Navigating a Biased Second Opinion in Workers' Compensation Claims

If you're an injured worker whose workers' compensation claim has been accepted but now faces a second opinion examination that seems prejudiced or improperly conducted, you may be at risk of losing your benefits. This guide provides practical tips and remedies to protect your rights and ensure fair treatment when a second opinion physician’s findings appear influenced by a claims examiner aiming for a predetermined outcome.

Understanding the Situation

When a second opinion physician determines that your injury is not work-related, the claims examiner may issue a Notice of Intent to Terminate Compensation. This notice typically gives you 30 days before your benefits end. The claims examiner often supports this decision with a Memorandum to the Director, outlining the reasons for denying your claim. This memorandum is a document that you never see but has a lot of prejudicial influence on the second opinion's determinations. There is a lot of these types of memorandums that hurt injured workers looking for fairness and help but instead receive a predetermined prejudiced outcome that is negotiated in these type of memorandum that often hurt the injured worker claimant. 

If the second opinion feels biased or the examination was not conducted appropriately, you have options to challenge the findings and protect your benefits. Acting quickly and strategically is critical.

Steps to Take

1. Request Key Documents

To build a strong case, you need access to the documents influencing the decision. Take these actions immediately:

• Obtain the Memorandum to the Director: Request a copy of this document from the claims examiner. It details why your claim is being denied and is essential for your treating physician to understand the basis of the denial.
• Request the Second Opinion Doctor’s Report: Ask the claims examiner to send a copy of the second opinion physician’s report to your treating physician. This ensures your doctor has the full context of the findings to address. for more information click on the transcript: 

Dr. Taylor’s contact information is: [email protected] 

If you need a medical provider or assistance with an OWCP /  DOL claim in Tamps, Pensacola Florida. south Mississippi or Daphne Alabama    you can make an appointment to see Dr. Taylor, or Dr. Sullivan   at the clinic at  FWC Medical Centers. To make a consultation with Dr. Taylor  call the clinic at 813-215-4356 or go  to our website at  https://fedcompconsultants.com/

For responses email Dr. Taylor at [email protected]

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Government Agency -Medical and Occupational Health Program consists  of agency personnel that provide administrative functions, wellness initiatives, and other medically related activities designed to address the health and safety of employees in the workplace. The mission of the National Medical and Occupational Health Program is to reinforce the relationship between health, productivity, and the achievement of the Government Agency's business goals. This is accomplished through the development of quality programs and policies designed to promote and maintain employee health and to help ensure a safe, healthful work environment. The program’s services include but are not limited to the following activities:

      a. Providing preventive medical programs in health counseling, education, and        training.

      b. Managing the care of acutely ill or injured employees.

     c. Determining medical ability of applicants and employees to perform the

    functions of the job.

    d. Managing applicant and employee drug and alcohol testing programs.

    e. Managing compliance with the regulatory requirements of the

Department of Transportation, Office of Worker’s Compensation Programs, Occupational Safety and Health Administration, and other entities for which program compliance is required.

For more information click on the show transcript:

Dr. Taylor’s contact information is: [email protected]

If you need a medical provider or assistance with an OWCP /  DOL claim in Tampa,  Pensacola Florida or Mobile Alabama    you can make an appointment to see Dr. Taylor, or Dr. Sullivan   at the clinic at  FWC Medical Centers. To make a consultation with Dr. Taylor  call the clinic at 813-215-4356 or go  to our website at https://mrtherapycenter.com/or https://fedcompconsultants.com/

For responses email Dr. Taylor at [email protected]

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Federal Workers Compensation Coffee Break Podcast is an educational and informative training on how to navigate the DOL -OWCP claims filing process for all types of injured US government and federal workers. The podcast is free and is educational. If you need help with anything related to a federal workers compensation claim...help is just a cup of coffee away.

