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 Post subject: OWCP district medical doc cut impairment rating 17%
PostPosted: Tue Mar 27, 2012 11:40 pm 
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Joined: Tue Mar 27, 2012 11:15 pm
Posts: 25
:x I finally made it back to work with restrictions from work injury 1/18/2011. The Physiatrist I saw (approved by OWCP) for my Impairment Rating assessed 37% using 6th AMA Edition. Then OWCP sent it to the DMO, Dr. Morley Slutsky in Tacoma, WA. who of course has never seen me (I live in South Dakota). He reviewed my records and the IR and accepted a Prompt Pay $350 for doing it and docked me down to 20% Impairment. I know he is wrong. I have RSD from bad surgery for a wrist fracture.I can't straighten or bend my fingers, am too weak to do a lot of the parts of my job I did before, etc. yada yada. I am sick of talking about my disability and it hurts to type, but I am a Physician Assistant in a clinic using electronic health record all day in a remote Indian Health Service Hospital. I applied for the Schedule Award based on the 37% impairment of the right upper extremity. My accepted conditions are Causalgia, right distal wrist fracture and adhesive capsulitis of the right shoulder.

Does anyone know if OWCP or my doctor can help change or upgrade the opinion of Dr. Slutsky?
I am going to appeal this no matter what, but do I have to have a lawyer for a good outcome now?
Do I have to suffer yet another Impairment Rating with another doctor of OWCP's choosing?
I feel so discouraged. I did request my records including the letter from Dr. Slutsky, so I will have more information soon as far as how he rationalized cutting 17% off my Schedule Award assessment.Anyone have any success stories relating to a situation like this? Thanks.


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 Post subject: Re: OWCP district medical doc cut impairment rating 17%
PostPosted: Sun Apr 01, 2012 11:27 pm 
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Joined: Wed Mar 16, 2011 11:05 pm
Posts: 933
Highplains:

It is SOP for OWCP to send your impairment rating to a District Medical Advisor, (DMA), that's what Dr. Slutsky is...a DMA. Dr. Slutsky is used to knock down impairment ratings.

Yes you can appeal. You do not necessarily need another impairment rating.

You should write OWCP and ask for a copy of Dr. Slutsky's report as well as any documents bookmarked for him. Bookmarked documents are the records your CE sends to the DMA. You should also ask for any questions the CE posed to Dr. Slutsky.

Once you have the report, you can take it to the physician that did your impairment rating. You physician can then "rebutt" Dr. Slutsky's report and opinion. It would be very helpful if your physician could say how/why Dr. Slutsky got it wrong and the page number of the 6th Edition of the Guides where your physician got the information.

The rebuttal from your physician is how you would appeal Dr. Slutsky's opinion/rating. OWCP can either accept your physician's opinion, explain why Dr. Slutsky is the weight of medical opinion or send you to an Independent Medical Evaluation, (IME) to be the deciding opinion.


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 Post subject: Re: OWCP district medical doc cut impairment rating 17%
PostPosted: Sun Apr 15, 2012 5:35 pm 
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Joined: Tue Mar 27, 2012 11:15 pm
Posts: 25
I did request the OWCP files and received them on a CD within a few days. I carefully read Dr. Slutsky's report and actually agreed with him that the physician who performed my Impairment Rating was kind of lazy and didn't do or document the full exam according to the 6th Edition which might have given me a rating both physicians could agree upon. When I had my IR exam the doctor failed to measure my loss of range of motion on the affected side and compare it to the uninjured side. I wish I had a full copy of the exam requirements before I went through this, but they were not available to me.

I wrote to my Claims Examiner and itemized the areas where I agreed that additional measurements of my impairments were required by the 6th Edition and asked if all the points Dr. Slutsky mentioned could be amended to close the 17% discrepancy. I have not heard back yet. I know Dr. Slutksy is wrong in his only 20% rating compared to my physicians 37%. I called a few Federal Work Comp lawyers, but they were so rude and aggressive to get me to sign up with them, I decided that armed with the OWCP reports, I probably have a better understanding about methods used to decide on each rating than the doctors who did them.

The 20% fee the lawyer would get by helping me just isn't worth it. He wasn't the one lying with a broken wrist in a blizzard outside the hospital I work at and he wasn't the one who developed RSD from the surgery of the arrogant 1st year surgeon who felt that she knew what she was doing. Regaining one's sense of self-confidence and personal power after a disabling accident is difficult but educating yourself on the details of your case and not delegating this power to someone who doesn't care as much as you is a good way to help you heal, at least it has helped me.

I will keep you posted about how my Claims Examiner decides to handle my case. When there is a 17% discrepancy they can't award a schedule payment. Even OWCP has to find a way to appeal to the physicians involved to re-work the data.


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 Post subject: Re: OWCP district medical doc cut impairment rating 17%
PostPosted: Mon Apr 16, 2012 11:24 pm 
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Joined: Wed Mar 16, 2011 11:05 pm
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A couple of things here. First, an attorney/representitive CANNOT charge you a percentage. In OWCPland, it MUST be an hourly rate with an itemized bill.

