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| Survey Report | Reform | More Issues | Official Reports |
| May 18 '99 Hearing | July 6 '98 Hearing | Perez Papers | Perez Testimony |
| GAO and IG reports and "customer surveys" were based on reports from OWCP that are, predictably, self serving, and not based on independent research. The 1994 GAO/GGD-94-67 is a case in point. It was done in response to widespread allegations of doctor shopping by OWCP. While they did not find doctor shopping for bias against claimants, they were focusing on IMEs, not second opinions which are not subject to impartial rotation in the PDS system (page 5 of report). We point out that second opinions have been increasingly used in place of referees (IMEs), which Joseph Perez testified is contrary to the plain language of the FECA. OWCP conveniently believes that opinions have to be of "equal weight" to warrant actual IME (page 5 of report); so secops can be used in their place as often as needed to get the desired opinion. Our members report that this happens often. There is also evidence that some agencies are using fitness-for-duty examinations to create the "medical conflict" that opens the door for OWCP to use secops to cut off claims and return untreated workers to the jobs that disabled them in the first place. Apparently they neglected to ask injured workers themselves why they felt that doctor shopping was going on, and never investigated those reasons in the real life situations they would have related to investigators. The study is too narrowly focused and does not begin by asking injured workers how the system works against them in the real world. If it did, they would learn that, even if secop and IME selections were fair and not predisposed against claims, OWCP is still free to shop around and keep sending orders to see secops until they hit one who will order the worker back to work untreated. (Of course, the worker is stuck with initial choice of physician who may or may not be getting paid by OWCP). The report claims that OWCP paid over 95 percent of treating physicians bills in their own time frame of 60 days. This is interesting, because a large percent of all claims are minor scrapes and so forth where they return to work immediately or shortly thereafter. Brief, uncontested (and cheap) claims form the bulk of all doctor bills (in the number of bills). But no information is given on payment of the other 5 percent of bills--if they ever got paid at all. Clearly, they would be the contested claims and the more expensive, long term disabilities. This is not a small figure. 5 percent of 175,000 claims a year is a lot of people. GAO did not investigate that 5 percent and the circumstances involved. The report acknowledges that treating physicians take a lot longer to get paid than OWCP secops or IMEs, but excuses that on grounds that it takes OWCP a lot longer to figure out whether treating physicians' bills are correct (page 11 of report). Obviously, they might be cheating on their bills, but OWCP picked doctors are passed on through in 30 days. We need to see a full comparison on how much they are paid for the same kind of examinations. Certainly, it would be a bargain for OWCP if they can approve their own secops bills without being too hard on them, and make much larger gains in cutting long term disability costs by returning sick people to work or by getting them to quit and give up. This is what many of our members feel is happening to them. It's called cutting corners to make the numbers, and many jobs depend on doing just that. Medical bills for OWCP doctors are subject to the Prompt Payment Act and must have interest paid on overdue bills, but treating physicians bills are not. Finally, OWCP District officials admitted in the report that they have trouble getting a larger pool of physicians to accept their secop and IMEs. They pretend to be puzzled and frustrated over this. We are not surprised. After they run off most of the fair and unbiased doctors who have supported claims, there aren't many left to do their dirty work. Based on reports furnished by OWCP, the 1998 report from the Subcommittee on Workforce Protections shows they are not even aware of any reports of problems with injured workers getting the protections that the law intended. The only action in 1998 apparently was a minor technical ammendment. H.R. 3096 was signed into law October 9, 1998. It became P.L. 105-247. The subcommittee report is at http://frwebgate.access.gpo.gov/cgi-bin/useftp.cgi?IPaddress=162.140.64.21&f ilename=hr836.105&directory=/diskb/wais/data/105_cong_reports (If reports from claimants themselves are to be cynically disregarded on some grounds that they would be too self serving, then reports from agencies should be given the same treatment on grounds that they are self serving, making the numbers look good at the expense of the injured.) The lack of official interest in why claimants give up and don't file appeals on denials was questioned in Rep. Horn's hearing in Long Beach July 1998. They don't study how many claimants are losing income that should be getting compensation, or how many are not getting the medical care and getting worse as a result, or how many people are being forced back to work that aggravates their conditions because of OWCP red tape and loss of paychecks, and agency intimidation. The official reports simply do not ask whether medically supported claims are getting the medical treatment and wage loss protection the law intended. How many people have their health and career ruined, only to have their claim accepted later on the medical evidence? They don't know because they don't ask. Yet these are responsible, knowledgeable career employees who report to us that they can't handle the red tape and OWCP gobbledegook, and neither can their doctors. Surveys don't reveal the thousands who fall between the cracks, and lose their health, their hope and their will to live through it. There are suicides, attempted suicides; and it is common, we believe, for claimants to be treated for clinically diagnosed depression, which stems from pain as well as the frustration of dealing with the process. |
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