OWCP Updates

(This article appeared in the September/October 2009 issue of The American Postal Worker magazine.)

Sue Carney, Director Human Relations Dept.

The Office of Workers’ Compensation Programs has made several important changes in recent months. Below is a summary.

Claimant Query System (CQS) - On June 25, the OWCP rolled out a new Web feature that provides injured workers with 24-hour access to their case-file status, accepted conditions, and compensation payments. The tracking system is accessible at the ACS FECA Claimant portal. Claimants will need their case number and date of injury to view the records.

Employees’ Compensation Appeals Board – Some key changes were made to the Code of Federal Regulations relating to ECAB on Oct. 20, 2008. The principal change is that the time limit for an appeal to the board has been extended from 90 to 180 days. It can be further extended — to one year — if the appellant demonstrates “compelling circumstances.” Another significant change is that a request for oral argument will no longer be automatically approved. The appellant (or rep) must first request oral argument and specify the issues to be argued by providing a statement supporting the need to appear in person.

ECAB Decision on LWEC – On March 10, an ECAB decision (Docket No. 08-1286) addressed wage-loss compensation after a formal Lost Wage-Earning Capacity (LWEC) determination has taken place. A formal LWEC cannot be modified unless the medical condition has materially worsened, there has been substantial financial rehabilitation, or the original LWEC determination was in error. The ECAB ruled, however, that if the claimant has been determined to have intermittent periods of disability caused by the failure of the employer to provide medically suitable employment, then the claimant can be paid compensation even if none of the three elements normally required for LWEC modification is present. Such payment would not be considered a “modification” of the formal LWEC. Please note: previous LWEC decisions will not automatically be overturned; workers who have received a denial based on this issue should make a Request For Reconsideration through their OWCP District Office. When requesting reconsideration, workers should cite the ECAB decision and should argue that there was a “clear evidence of error.” Making this argument negates the usual one-year time limit to file this type of appeal.

AMA Guide – The OWCP began using the Sixth Edition of the American Medical Association’s “Guides to the Evaluation of Permanent Impairment” on May 1 to determine the percentage of permanent impairment for schedule awards.

Death Gratuity – An amendment to the Federal Employees’ Compensation Act created a death gratuity paying up to $100,000 to the survivors of a federal employee who dies of injuries resulting from service in an armed forces’ contingency operation. This provision became effective in 2008, and OWCP is currently drafting regulations implementing the amendment. The gratuity is to be disbursed in a specific and somewhat complicated order of precedence. These beneficiary stipulations are unique to the new provision, with no existing Department of Labor (DOL) rules or guidelines covering these circumstances. The statute gives the employee the opportunity to change the order of precedence of certain survivors, as well as to designate up to 50 percent of the benefit to any person. DOL believes potentially affected federal employees must be provided the opportunity to exercise the designation option; therefore, form OWCP 1168 has been created. The form is available on the DFEC website.

Provider Search – A feature that helps injured workers locate physicians willing to treat their work-related injuries is now part of an online database. The Provider Search system generates custom lists of providers by specialty and location. To see this feature, click on the link in the “Available Features” section on the ACS Web portal page.

New Billing Requirements – Claimants should make their providers (except pharmacies) aware that they must bill with their ACS OWCP provider number in OWCP-1500 or OWCP-04 forms. If the number is not on the form, the bill will be returned without payment.

Interactive Voice Response System – FECA users can access a 24-hour system to inquire about the status of bills, claimant eligibility, and medical authorization. To access IVRS, call 866-335-8319 and select “Option 1” from the main menu.