This episode is an emailer asking a question and being answered in the podcast episode. The scenario the emailer presented for an injured federal employee is the following:

An injured worker came in her OWCP doctor's office for an urgent care visit appointment due to her shoulder being in severe pain and cannot raise it. This shoulder injury is an accepted condition and she is on modified duty. She has been working 8 hours with restrictions but today has been removed from work for 5 days. In circumstances like this, would she file a CA-2A for recurrence of disability? My second question would be, if a patient is removed from work due to worsening of an injury whether it be 2 days or 30 days, is a CA-2A filed?

Great question: Here is what the FECA ACT says about this …

(DFEC) FECA Part 1 Chapter 1-0400 Sub-sec: 9

A Recurrence of Disability is a work stoppage caused by:

1. A return or increase of disability due to a consequential injury (defined as one which occurs due to weakness or impairment caused by a work-related injury);

2. Withdrawal of a specific duty assignment when the employee cannot perform the full duties of the regular or limited duty position.

For more information on this topic click on the show transcript...

The podcaster is Dr. Stephen Taylor, OWCP medical-legal consultant & DOL expert for Oberheiden Law Firm. Dr. Taylor’s contact email information is:

fedcompconsultants@protonmail If you need a medical provider or assistance with an OWCP / DOL claim in Pensacola Florida you can make an appointment to see Dr. Taylor at the clinic at FWC Medical Centers or check out the webiste at fedcompconsultants.com To make a consultation with Dr. Taylor call the clinic at 813-215-4356 in Florida.

For responses email Dr. Taylor at fedcompconsultants@protonmail.com

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For responses email Dr. Taylor at fedcompconsultants@protonmail.com

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There is recent evidence that OWCP (under the U.S. Department of Labor) has increasingly began to outsource significant portions of claims-related services for FECA (federal workers' compensation) to third-party vendors, including private companies traditionally known for state workers' compensation claims management. This is a change in the entire structure of the FECA and OWCP government division's responsibilities.

OWCP has been slowly outsourcing divisions of OWCP to outside contracts in the form of third party vendors. This began with medical bill processing (e.g., past transitions to vendors like CNSI now called ACCENTRA) and medical authorizations. This began when OWCP decided to outsource the pharmacy benefits to an outside corporate vendor called OPTUM, a pharmacy benefit manger to manage all of OWCP's pharmacy benefits. We can expect to see an increasing amount of companies continue to be added for specifically handling broad OWCP claims adjudication, the overall trend of outsourcing to experienced private-sector TPAs vendors from the state workers’ comp ecosystem is now the wave of the future.

For more information read the show transcript.

The podcaster is Dr. Stephen Taylor, OWCP medical-legal consultant & DOL expert for Oberheiden Law Firm. Dr. Taylor’s contact email information is:

https://fedcompconsultants@protonmail.com If you need a medical provider or assistance with an OWCP / DOL claim in Pensacola Florida you can make an appointment to see Dr. Taylor at the clinic at FWC Medical Centers . To make a consultation with Dr. Taylor call the clinic at 813-215-4356 in Florida.

For responses email Dr. Taylor at fedcompconsultants@protonmail.com

Support the show

FEEDSPOT TOP #1 Federal Workers Compensation Podcast & #6 National Workers Compensation Podcast:

For responses email Dr. Taylor at fedcompconsultants@protonmail.com

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FEEDSPOT TOP 10 National Workers Compensation Podcast:

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CHALLENGING VALIDITY OF OWCP CLAIMS –
If the validity of a claim is questioned, the Agency supervisor should investigate the circumstances and report the results to OWCP. However, filing of the claim
should not be delayed whether the claim is disputed or what OWCP calls controverted.
A. Allegations Must be supported by factual evidence.
1) Different Versions of incident by several witnesses, whose accounts
differ, should provide supervisor with written statements of their
information.
2) Previous Injury – Agency should request statements from witnesses if
on the date on the claimed injury the appearance of a previous
condition or injury.
3) Time Frame – Agency should provide written statement if the injury is
reported after a lapsed time from the reported date of injury.
4) Outside of Employment – If employed outside of the agency and
injury is claimed, supervisor should inquire about the duties of the
other employment and report it to OWCP.
B. Notifications and Decisions – for more information click on the show transcript!

The podcaster is Dr. Stephen Taylor, OWCP medical-legal consultant for Oberheiden Law Firm. Dr. Taylor’s contact email information is:

https://fedcompconsultants@protonmail.com If you need a medical provider or assistance with an OWCP / DOL claim in Pensacola Florida you can make an appointment to see Dr. Taylor at the clinic at FWC Medical Centers . To make a consultation with Dr. Taylor call the clinic at 813-215-4356 in Florida.

