately is best)You have the right to choose your own doctorSupervisors cannot tell you where to go for treatmentRural carriers: job held for 2 years; other crafts: 1 yearRetaliation for reporting injuries is ILLEGAL**7. Getting HelpFile grievances through your union for supervisor violationsContact claims examiner directly about issuesCall OSHA: 1-800-321-OSHA for retaliationContact Inspector General or Postal InspectorsReplace nurse case managers if not working in your best interest8. Maximum Medical Improvement (MMI)Medical determination only - doctor decidesMeans "as good as you're going to get"Can occur if you refuse recommended treatmentLeads to impairment rating and Website for Locations. www.federalinjurycenters.comContact: 877-787-OWCP or message us FacebookTo Buy The Book: www.breakingowcp.comTo Email information: [email protected] Us on Facebook, YouTube, LinkedIn, Instagram @Wednesday Night OWCP Chats with Chris & Gini