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 Post subject: confusing CQS
PostPosted: Thu Aug 04, 2011 5:28 am 
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Joined: Wed Aug 03, 2011 9:42 am
Posts: 21
I would like to ask if anyone knows anything about the CQS. I was on PR for a very long time. Not sure the difference between the PR or DR or what they really mean for me. I believe I was moved to DR when i was paid for my lost wages, but I don't get weekly or monthly checks for compensation, nor have i been accepted for a schedule award, so why I would be on a daily roll when I am only recieving medical is confusing. I have seen a change now where it states DR 05/04/2005. I know It has not stated being on the DR since 2005, but it changed from PR to DR in 2010.

Current Case Status DR - 05/04/2005 - Payment on Daily Roll
Current Location OLI - 07/22/2011 - DESC MISSING
Continuation of Pay was not elected
Case Created: 04/18/2005
Closed:
Lost Time Began:
Reopened:
Last Updated On: 01/19/2010
Retired:

On the 21st of this month after they granted reconsideration, but during the time for the employer to respond (July 13th -August 2nd), I brieflly saw the Location was DM something, I am guessing A? on 7-21-2011-district medical director function. Which i found odd seeing they don't do the reconsideration process until after the 20 days for the employer to respond. They didn't respond last time, as of yesterday august 2nd I hadn;t heard they have this time yet either. The last time I was in reconsideration it did say DMA-district medical advisor, and I have seen it say Oasis. I am wondering what's the difference for district medical director function verses district medical advisor?

There have never been any codes for the reconsideration status, or any adjudication codes. The Description missing seems to always be there & has been this way for 6 years. The only thing i have found about OLI is its short for optional life insurance, but i haven't had a discussion with anyone about that nor what it really means. I can't find anything for the number codes 71,93,91, 74 or 94 on the following decisions. Nor is there anything I am seeing anything about the Ca2 i submitted, with the CA-7 compensation request and reconsideration.

Date CA-7 Received by OWCP Decision Code, Date, & Description Date
71 - 2010-07-28 Already Paid/Duplicate - LWOP 2010-02-10
93 - 2009-11-10 Formally Denied - OWL 2009-08-14
71 - 2010-07-28 Already Paid/Duplicate - LWOP 2010-02-10
91 - 2010-07-28 Formally Denied - LWOP 2010-02-10
- - 2009-10-05 74 - 2009-10-16 Already Paid/Duplicate - SA 2009-08-14
- - 2009-09-09 94 - 2010-01-20 Formally Denied - SA 2009-08-14

when i recieved my wage loss a year ago on compensation tracking it states disibility, not wage loss, so i wondered if i was ever lucky or blessed enough to win this reconsideration this time around, & they were going to grant a schedule award....what would that read if not disibility. I am also confused if I recieved my wage loss why is that not reflected above? Or am I missing something? I don;t know but I thought I could look up more things or see the rogress of things but I seem to be seeing more of my denials, no descriptions of current appeal or denial to modify the decision, the result of the last reconsideration in March of 2011. I have no understanding of the location status...Any knowledge of this would be very helpful....Seeing i don;t seem to know just what status my case is in...
(Edensvision)


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 Post subject: Re: confusing CQS
PostPosted: Fri Aug 05, 2011 8:55 pm 
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Joined: Wed Mar 16, 2011 11:05 pm
Posts: 862
Edenvision: The codes your talking about are codes that OWCP uses to identify things about your case file. The difference between DR and PR is filing CA-7's for compensation. Under DR (daily rolls) you must file CA-7's to be paid. Under PR (periodic rolls) you automatically get paid every 28 days.

If your case went to the District Medical Advisor, (DMA) then it's easier to look under the 'bills' section of ACS. You'll see a PROMPT PAY and it will probably say something like CONSULT. If the doctor's name is there, you probably won't reconize the name. If you have one of these in your bill section, there's a DMA report and you should request a copy of it/them. The bill date is usually the report date.

