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In this episode of the Injured Federal Workers Podcast, attorneys Erik Blowers and Mitchell Henshaw explain how federal employees can navigate the OWCP claims process after a workplace injury. They cover filing CA-1 and CA-2 claims, the importance of medical documentation, common delays and challenges, second-opinion examinations, and when it may be time to seek legal assistance.
Filing a claim is the first essential step after a federal employee is injured. Many people, particularly older individuals, tend to downplay their injuries, which can be detrimental. It’s crucial to acknowledge the injury and file the appropriate claim, either a CA-1 for traumatic injuries or a CA-2 for occupational diseases. The filing is now done online, which captures metadata, including filing time, and supervisors have ten days to sign off on the claim. It’s important to seek medical treatment simultaneously and consider reaching out to an attorney if the injury is serious.
For an occupational disease claim, five elements must be proven: timely filing, being a federal employee, the occurrence of an injury, the injury happening in the performance of duty, and a causal relationship to federal employment duties. Often, claimants mistakenly think a diagnosis alone is enough, but OWCP requires thorough documentation of the causal relationship, detailing how specific job duties led to the disease.
OWCP considers several factors, including whether the injury occurred within the scope of employment. Issues like whether the employee was on duty or fooling around are examined. A major focus is on the causal relationship and whether the medical evidence supports the claim. The medical documentation must thoroughly explain how the injury occurred and led to the current condition, which can be quite complex.
The processing time of OWCP claims can vary significantly. OWCP’s recent procedural changes require second opinion examinations, which can delay claims. These examinations are often criticized for being neither independent nor thorough. The complexity of the medical evidence and the backlog at OWCP also contribute to delays. Claims examiners might repeatedly ask for additional information, further extending the timeline.
OWCP often asks for information they already have, which can be a tactic to delay the process. It’s vital for claimants to respond promptly and provide the requested information, even if it’s redundant. Missing deadlines can lead to claim denial, so it’s crucial to meet all submission deadlines. Claimants should not give up, as the process can be frustrating and complex.
Once a claim is accepted, the next steps depend on the need for medical care or wage loss. Serious injuries may lead to surgeries, while wage loss claims can be complex due to attempts by agencies to offer jobs within medical restrictions. Getting paid for wage loss can be a lengthy process, and the system is often criticized for its inefficiencies.
Federal employees often seek help after a claim denial or when they encounter repeated issues with their physician’s reports being rejected. Frustration arises when common sense suggests approval, but technicalities cause denials. Many give up without realizing they could benefit from expert assistance. The adversarial nature of the process, despite being non-adversarial in theory, often necessitates professional help.