Step-by-Step Tutorial: How to Fill Out and Submit OWCP Form 957 for Travel Reimbursement

 If you’re a federal employee or a worker covered under programs like the Federal Employees’ Compensation Act (FECA), Black Lung Benefits Act, or the Energy Employees Occupational Illness Compensation Program Act (EEOICPA), you may be eligible to get reimbursed for travel expenses related to medical treatment for a work-related injury or illness. The key to unlocking this benefit is the OWCP-957 form, also known as the Medical Travel Refund Request. In this step-by-step tutorial, I’ll walk you through how to fill out and submit this form accurately to ensure you get reimbursed without unnecessary delays. 

Step 1: Understand When to Use the OWCP-957

Before you start, confirm that your travel qualifies for reimbursement. The OWCP-957 is for travel expenses tied to medical care for an accepted work-related condition—think doctor visits, pharmacy trips, or approved treatments. You can claim up to three trips per form, and all requests must be submitted within one year of the expense. If your travel exceeds 200 miles round-trip, you’ll need pre-approval from your OWCP Medical Benefits Examiner, so keep that in mind. There are two different 957 forms for the process of filing for medical travel reimbursement.

OWCP-957A - Medical Travel Refund Request – Mileage

OWCP-957B - Medical Travel Refund Request – Expenses

For more information click on the show transcript:

Dr. Taylor’s contact information is: [email protected] 

If you need a medical provider or assistance with an OWCP /  DOL claim in Tampa, Pensacola Florida. Mississippi or Mobile Alabama    you can make an appointment to see Dr. Taylor, or Dr. Sullivan   at the clinic at  FWC Medical Centers. To make a consultation with Dr. Taylor  call the clinic at 813-215-4356 or go  to our website at https://mrtherapycenter.com/or https://fedcompconsultants.com/

For responses email Dr. Taylor at [email protected]

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Federal Workers Compensation Coffee Break Podcast is about all things related to Federal Workers Compensation, FECA, OWCP, DOL & Longshore claim filing as an injured federal worker.  The podcast is an educational and informative training on how to navigate the DOL -OWCP claims filing process for all types of injured US government and federal workers. The podcaster has 30 years in assisting with federal workers compensation as a consultant and trainer. The podcast is free and is educational. If you need help with anything related to a federal workers compensation claim...help is just a cup of coffee away.

Current rundown of the latest OWCP policy updates as of March 16, 2025. These updates are drawn from what’s been publicly shared by the U.S. Department of Labor and other reliable channels—perfect fodder for your next episode!

See transcript for more information on the policy updates of 2025.

The podcast Dr. Taylor’s contact email is: [email protected] 

If you need a medical provider or assistance with an OWCP /  DOL claim in Tampa, Pensacola Florida, Mississippi or Mobile Alabama    you can make an appointment to see Dr. Taylor, or Dr. Sullivan   at the clinic at  FWC Medical Centers. To make a consultation with Dr. Taylor  call the clinic at 813-215-4356 or go  to our website at https://mrtherapycenter.com/or https://fedcompconsultants.com/

For responses email Dr. Taylor at [email protected]

FEEDSPOT TOP 10 National Workers Compensation Podcast:

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An OWCP  traumatic injury is defined as: “A wound or other condition of the body caused by external force, including stress or strain, which is identifiable as to the time and place of occurrence and member or function of the body affected. The injury must be caused by a specific event or incident or series of events or incidents within a single work day or work shift.”

Notifying your supervisor and filing a claim & Immediately notify your supervisor of your injury and your intent to file a claim using ECOMP. Request your supervisor’s Postal Service email address to use in registering in ECOMP. Once you have registered in ECOMP, go to the top of your dashboard and click New Claim. Follow the directions for filing a CA-1 claim for traumatic injury. If you are filing the claim within one week of the injury, request form CA-16, Authorization for Examination and/or Treatment (must be supplied by your manager within 4 hour. Request a Form CA-17 Duty Status Report from your supervisor. The Postal Service is responsible for filling out the job requirements on the left (side A) of the CA-17. Once your doctor has completed the CA-17, make a copy or take a picture of the completed CA-17 and give the original to your supervisor. 

Your doctor should provide you with their report so you can send medical reports directly to OWCP.  You can  upload medical reports into your claim file via ECOMP. When the occupational & safety personnel ask you for your records you are required to provide them with your return to work CA forms CA-17 or CA-5C. Your medical reports are protected by the Privacy Act and should be sent directly to OWCP, not the Postal Service. Never give your private health information medical reports to an agency employee that is protected by federal law. For more information read the show transcript and listen to the podcast. 