Although, you can bring up the differences between Slutsky's report and the 6th Edition of the Guides as an arugment on appeal, it would be better to have a physician back you up.


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 Post subject: Re: OWCP district medical doc cut impairment rating 17%
PostPosted: Tue Apr 17, 2012 2:27 am 
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Joined: Tue Mar 27, 2012 11:15 pm
Posts: 25
Thanks. I agree. I will have to wait to see if my CE asks my physician to respond to the DMA's report. If not I may end up having to have a referree doctor. I don't have a plan yet, just waiting until I hear from the CE.


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 Post subject: Re: OWCP district medical doc cut impairment rating 17%
PostPosted: Tue Apr 17, 2012 2:43 am 
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Joined: Tue Mar 27, 2012 11:15 pm
Posts: 25
By the way, I am a Physician Assistant and have worked in the field for over 30 years. But I wouldn't dream of trying to appeal my own case without documentation of a doctor. I was told by one work comp lawyer that he charges 20% of the schedule payment. The other lawyer has a "free" blog and actually yelled at me for asking a question on his website.He was afraid I might get some of his wisdom without paying for it I guess.
I am trying to keep up a full-time job caring for people mostly more injured or afflicted than I am 40 hours a week. The hospital I work for has made almost no accomodations for my injury ( I am my own advocate here) and on top of this I am waiting to hear from the department of labor to see what hoops they will make me jump through next or what capitated settlement they try to offer me. I still might need help. Just don't have enough information right now to know what direction this is going. I couldn't have gotten as far as I did without studying OWCP classroom throughout every step of this work comp process. It has been rough, but I haven't given up yet. I am extremely grateful for this website and for this forum.


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 Post subject: Re: OWCP district medical doc cut impairment rating 17%
PostPosted: Wed Apr 18, 2012 10:39 pm 
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Joined: Wed Mar 16, 2011 11:05 pm
Posts: 933
I'm extremely happy to hear that The OWCP Classroom is helping you. That's exactly why I started it, so Claimant's would know their rights and what to do when OWCP attacks.

Being your own advocate has it's benefits. No one knows what's happened to you more than you do. If you get in trouble...you know where to ask. You shouldn't be yelled at for asking questions.

Stay strong and keep up the good work.


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 Post subject: Re: OWCP district medical doc cut impairment rating 17%
PostPosted: Mon May 07, 2012 11:53 am 
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Joined: Tue Mar 27, 2012 11:15 pm
Posts: 25
My Claims Examiner has determined that I have to go to a referree, second opionion exam, to be scheduled by their agency in California. According to OWCP, the District Medical Advisor, M.D. was right and my Impairment Rating physician was wrong in combining the impairment for CRPS/RSD with the range of motion impairments of each joint of the upper extremity. According to the AMA 6th Edition you can use one or the other and in my case RSD is rated higher than individual joints (hand, wrist, shoulder). It sounds complicated, but basically the 20% rating for CRPS is a good start. I also need to have xrays of my injured and uninjured upper extremity and if this shows trophic, bony destruction such as osteopenia on the injured side, this will add a higher percent of impairment to the 20%. It is likely that the referree doctor may find other characteristics of the CRPS injury that also add percentage points to the 20% rating.
I have been advised, informally, that OWCP has to accept the higher rating between the DMA and the second opinion.

Apparently the pearl of information for other injured work comp people is that very few doctors really understand the 6th Edition, but the DMA who reviewed my case was correct on paper. I will let you know what happens. Have been (informally) told by a work comp lawyer that I have a good case and that hiring a lawyer would not help me get a better rating, so even though it has been difficult, OWCP Classroom has been sufficient and accurate guidance.


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 Post subject: Re: OWCP district medical doc cut impairment rating 17%
PostPosted: Mon May 07, 2012 10:06 pm 
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Joined: Wed Mar 16, 2011 11:05 pm
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Highplains: Thanks and I'm glad it's helped you and wish you luck.

Just FYI FedDoctor.com is a network of physician's that are schooled in the 6th Edition of the Guides and more than willing to take on OWCP claimants for Impairment Ratings and as treating physicians.


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 Post subject: Re: OWCP district medical doc cut impairment rating 17%
PostPosted: Tue May 08, 2012 11:59 am 
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Joined: Tue Mar 27, 2012 11:15 pm
Posts: 25
I will be assigned a doctor by OWCP to referee the Impairment rating. I looked up FedDoctor.com and they list no doctor closer than 500 miles or more from where I live. My second opinion last july involved traveling a 600 mile round trip. The doctor was fair and not one who usually works for the department of labor. I was afraid he would sabotage me, but actually the second op was so knowledgible that he made the work comp people look really stupid and prejudiced, especially the field nurse from hell and they reassigned my Claims Examiner and changed my accepted conditions based on his excellent documentation. So the second opinion exam can work out in the claimants favor sometimes.


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