Continuing my article from yesterday, if you received a schedule award for a 20% permanent impairment to the lower extremity (based on an employee earning $50k a year with household dependants), you payments for the award would total $41,538.24.
But five years later, your injury may have deteriorated. It is time for another impairment rating by you federal doctor.
When it comes to impairment ratings for OWCP claims, not all doctors are equal. Most states in the country do not use the 6th Edition of the AMA Guides to Rating an Impairment. Many use the 5th Edition or even 4th Edition. Some states used their own books. Other states require whole person impairment and doctors are not used to using the federal workers compensation regulations. Read more about the 6th Edition and how it works with the OWCP in this article.
Finding a qualified doctor who understands the OWCP and how the federal workers compensation system works used to be difficult. That is what FedDoctor is all about. We have already found great doctors for you. They can provide treatment as well as the proper impairment ratings when it comes time for your first, or subsequent awards.
Once your doctor gives you a new impairment rating, taking into account the changes since the previous award, you can file a new schedule award claim to get compensated for the additional loss of use to that extremity. If you second impairment rating report imdicates that now you have a 34% loss of use to that lower extremity, you would be entitled to an additional 14% schedule award, or approximately $29,076.77 in our example.
You can continue to collect additional schedule awards as long the impairment increases, or until you reach 100% loss of use. Use FedDoctor.com to find the most qualified OWCP schedule award rating doctors in the country, and they work to help you!
This is a question that many federal employees do not know tha answer to. They believe that if they ever receive a schedule award, that the OWCP no longer has to pay for medical benefits or future compensation.
This is wrong.
A schedule award is given by the OWCP for permanent impairment (loss of use) to a part of your body. The federal workers compensation law lists each body part and how much they are worth in the “schedule”, therefore determining how much each award is worth.
For instance, a lower extremity is valued at 288 weeks of compensation. While that may seem confusing, it simply means that if you earn $50k a year, and you have household dependants (like wife or kids, making you entitled to the 75% compensation rate) a weekly compensation rate would be $721.15.
$721.15 X 288 weeks = $207,691.20.
That is the amount the claimant’s entire lower extremity is worth according to the OWCP. An qualified doctor who understands the differences between state and federal workers compensation impairment ratings will know that all impairment rating for federal comp claims must be completed under the 6th Edition of the AMA guides and left in a regional format, not commuted to the whole person.
If a federal doctor awards a 20% permanent impairment to that extremity, the claimant would be entitled to receive 20% of $207,691.20, or $41,538.24. Similarly, a 40% award would be for $83,076.48.
However, if you are originally awarded a schedule award from OWCP for a 20% loss and your condition deteriorates over the next few years, what is to stop you from getting the original impairment rating raised to consider the additional loss of use?
To Be Continued…….
The third and final of the three major OWCP benefits is the schedule award. Schedule awards are paid in accordance with the AMA Guidelines to Evaluating a Permanent Impairment 6th Edition. Often these are referred to as the Guides or the 6th Ed. Guides. OWCP also requires that the impairment is regional.
A medical doctor can perform an impairment evaluation on an injured employee once they reach Maximum Medical Improvement. MMI does not mean that the worker is entirely recovered, but rather that the condition has stabilized and is unlikely to change significantly in the next 12 months. Once MMI is reached, OWCP will allow the doctor to perform the impairment rating.
A good physician will gather information regarding your medical history and incorporate that into his opinion and report. Using measurement taken during the exam and the 6th edition tables and charts, the doctor calculates the percentage of impairment to the parts of your body that are affected by the at work injury. Finally, a report is generated that gives a clear Impairment percentage.
The Percentage of Impairment is then multiplied by the correct body part schedule. According to the OWCP, an upper extremity is valued at 3412 weeks of compensation. A 10% impairment would result in 31.2 weeks of compensation to the injured federal employee. At that point the worker’s pay rate is used to finish the final amount of award.
If the claimant’s annual salary was $52,000, that would average out to $1,000 pay rate. OWCP only pays 75% of the pay rate, however that is tax-free, leaving us with a compensation rate of $750 per week. 10% loss of use to the upper extremity with a $750 comp rate would yield a final award value of $23,400.
Of course the OWCP would have to approve of this figure and they have in-house doctors that may want to evaluate the ratings that your doctor came up with. If your doctor has little to no experience with the federal workers compensation system, they are unlikely to produce the type of reports that are needed. The OWCP requires that all impairment ratings are done using the 6th Ed., as mentioned before. Only 14 of the 50 State use the 6th Ed, and almost none of them do regional impairment.
Because it is unlikely for your doctor to have experience with the federal workers comp requirements, it is important that the doctor that provides the ratings for you understand the differences between a state workers comp claim and a federal claim. FedDoctor.com has found doctors who do.
It is important to understand the distinction of the 6th Ed. of the AMA Guides. Until May 1, 2009, the OWCP had used the 5th edition. There is a major difference in how impairments are calculated between the two books. The 5th Ed. was mostly based on a range of motion impairment while the 6th Ed. is diagnosis based.