The podcast Dr. Taylor’s contact information is:

https://[email protected] If you need a medical provider or assistance with an OWCP /  DOL claim in Tampa, Pensacola Florida, Mississippi or Mobile Alabama    you can make an appointment to see Dr. Taylor, or Dr. Sullivan   at the clinic at  FWC Medical Centers. To make a consultation with Dr. Taylor  call the clinic at 813-215-4356 or go  to our website at https://mrtherapycenter.com/or https://fedcompconsultants.com/

For responses please  email Dr. Taylor at [email protected]

For responses email Dr. Taylor at [email protected]

FEEDSPOT TOP 10 National Workers Compensation Podcast:

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OWCP reversed course on that new announcement literally two weeks later with no real explanation why they reversed course. On January 10, 2025, the Division of Federal Employees' Compensation (DFEC) announced significant updates to the Federal Employees' Compensation Act (FECA) Procedure Manual, specifically Chapter 2-0808, addressing schedule awards and permanent disability claims. These updates, outlined in FECA Transmittal 25-03, introduce changes aimed at enhancing fairness and efficiency in the claims process. 

FECA bulletin 25-03 was great new changes and I was excited about them…and OWCP killed it and withdrew it two weeks later…. So let’s read the new OWCP bulletin on impairment ratings announcement. 

RELEASE – REVISION TO FECA PROCEDURE MANUAL

CHAPTER: 2-0808, Schedule Awards and Permanent Disability Claims

FECA TRANSMITTAL NO. 25-04 - February 10, 2025

Upon further review, it has been determined that to ensure all claims are treated fairly and consistently, a single version of the Guides should be used. Accordingly, DFEC is hereby revoking FECA Transmittal 25-03 and reinstating its procedures in effect prior to January 10, 2025.

 Effective the date of this transmittal, Form CA-7, Claim for Compensation, should again be used to file claims for schedule awards under the FECA.

 All schedule award claims, including those submitted with a CA-9 since January 10, 2025 in which an award has not yet been issued, will be processed under the procedures effective with this transmittal. Any claim filed in the Employees' Compensation and Operations Portal (ECOMP) that has not yet been submitted to OWCP will be cancelled so that a CA-7 can be filed. For more info here is the link for the new FECA bulletin 25-04: https://www.dol.gov/agencies/owcp/FECA/regs/compliance/DFECfolio/FECATransmittals#FECAT2504

The podcast Dr. Taylor’s contact information is:

https://[email protected] If you need a medical provider or assistance with an OWCP /  DOL claim in Tampa, Pensacola Florida or Mobile Alabama    you can make an appointment to see Dr. Taylor, or Dr. Sullivan   at the clinic at  FWC Medical Centers. To make a consultation with Dr. Taylor  call the clinic at 813-215-4356 or go  to our website at https://mrtherapycenter.com/or https://fedcompconsultants.com/

For responses email Dr. Taylor at [email protected]

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Simplifying FECA Bulletin No. 24-06: A New Streamlined Process for War Hazards Compensation Act (WHCA) Claims

CLAIM FOR REIMBURSEMENT OF BENEFIT PAYMENTS AND CLAIMS EXPENSE  

                  UNDER THE WAR HAZARDS COMPENSATION ACT

The U.S. Department of Labor has introduced a new process to speed up decisions on claims made under the War Hazards Compensation Act (WHCA). This process allows insurance companies to submit suggested claim decisions, which the Office of Workers’ Compensation Programs (OWCP) can approve if they meet all legal requirements. This change aims to make claim reimbursement  processing faster and more efficient.

With a few exceptions, the DBA incorporates the provisions of the Longshore and Harbor Workers’ Compensation Act (LHWCA). The War Hazards Compensation Act (WHCA) applies to DBA employees who are injured as a result of hostile actions. 42 U.S.C. §§ 1701 – 1717. While WHCA claims can be considerably substantial, the statute provides a detailed set of procedures and requirements which, if performed properly, allow the employer or carrier to see 100% reimbursement of such claims including allocated and unallocated expenses  from the government. 

