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Take our survey FedupFeds Report Reform Agenda FECA - loopholes Perez Papers
Actionline-Congress July 1998 Hearing May 1999 Hearing Linehan testimony Perez testimony
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This Report, along with copies of all responses at that time, was submitted at the May 28, 1999
hearing of the House Government Management, Information and Technology Subcommittee.  
This Report is updated periodically to include data from the ongoing Survey.
To add your voice to our ongoing survey, go to the  Survey and fill out the form online         Our online survey of seriously injured federal workers has documented the failure of OWCP under the Federal Employees Compensation Act.  Official "customer service" surveys have avoided asking these questions.
       How bad is it?
       The average person reports experiencing at least six out of ten different kinds of problems EACH with their OWCP claim   (other than having claims denied or delayed).  These problems are the kind of roadblocks no one should ever experience regardless of the merits of a claim.   One or two snags along the way could happen to anyone.  But an average six out of ten cannot be coincidence or isolated cases.  They suggest systemic, deliberate stonewalling and obstruction on the more serious, costly claims, and an agency out of control and far from its intended purpose.
     FedupFeds is speaking for hundreds of injured federal workers nationwide, across a wide range of federal agencies, who report serious failures of the federal injury compensation system under the FECA. But with 175,000 reported injuries annually, this survey only shows the tip of the iceberg.
  
Table 1:  Percent of responses answering YES to 10 problem areas no one should experience,
regardless of the validity of a claim
 
55%
 
74%
 
72%
 
88%
 
85%
 
66%
 
77%
 
65%
 
64%
 
47%
 
1 2 3 4 5 6 7 8 9 10
  
1.  difficult to get claim forms
2. intimidation or retaliation at work
3. agencies mishandling claims or falsifying
4. difficult to deal with the red tape
5. difficulty getting OWCP to communicate
6. difficulty getting doctors paid
7. medical care interrupted or delayed
8. condition worsened due to treatment delay or return to work
9. doctors reluctant to take claims
10. second opinion doctor did a sloppy exam
   
        See complete results of 24 questions below. 
Effects of initial denial      In spite of these roadblocks, 45% report that claims initially denied were later accepted by OWCP, showing that those claims should have been accepted in the first place.  These are unquestionably valid, compensable claims by OWCP's own admission, yet the process seriously failed these 45% before finally accepting their claim.  Many of those whose claims were accepted still lost income, assets, and/or medical treatment, and/or saw their condition worsen from the delay.   Much of their loss can never be replaced with a check for back pay.  Many of the rest never had a claim accepted at all.
Second opinions        Of those accepted, we do not yet have any data showing how many were immediately overturned again by OWCP second opinion doctors, or how many months it took to get doctors and pharmacies to get paid after they were accepted--if ever.  However. 46% did report being sent to multiple second opinions.  No one--0%--reported being sent to a second opinion doctor while their claim was already in a denied status at the time.   This indicates that second opinions are used only to deny claims.
Devastating effects        The negative impact of these problems is shown by the fact that 76% of those responding experienced serious interruption of income, 56% lost family assets or credit rating in the process, 38% had been fired or separated due to their medical condition, 77% had their medical care interrupted or treatment delayed, 66% had a condition worsen due to treatment delay, 66% had a condition aggravated because of return to work, and 72% had another condition develop from the original injury.
It's all adversarial        In questions # 14 & 20,  64% find it difficult to get the services of lawyers and doctors for their claims.   Claimants are usually on their own against the legal and medical expertise of the OWCP establishment.  This also makes the process adversarial.  Mr. Perez' testimony sheds light on the reluctance of doctors to treat OWCP claimants, and these percentages back him up.   Question # 10 suggests widespread breach of medical ethics by "rehab" nurses, that should be investigated and remedied by medical authorities and government.
Cost-shifting:   Who gets stuck with the  bill?         Another obvious conclusion is that delays and denials of treatment run up the cost of medical care, regardless of who ends up with the bill, by worsening their condition physically and mentally.  The true cost of that should be studied from official records, along with billing from second opinion doctors, and of course, the enormous cost-shifting referred to above.
       We are calling this survey to Congress' attention because it indicates that systemic failures of OWCP have much wider effects on other government programs.   Beyond the direct harm to many thousands of injured workers, our data indicates that massive and hidden cost-shifting is occurring.  Federal on the job injury costs, because of unjustified denials, delays, and roadblocks by OWCP and employing agencies, are unfairly burdening the Social Security Disability program, federal health insurance (FEHB), and public assistance, and are eroding the tax base and national productivity.  We are contacting other organizations who share those concerns as well.  These costs and our own survey results should be independently investigated by a high-level commission for Congress, and the voices of thousands of injured federal workers should be heard for the first time.  Previous studies have left them out completely, leaving the fox to guard the henhouse.
 