If you had optional life insurance through your employer when you were injured, you carry that option through your OWCP claim. The charges for the insurance will be taken out of your compensation payments. This charge will be on your "benefits statement".

For the CA-2, there should be a place on ACS that is just for that...like your CA-7's. The last two CA-7's on your list are for Schedule Awards, the 'SA'. If you submitted a CA-7 with the CA-2, those would be separated when they hit the system. The CA-7 would go with the other CA-7's and the CA-2 would go with any other CA-2's.

If you have more than one claim number, you'll need to look up each claim number to see what's going on. You will only get paid under one claim, usually what OWCP determines to be the Main claim.

OWCP can determine you're not entitled to compensation, but that your case is still open for medical. That means you don't get compensation, but any medical treatment, etc...is still covered.

For the reconsideration or any appeal, the codes should be at the physical location of the file. These three letter codes usually begin with an 'X'. 'X' meaning transfered. 'O' meaning out 'I' meaning in and the thrid letter usually refers to the where it's going or coming from.


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 Post subject: Re: confusing CQS
PostPosted: Sat Aug 06, 2011 12:22 am 
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Joined: Wed Aug 03, 2011 9:42 am
Posts: 21
Thank you very much Jessee: I have responded under yours

jesse wrote:
Edenvision: The codes your talking about are codes that OWCP uses to identify things about your case file. The difference between DR and PR is filing CA-7's for compensation. Under DR (daily rolls) you must file CA-7's to be paid. Under PR (periodic rolls) you automatically get paid every 28 days.

Thank's....That helps understand the logistics, could you explain What is daily roll and preiodic roll and why your put in which catagory?

If your case went to the District Medical Advisor, (DMA) then it's easier to look under the 'bills' section of ACS. You'll see a PROMPT PAY and it will probably say something like CONSULT. If the doctor's name is there, you probably won't reconize the name. If you have one of these in your bill section, there's a DMA report and you should request a copy of it/them. The bill date is usually the report date.

I had been doing that today and wrote those down, thank you so much for clarifying and what to ask for. Seeing these things are past I am unsure what grief i see can be brought up now? The second opinion Dr was a nightmare, back in 2009. They are currently using the DMA who denied my 1sy surgery, approved my 2nd surgery and is currently doing this reconsideration review. I also posted a seperate question about thiat, but I will most certainly send out this request first thing tomorrow.

If you had optional life insurance through your employer when you were injured, you carry that option through your OWCP claim. The charges for the insurance will be taken out of your compensation payments. This charge will be on your "benefits statement".

I don't know what insurance I have no one has talked to me about any of that. I do not recieve compensation and thus do not get a benefits statement either.

For the CA-2, there should be a place on ACS that is just for that...like your CA-7's. The last two CA-7's on your list are for Schedule Awards, the 'SA'. If you submitted a CA-7 with the CA-2, those would be separated when they hit the system. The CA-7 would go with the other CA-7's and the CA-2 would go with any other CA-2's.

All i am seeing is the CA-7's up to 2010/under the compensation tracking. The January 2011 for reconsideration is not showing up. The current one with the current reconsideration is not showing up. I see no place for a seperate CA2--the only forms that say they recieved is Form Rcv'd: CA1 - 04/15/2005. If i have a seperate claim or place for CA2 it;t not showing up nor do i have a different case number to look up.

If you have more than one claim number, you'll need to look up each claim number to see what's going on. You will only get paid under one claim, usually what OWCP determines to be the Main claim.

I only have one claim number, one case at this time. I have no idea if they will accept my CA2 or accept my additional injuries to one accident event.

OWCP can determine you're not entitled to compensation, but that your case is still open for medical. That means you don't get compensation, but any medical treatment, etc...is still covered.

Would my case status state Medical only if that is all I am eligible for? If so its not stating that./color]

For the reconsideration or any appeal, the codes should be at the physical location of the file. These three letter codes usually begin with an 'X'. 'X' meaning transfered. 'O' meaning out 'I' meaning in and the thrid letter usually refers to the where it's going or coming from.