For responses email Dr. Taylor at fedcompconsultants@protonmail.com

Support the show

FEEDSPOT TOP #1 Federal Workers Compensation Podcast & #6 National Workers Compensation Podcast:

For responses email Dr. Taylor at fedcompconsultants@protonmail.com

Support the show

FEEDSPOT TOP 10 National Workers Compensation Podcast:

https://podcast.feedspot.com/workers_compensation_podcasts/?feedid=5557942&_src=f2_featured_email

OWCP CLAIMS PROCESSING –

Certain procedures and responsibilities have to be accomplished once the

forms and information have reached OWCP for appropriate adjudication of

claim.

A. Initial Processing –

Once claim is received with all supporting documentation (when possible)

claim number will be assigned to the case. OWCP will notify the

employee and agency once claim has been received. Uncontroverted

claims with medical bills totaling less than $1500 will be administratively

closed by OWCP. Thos claims not meeting that criteria will be assigned to

a claims examiner for formal adjudication. When additional information is

required, the claims examiner will notify the employee by letter in ECOMP with a

copy to all parties to the claim. For more information click on the podcast transcript.

The podcaster is Dr. Stephen Taylor, OWCP medical-legal consultant for Oberheiden Law Firm. Dr. Taylor’s contact information is:

https://fedcompconsultants@protonmail.com If you need a medical provider or assistance with an OWCP / DOL claim in Tampa, Jacksonville, Pensacola Florida, Southern Mississippi or Daphne Alabama you can make an appointment to see Dr. Taylor, or Dr. Sullivan at the clinic at FWC Medical Centers or M & R Medical Centers. To make a consultation with Dr. Taylor call the clinic at 813-215-4356 or 813-877-6900 in Tampa go to our website at https://fwcmedicalcenters.net/ or https://fedcompconsultants.com/

For responses email Dr. Taylor at fedcompconsultants@protonmail.com

Support the show

FEEDSPOT TOP #1 Federal Workers Compensation Podcast & #8 National Workers Compensation Podcast:

https://podcast.feedspot.com/workers_compensation_podcasts/?feedid=5557942&_src=f2_featured_email

For responses email Dr. Taylor at fedcompconsultants@protonmail.com

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FEEDSPOT TOP 10 National Workers Compensation Podcast:

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Continuation of Pay (COP) is continuation of regular pay up to 45 calendar

days for periods of disability and or medical care, which occur in connection

with a Traumatic Injury. COP must begin within 45 days of the injury.

A. Entitlement –

Permanent and Temporary employees are entitled to COP when

Traumatic Injury is reported within 30 days. Medical documentation must

support all periods of COP. Normally, COP will begin the day following

the date of the traumatic injury. Except for Injuries that occurred prior to

the start of the workday, then COP will begin on date of injury. Medical

documentation must be received within 10 days of the injury to receive

COP and COP will be terminated if medical documentation is not received

within the allotted time frame. For any additional details, please click on the show transcript!

The podcaster is Dr. Stephen Taylor, OWCP legal consultant for Oberheiden Law Firm. Dr. Taylor’s contact information is:

https://fedcompconsultants@protonmail.com If you need a medical provider or assistance with an OWCP / DOL claim in Tampa, Jacksonville, Pensacola Florida, Southern Mississippi or Da

For responses email Dr. Taylor at fedcompconsultants@protonmail.com

Support the show

FEEDSPOT TOP #1 Federal Workers Compensation Podcast & #8 National Workers Compensation Podcast:

https://podcast.feedspot.com/workers_compensation_podcasts/?feedid=5557942&_src=f2_featured_email

For responses email Dr. Taylor at fedcompconsultants@protonmail.com

Support the show

FEEDSPOT TOP 10 National Workers Compensation Podcast:

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OWCP Claims for Compensation for federal - civil employees injuries, must meet certain requirements before being accepted. These five (5) requirements ( also known as the 5 elements of coverage determination criteria) must be met within the sequence below and if not, claim will be adjudicated or held up by requesting information from the injured work to satisfy each of the 5 element requirement in sequential order to be given due process:

A. Time

B. Civil Employee

C. Fact of Injury or Occupational Disease or Illness

Two factors are involved in the determination of whether the employee did in fact suffer the injury:

1) Occurrence of the Event 2) Existence of a Medical Condition

D. Performance of Duty

E. Causal Relationship

Each of these 5 requirements (elements) for establishing conditions of coverage criteria are covered in detail in this podcast episode to assist civil employees with successful claim adjudication of an on the job injury or illness. This episode is utilizing OWCP claims examiner training materials to explain how to meet the eligibility requirements from the claims examiner's training and understanding. It helps to understand how to speak the language that the OWCP claims examiner is trained in.