Table 2:   Percent of those answering yes to each of  24 questions
55 % 1.      Did you or do you have trouble getting the needed claim forms at work?
74 % 2.      Have you experienced intimidation or retaliation at work (made an example)? 
72 % 3.      Did your agency mishandle your claim or falsify information against your claim?
76 % 4.      Have you experienced serious interruption of income?
56 % 5.      Have you lost family assets or credit rating in the process?
44 % 6.      Have you had another work-related condition with no claim filed for it?
45 % 7.      Has your claim(s) been denied and later approved by OWCP?
38 % 8.      Do you have another claim (resulting from first condition) denied by OWCP?
57 % 9.      Have you found it difficult to get a copy of your case file?
20 % 10.    Have you had a rehab nurse tell a doctor to return you to work?
88 % 11.    Have you found it difficult to deal with the red tape in OWCP? 
74 % 12.    Has OWCP been confusing about what was needed to approve your claim?
85 % 13.    Have you found it difficult to get OWCP to communicate with you?
64 % 14.    Have you found it difficult or impossible to use a lawyer?
38 % 15.    Have you been fired or separated due to your medical condition?
62% 16.    If you knew what you know now, would you avoid federal work?
77 % 17.    Has your medical care been interrupted or treatment delayed?
66 % 18.    Have you had a condition worsen due to treatment delay?  
66 % 19.    Has a condition been aggravated because of return to work?
64 % 20.    Have you found doctors reluctant to take OWCP claims?
66 % 21.    Have you had trouble getting medical treatment paid for?
46 % 22.    Have you been sent to multiple second opinions?
47 % 23.    Has a second opinion doctor done a sloppy exam or no exam at all?
72 % 24.    Have you had another condition develop from the original injury?
Conclusions     Under the Federal Employees Compensation Act, FECA, the Federal government is mandated to be a model employer.  The FECA was intended to provide medical care and income replacement for federal workers injured on the job.  It is not a tort system, but an administrative process that bars recourse to the courts and rarely involves attorneys.   It is supposed to be non-adversarial and impartial.    
     Generally the injured worker is left to navigate a muddled and confused system without any assistance and information needed to document and process their claims.  A majority of cases also incurs additional medical problems, along with financial problems and strain on families.   Since OWCP reports more than 170,000 new claims each year, the implications of such failures are far-reaching.    
      We find that instead of being a "gravy train", OWCP has turned into a national disgrace and that the agency is literally above the law.  Previous testimony shows that no agency wrongdoing is ever prosecuted, and no one gets their day in court either, to enforce the laws that are routinely violated.   We find that convicted felons and prisoners of war have legal rights that injured federal workers can only wish for.  We find that they are destroyed not so much by their injuries as the government's MIStreatment of them.  We ask Congress to order its own comprehensive, independent investigation of OWCP "customer service", by going directly to the injured workers themselves as we have demonstrated by our survey.    (3)   We find that previous investigations and reports of "customer service" improvements conflict with the experience of injured workers themselves. (4) 