[color=#008080]I wish i knew how to post the picture of the screen on here so you could see. but there is status location:OLI if that's not for insurance purpose then what would it mean. O="out" L="?" I="in" ??? or option life insurance? I have no idea. This is where it stated DMA when it went to the DMA. Found it odd it went to the DMA during the 20 waiting for employeer to respond process before the review the merits in the reconsideration process. But it did, its been reviewed and the bill for the prompt pay came up yesterday. Of course after it was DMA it says OLI again-descr missing after 6 years, my case is still undeveloped i guess, but they keep denying me compensation, ugh. :roll:


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 Post subject: Re: confusing CQS
PostPosted: Sat Aug 06, 2011 12:43 am 
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Joined: Wed Mar 16, 2011 11:05 pm
Posts: 862
The Daily Roll, (DR) comes about after your initial injury. If you stay out a while and it appears from your medical evidence that you'll continue to be out a while, you're switched to the Periodic Rolls, (PR). The DR requires filing CA-7's and PR doesn't. The advantage is not filing the CA-7's and just getting your compensation every 28 days.

Have you requested a complete copy of your file? If not, it may be faster and less headache to ask for a copy of your file. The DMA reports should be in there. If you have requested your file before, request the updates now. If you've never requested a copy of your file, there's a How To letter on the blog on the How To page...scroll down to How To Request A Copy Of Your File.

You can still request the DMA reports in a separate letter. You can mail them in the same envelope. If you request your file (or updates) and ask for the DMA reports, you've got two chances to get them in a timely manner.

The DMA reports may be important if your reconsideration is denied. Their reports are usually not very good and someone who knows what they're looking for might find a new argument for a second reconsideration.

Okay, when you originally got denied, the letter should have said contact your Agency about life and health insurance. If you had insurance then, it follows you to your OWCP claim. If your OWCP claim is denied, it goes back to your Agency.

The OLI could also mean your case file is fully imaged. Basically, they've copied it into the system.

Once you filed your CA-2, OWCP would have sent you a little post card or pamphlet. On the address label of the post card is the claim number assigned to the CA-2. If your CA-2 isn't showing received in the system, then I'd send it again along with any proof you previously mailed it and they received it and a letter laying that out and that you're enclosing a copy so that it can get entered into the system.

It's either going to be Open or Closed. If it's Open, it can be open for medical or for medical and compensation.

Once your reconsideration is received, you should receive a decision within 90 days. Usually they write it on the 90th day and then mail it out, so you really have to wait 97-100 days.


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 Post subject: ca2
PostPosted: Thu Sep 27, 2012 5:57 am 
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Joined: Mon Jul 23, 2012 8:09 pm
Posts: 4
If was injured on 11-08-07/ and filled out a ca2 but didn't put date/ but i got a copy of my case file in 2012 and it states that it was rec'd on 1/31/08 can i get a occupational disease if the claims examiner stated she never got it before the 3years and that would of been 11/8/10. owcp accepted my conditions for lumbar strain/thoracic strain/ on 9/08. letter from washington dated may 16, 08--claimant did not file ca2, but with this disc from injury date i found that it was a ca2 in my file before the may 16-08 date! i tried to file a occupational disease in between 11-08-07 --rec'd date and owcp stated i haven't filled out the ca2! signature on it but not date. what can i do?


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 Post subject: Re: confusing CQS
PostPosted: Thu Sep 27, 2012 6:12 am 
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Joined: Wed Mar 16, 2011 11:05 pm
Posts: 862
If you can prove OWCP received the CA-2, then you'd need to start by getting them to aknowledge that. So you'd start with a copy of whatever you have that states OWCP did not receive the CA-2 and a copy of the CA-2 which shows when it was received by OWCP. Alert them that they were not correct that the CA-2 was not received and request that the CA-2 be processed. This should be done in writing so that you have a paper trail.


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