Managing Your Claim
ATTENTION ALL CARRIERS THAT HAVE FILED A CLAIM TO OWCP. Once you receive a Development
Letter YOU MUST CONTACT ME IMMEDIATELY. Call 631-789-1616 so we can review your claim to determine what you need to do to help get your case approved. Failure to contact me could result in your claim being denied.
Once you have filed your claim and all your paperwork has been received by the Department of Labor (DOL), including all your documentation from your Doctor, the DOL has three options they could determine one of three options about your claim. The Options are as follows:
1. Request more information
OWCP will notify you if your claim lacks sufficient information for them to make a decision for your case. In this scenario the DOL will send you a development letter requesting more information citing several questions for you and your Doctor to answer. These letters only give you 30 days from the date it was issued to respond.
It is important that you respond immediately and answer the questions within the time frame of 30 days from date of issuance. Make an appointment with your Doctor as soon as possible the clock is ticking. Take the letter from OWCP to your Doctor’s appointment and have the Doctor thoroughly answer the questions. Convey to the Doctor the importance and urgency in returning the information within the time frame. This new information must be received by OWCP within 30 days, having the letter postmarked is not sufficient enough. Mail the document by certified mail with a return receipt to track the letter. Use ECOMP to upload your documents directly to your file if necessary. ECOMP is a free web-based application hosted by the Office of Workers' Compensation Programs (OWCP) that provides Federal agencies with an electronic system for recording workplace injuries and illnesses, and processing claims under the Federal Employees' Compensation Act (FECA).
Prior to mailing out the documents make sure you make a copy of all the information for your own records. You need to maintain copies for your records when you have to respond to OWCP. If you have questions with your claim, contact me at the Branch Office (631-789-1616). I will guide you what you need to do next. FECA gives you the right to appoint a representative of your choice.
2. Claim is accepted
In accepting your claim OWCP has determined the documentation provided is sufficient. If you selected Continuation of Pay (COP) and after you’re out 45 days, the postal Service is required to provide you with Form CA-7 request wage –loss compensation. The Form comes with instructions on how to properly complete the form and submit it.
If you do not receive the CA-7 from the Postal Service request one from your Supervisor. You can also print one from the Department of Labor’s website (you can google CA-7 as well to download the form). You will be required to complete a new CA-7 every two weeks (usually on the last Friday) and send it to your compensation specialist at the district. Send a written request for a copy of the completed CA-7, including Management’s portion for your records every time you submit it to injury compensation in the district.
Ask your Supervisor for injury compensation office’s address along with their fax number. The Postal Service has five (5) work days to complete their portion of the CA-7 and send it to OWCP. Always keep a copy of your CA-7 for your personal files.
If the Postal Service notifies you that they have a Limited Duty Job offer (LDJO) you need to review it to determine if it falls within your doctor’s restrictions listed on your most recent CA-17. If the job offer looks reasonable and is within your medical restrictions accept the job offer and begin working. If you believe the job offer exceeds those limitations, you have the right to take the offer to your doctor. The doctor then will determine if the job offer falls within your medical restrictions.
Do not refuse a job offer. If Management demands you to either accept or reject the job offer, accept the offer and write “pending doctor’s approval” next to your signature. FECA regulations allow you to have your doctor review any job offer for compliance with your medical restrictions.
Take the job offer to your doctor as soon as possible and give the Postal Service and OWCP the medical provider’s response. The Postal Service may offer you multiple job offers and you should follow the above procedures I have stated each time to determine whether the LDJO is suitable. If OWCP determines the job offer is within your restrictions, they will notify the employee in writing and give the employee 30 days to begin the job offer.
3. Claim denied
If OWCP denies your claim they will list the reason(s) why. Along with the denial, OWCP will give you a list of your appeal rights. Each venue has specific time limits that are absolute. In order to successfully appeal the denial, you must address each of OWCP’s reason(s) for the denial. In most cases it involves further medical documentation and new medical opinions from your doctor or specialist.
Contact me at the branch office (631-789-1616) in choosing the proper venue for your appeal. I just want to wish everyone a Happy Easter or Passover.