Gravy train???       The existing system for handling work injuries tends to aggravate the overall situation it was supposed to alleviate.   It has an unintended effect on not just the injured, but the government and economy as a whole.  The enormous cost shifting of claim denials force up insurance costs for the rest of the workforce, as well as reducing the tax base, and adding to the costs of other public services and public health. This also shifts accountability for safe working conditions as a result.   Tens of housands of the injured see that agencies are above the law, and, sadly, lose faith in our form of government and the country they have loyally served most of their careers.  This represents damage to the nation that cannot be undone.  The general welfare demands quick, competent handling of claims and treatment, and the federal government should be in fact the model employer in the national interest. 
     The conscience of the Nation and its Representatives has brought many reforms over the years in the name of fairness and equality under the Constitution.  Your concern encourages us to believe that right will be done, and that those who label this OWCP system a "gravy train" will admit that it is a national disgrace, and right a great wrong for the people who work for this Nation.   We trust that a fully informed Congress will want to take whatever action is needed to return the agency to Congress' original purpose in enacting the law. 
Origin of this Survey      This "customer service" survey is the voice of injured federal workers nationwide.   FedupFeds is an online grassroots organization of hundreds of injured federal workers who have experienced the failures of OWCP.  Our own online survey of injured workers themselves documents serious claims about the adversarial nature of the process brought out by Mr. Joseph Perez and others  in Congressional testimony (1).  Our survey includes a wide range of federal agencies nationwide.  This survey is not a pile of complaints, but rather reports of specific, named problems that cannot be justified in any case, and can be fixed in specific ways. (2)   Our members are not asking for a higher level of benefits, but simply for the system to work the way that Congress intended.
  Why we call for an independent Congressional study     1.  The inhouse surveys that never ask the real customers--injured workers--how they are being served, and what difficulties they are experiencing with the process.
    2.  The OWCP mission statement and customer service plan that don't even attempt to address the systemwide problems that our members report.
    3.  The Perez and Usher testimonies about OWCP priorities that neglect the goal of covering work-related injuries under the FECA.
    We emphasize that the adversarial nature of the claims process has not shown up in reports and surveys because they have asked the wrong questions of the wrong people; and we urge Congress to order a first-ever, comprehensive, independent study of the real customers, the injured claimants, and ask them "How are you being served?"  We expect that such a survey would be needed to corroborate our own survey and document the need for specific reforms as we propose.  See Further Abuses and Issues
(See Reform for further analysis and recommendations for reform)
____________________________
NOTES