Click on the transcript for more information to source for Initiating Claims with OWCP

The podcaster is Dr. Stephen Taylor, OWCP legal consultant for Oberheiden Law Firm. Dr. Taylor’s contact information is:

https://fedcompconsultants@protonmail.com If you need a medical provider or assistance with an OWCP / DOL claim in Tampa, Jacksonville, Pensacola Florida, Southern Mississippi or Da

For responses email Dr. Taylor at fedcompconsultants@protonmail.com

Support the show

FEEDSPOT TOP 10 National Workers Compensation Podcast:

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Initiating Claims with OWCP.

Procedures initiating claims with OWCP for an employee who has (A)

suffered a Traumatic Injury, (B) suffers from an Occupational Injury or

Disease, (C) Recurrence of Injury or Disease, and (D) Death:

Seasosn 5 podcast episode 1 explaining how OWCP works from an OWCP Claims examiner's training. Today we are going over something I have never addressed in the podcast before…we are going to teach OWCP from OWCP Claims Examiner training material. In order to be successful with communication with an OWCP claims examiner, it is important to understand what they are trained to do, trained to look for and how to meet the eligibility requirements from their training and understanding. It helps to understand how to speak the language that the OWCP claims examiner is trained in.

Click on the transcript for more information to source for Initiating Claims with OWCP

The podcaster is Dr. Stephen Taylor, OWCP legal consultant for Oberheiden Law Firm. Dr. Taylor’s contact information is:

https://fedcompconsultants@protonmail.com If you need a medical provider or assistance with an OWCP / DOL claim in Tampa, Jacksonville, Pensacola Florida, Southern Mississippi or Daphne Alabama you can make an appointment to see Dr. Taylor, or Dr. Sullivan at the clinic at FWC Medical Centers or M & R Medical Centers. To make a consultation with Dr. Taylor call the clinic at 813-215-4356 or 813-877-6900 in Tampa go to our website at https://fwcmedicalcenters.net/ or https://fedcompconsultants.com/

For responses email Dr. Taylor at fedcompconsultants@protonmail.com

For responses email Dr. Taylor at fedcompconsultants@protonmail.com

Support the show

FEEDSPOT TOP 10 National Workers Compensation Podcast:

https://podcast.feedspot.com/workers_compensation_podcasts/?feedid=5557942&_src=f2_featured_email

A psychiatric condition is accepted under FECA only if a qualified mental health professional diagnoses an emotional condition and provides a rationalized opinion that it was directly caused or substantially aggravated by specific, substantiated incidents or conditions of federal employment — not by general job stress or properly conducted personnel actions.

If you are pursuing such a claim, almost all successful claimants use an attorney or experienced representative who specializes in federal workers’ compensation, because the medical and factual causation burdens are extremely high.

. Medical Causation Requirements for Establishing a Psychological DSM-5 Diagnosis for a Federal Employee Work-Related Injury

Under FECA, a psychological condition (e.g., PTSD, major depressive disorder, or anxiety disorder per DSM-5 criteria) qualifies as a compensable "injury" if it arises out of and in the course of employment (5 U.S.C. § 8101(5); FECA PM Part 2, Chapter 2-0200). Emotional/psychiatric claims are scrutinized closely due to their subjective nature, and OWCP applies the Lillian Cutler criteria from ECAB precedent (28 ECAB 125 (1976)) to establish eligibility.

Click on the transcript for more information to source for scheduled awards.

The podcaster is Dr. Stephen Taylor, OWCP legal consultant for Oberheiden Law Firm. Dr. Taylor’s contact information is:

https://fedcompconsultants@protonmail.com If you need a medical provider or assistance with an OWCP / DOL claim in Tampa, Jacksonville, Pensacola Florida, Mississippi or Daphne Alabama you can make an appointment to see Dr. Taylor, or Dr. Sullivan at the clinic at FWC Medical Centers. To make a consultation with Dr. Taylor call the clinic at 813-215-4356 or go to our website at https://fwcmedicalcenters.net/ or https://fedcompconsultants.com/

For responses email Dr. Taylor at fedcompconsultants@protonmail.com

For responses email Dr. Taylor at fedcompconsultants@protonmail.com

Support the show

FEEDSPOT TOP 10 National Workers Compensation Podcast:

https://podcast.feedspot.com/workers_compensation_podcasts/?feedid=5557942&_src=f2_featured_email

For responses email Dr. Taylor at fedcompconsultants@protonmail.com

Support the show

FEEDSPOT TOP 10 National Workers Compensation Podcast:

https://podcast.feedspot.com/workers_compensation_podcasts/?feedid=5557942&_src=f2_featured_email