The federal workers compensation programs also specifically exclude the brain, heart, and spine from schedule awards. You can get a schedule award from a back injury only if the injury causes radiating problems from nerve injury as it exits the spinal cord. These are extremely complicated and require diagnostic evidence such as MRI and EMG/NCV testing to accompany the physician’s report.
Welcome aboard Tulsa! FedDoctor now also has coverage in Oklahoma’s second largest city. Eastern Oklahoma can also provide access to care for federal employees in the southwestern portion of Missouri and northwest corner of Arkansas. Federal doctors can be hard to find, but we are here to help.
Type in your zip code to get started making you appointment. This office can help you with treatment of your conditions as well as independent medical evaluation including schedule award exams using the 6th edition of the AMA Guides. This is your chance to finally get the care and documentation that are required to receive all of your federal workers compensation benefits.
Under federal workers compensation benefits, you may be entitled to a number of different benefits. When one is referring to a new OWCP claim, there are generally three main benefits that are most common.
The first is lost wage compensation. Most claimants refer to this as workers comp payments, or being “on the roles.” Lost wage compensation is paid tax-free to the claimants at either 75% or 66.6% of normal wages depending on whether the claimant has dependants. This benefit is paid if the symptoms of the conditions caused by employment are preventing the employee from performing their duties and the agency is unable to offer limited duty that fits within their physicians limitations for them.
Once you actually get your claim accepted, you can see how important your doctors reports can be! If your doctor is not clear on how your injury was caused and how your claim needs to be accepted, you may never have a chance at any benefits. But if your physician does not supply ample documentation to the OWCP regarding your ability to perform work, it will severely affect whether or not you receive a check for the time that you have to miss work.
Remember that even if you are working for part of the day and you are planning on collecting lost wage compensation for the other part of the work day, your doctor needs to understand that the way your reports are worded make a big difference in whether or not you CA-7′s get paid. You are also entitled to be paid if you have to leave work to see the doctor regarding your work related injury.
Consult with a federal attorney to have questions answered regarding benefits. Consult with a federal doctor to get the medical evidence that you need to support your claim. Visit FedDoctor to find a quality federal physician that understands the OWCP and how they can help you with your federal workers compensation claim.
Stay tuned for parts 2 and 3 in the next few days.
This website is designed to help federal employees nationwide for free! It is a connection point to find quality medical care for anyone with an ongoing federal workers compensation claim with the OWCP.
You can search locally using your zip code to determine if we have been able to find a doctor in your area that specifically treats federal workers and understands how to help with their workers comp medical files. I you have not been injured at work, you can still familiarize yourself with the website and stay up to date on local doctors.
If you know anyone who has been injured at work, please tell them about FedDoctor.com. Having a doctor on your side can be the difference in their OWCP claim.
FedDoctor.com is happy to report the Broady Clinic in Ooklahoma also has a Tulsa office that is accepting patients with federal workers compensation claims. For years the Broadway Clinic has been assisting federal employees, now they have joined with us to let federal employees know that they are here to help!
Visit FedDoctor today to schedule your appointment and get started with the care that you need to satisfy the OWCP and start receiving benefits!
Of course, every doctor’s wish is to be the first to see an injured employee. That is not always realistic. While you should always try to see your doctor as soon as possible, there are some ways to switch to a new doctor while working on the acceptance of an OWCP claim.
You can request that OWCP allow you to switch to a new treating physician. Your claims examiner should allow you to do so. Making your request in writing should help and documenting a reason for the switch may help persuade the CE to allow the switch.
You can ask your current doctor to refer you to the new doctor. This may work. If your current doctor will do it, OWCP should automatically allow it. However, some doctors will not refer you to a doctor that hey are not familiar with.
You could also ask your doctor to release you from care. At that point you have no doctor and you are free to pick a new one.
These are some of the ways that you can work with OWCP to find a new treating physician. Often times this is only necessary when your current doctor does not know how to effectively work within the federal workers compensation system. Consult a federal attorney if you need advice on how these processes work. They may give you some helpful information about how to legally work through this process.
Remember, we are not offering any legal advice. Simply giving some suggestions that may be helpful. FedDoctor.com is here to help you find the best treating doctors available who work on OWCP injury claims. If you are a federal employee who was injured on the job, a federal doctor can mean the difference in your medical file.
Search your zip code today to find your new doctor, and tell your friends!
Great new practice is now partnering with us to let you know that they are here to help Feds!
Oklahoma City is a central location within the state to find a practice that offers treatment to federal employees. From diagnosis and claim expansion to 6th edition AMA Guides impairment ratings for your schedule award,this practice can help you with the paperwork as well as the treatment.
They have been helping federal employees get the treatment that they deserve for years and now the are working with us to help spread the word to the federal community.
Visit today and make your appointment to start getting the medical care and support you need to move your claim along and start your recovery.
This is a great question. Many federal doctors do not charge the employee directly for their office visits. Most bill OWCP directly for their fees.
However, if you are only seeing a doctor for a one time evaluation, such as an impairment report for a schedule award, a doctor may charge you on an out-of-pocket basis. Remember every doctor is entitled to charge and bill how they see fit. FedDoctor.com does the best it can to find doctors who understand the OWCP and the federal workers compensation system, but how they charge is up to them.
Here is a great article on the process of billing for one time visit exams.