(1)    Our survey serves to document statements made by Mr. Joseph Perez, former OWCP hearing representative, about the system's built in bias against injured workers.  His 88-page testimony submittted to the subcommittee previously is found in our website at http://fedupfeds.org/pereztoc.htm   and the earlier Perez Papers are found at http://fedupfeds.org/perez.htm .

(2)     To document our survey results in this summary, we are furnishing Congress hard copies of these survey responses.  The answers given can be verified through official records, medical sources, and OWCP.  Many of their comments in them illustrate the extreme individual difficulties reported in their answers, as well as many outrageous experiences that no survey could anticipate. 

(3)     We recognize that minor injury claims (that are cut-and-dried and right back to work with no lasting disability) are underrepresented among those responding to this survey. However,  with 175,000 new injury claims reported each year , this number which are serious injuries with serious claim problems, can easily run into tens of thousands every year.  When you add to that the estimates of thousands more who feel forced to shift the cost to FEHB insurance, instead of filing as on the job injuries, the numbers may go far higher. 

(4)       This reports preliminary results of the FedupFeds online survey of injured federal workers'  claim difficulties.  The survey is still in progress, and we will continue to update the results.  The current survey results are based on all responses received by May 18, 1999.

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Further issues to investigate

     OWCP admits injured workers aren't told how to satisfy their burden of proof, in their Customer Service Plan:   ". . . we need to do a much better job of informing injured workers what the adjudication process entails, the type of evidence they need to supply, and the target timeframes we strive to meet in adjudicating their claims. Goal: We will begin to notify employees filing occupational illness claims of these evidentiary requirements, what they can do to speed the process . . .".  This is found in the Customer Service Plan.   No further proof of the adversarial nature of the process can be required, by their own admission.

     We would all like to know how many doctors' entire practice consist of sending people back to work with opinions of no injury or no disability, and who they are.  We would also like to know how much OWCP uses the same small physician pools around the country to do their second opinions, and why the pool of "available" secop doctors is not much larger than it seems to be.  The practice of using cursory hands-off secops to create medical conflicts to deny claims or terminate benefits should be investigated in detail.  We believe that statistical studies of these issues would reveal the most serious abuses by OWCP.

     They don't tell injured workers or their doctors what is actually needed to accept a claim , but play guessing games with the wording on causal relationship and medical evidence. They offer easy access to case files for the agencies, but claimants continually report they can't even get copies of their own files and medical reports in a timely manner.  Many cannot even find out what doctors said to cut off their benefits without having to involve their Congressmen.  The way they interpret "burden of proof" is to expect injured workers and their doctors to dig out all the obscure rugulations and case law that OWCP or ECAB might feel is applicable to their case.   This is an obvious impossibility without being able to routinely afford and use lawners, yet many thousands of claims depend on being able to do this expertly.

     Doctors everywhere hate to take federal injury cases. Our members report that many times it's hard for treating physicians to get paid, and they are routinely insulted, ignored,  and pressured by agencies and "rehab" nurses. Once a claim has been denied, claimants find it difficult to get doctors to continue treatment or fill out the needed paperwork to rebut OWCP's own doctors regardless of how unqualified or incompetent OWCP doctors may be. They get harassed by agencies and by OWCP to return claimants to work, regardless of their own firsthand medical evidence and knowledge.

     Agencies commonly make verbal accommodations to light duty needs, and then force returning workers to aggravate the original injury or lose their job, then lose their claims, and lose their health insurance and family security with it. They wait months or years for treatment and income replacement, only to have OWCP finally approve it as it should have done long before. Due to OWCP delays, medical conditions get worse and the final cost goes up out of control. The worker sometimes ends up totally disabled for lack of treatment.

     One of the most obvious abuses is cutting off compensation and treatment without sufficient warning, without time for them to revisit their treating physicians for more specific examinations and reports for OWCP, and without understanding why claims are cut off. If any warning is given, the time frame is too short to respond with needed medical evidence in most cases, and in any event, the only recourse is to do without and appeal for a hearing to be held months in the future.  Time limits for injured workers to respond should be from the date received, not from any old date that OWCP puts on their letters.

     Many of the injured report agency intimidation and retaliation. We don't know how many legitimate claims are never even filed because they make examples of those who do. But they can't sue; they can only try EEOC and wait years for justice. By then, their careers, homes, and families may be history. This happens far too often.

     Our reports from claimants indicate that the whole OWCP system with its paperwork, red tape, and obscure regulations is simply too complicated for many of the injured (and their doctors) to make effective use of the system and get the protections that Congress intended.  In most cases there is no realistic guidance for the claimant to cope with the red tape and requirements.  This makes the process especially adversarial when people are in pain with attendant difficulty in coping with the injury or disease itself and the frequent emotional damage or clinical depression that may arise from it.  Such collateral difficulties are well documented in medical literature.   But nowhere does the process take this into account.   Meanwhile, the claimant is up against an army of red tape experts in OWCP and the agencies.

     There is no ombudsman looking out for the rights of the injured worker.  How can we have an impartial and nonadversarial system without independent assistance to those injured and disabled?  OWCP has long demonstrated that their primary allegiance is to the employing agencies, fostering widespread allegations of collusion and unethical conduct.

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