The WHCA provides financial coverage for employees injured or killed due to war-related hazards while working under the Defense Base Act. If an injury or death occurs because of a war risk hazard, private insurance carriers or self-insured employers can seek reimbursement for the benefits they have already paid out, such as:

 Disability and death benefits                                                                                                 Funeral and burial costs                                                                                                         Medical expenses                                                                                                                     Other necessary claim processing costs

The OWCP, through its Division of Federal Employees’, Longshore, and Harbor Workers’ Compensation (DFELHWC) division, reviews and decides whether a claim qualifies for reimbursement through the guidelines established in the Defense Base Act.

The rules for requesting reimbursement under the WHCA are highly detailed and lengthy. Applications must be well-documented and include essential evidence that are outlined in the federal rules outlined in the DBS. For more information click on the transcript. 

The podcast Dr. Taylor’s contact information is:
https://[email protected] If you need a medical provider or assistance with an OWCP /  DOL claim in Tampa, Pensacola Florida or Mobile Alabama    you can make an appointment to see Dr. Taylor, or Dr. Sullivan   at the clinic at  FWC Medical Centers. To mak

For responses email Dr. Taylor at [email protected]

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  War Hazards Compensation Act (WHCA) Overview

The War Hazards Compensation Act (WHCA) extends additional benefits to federal employees and contractors injured due to war-related hazards, including:

- Hostile Actions: Injuries resulting from acts of war, terrorism, or civil disturbances in foreign countries.

- Detention Benefits: Compensation for employees detained by hostile forces.

- Reimbursement to Contractors: WHCA reimburses contractors for compensation paid under the Defense Base Act (DBA), which extends LHWCA provisions to overseas federal contractors.

  Eligibility Criteria under FECA & WHCA

1. Federal Employment or Contract Work: The worker must be a federal employee or contractor covered by FECA or the DBA (Defense Base Act).

2. Injury During Official Duties: Injury must occur while performing work-related tasks.

3. War or Hostile Hazards: For WHCA coverage, the injury must result from war hazards, such as:

 - Military operations                                                                                                                 - Terrorist attacks                                                                                                                     - Civil unrest in foreign countries

WHCA Supplementation

- If the injury is directly tied to a war hazard (e.g., terrorism, military conflict, or civil unrest), the WHCA may provide supplemental coverage:

  - Additional Compensation: If the benefits under FECA do not fully cover the costs associated with the war-related hazard, WHCA may bridge the gap.

  - Detention or Hostage Situations: WHCA offers specific compensation for federal employees detained by hostile forces abroad, which FECA doesn’t cover comprehensively.

For more information click on the show transcript:

The podcast Dr. Taylor’s contact information is:

https://[email protected] If you need a medical provider or assistance with an OWCP /  DOL claim in Tampa, Pensacola Florida or Mobile Alabama    you can make an appointment to see Dr. Taylor, or Dr. Sullivan   at the clinic at  FWC Medical Centers. To make a consultation with Dr. Taylor  call the clinic at 813-215-4356 or go  to our website at https://mrtherapycenter.com/or https://fedcompconsultants.com/

For responses email Dr. Taylor at [email protected]

FEEDSPOT TOP 10 National Workers Compensation Podcast:

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On January 10, 2025, the Division of Federal Employees' Compensation (DFEC) announced significant updates to the Federal Employees' Compensation Act (FECA) Procedure Manual, specifically Chapter 2-0808, addressing schedule awards and permanent disability claims. These updates, outlined in FECA Transmittal 25-03, introduce changes aimed at enhancing fairness and efficiency in the claims process. 
The Office of Workers' Compensation Programs (OWCP) recently introduced updates to its impairment rating system, aiming to create a more equitable and comprehensive approach for injured federal workers. These changes seek to balance medical assessments and rating methodologies, ensuring that workers with complex or unique cases receive fair evaluations. This balance directly benefits injured workers by accommodating conditions that may not fit traditional assessment models, allowing for more individualized determinations that better reflect their true level of impairment.
These changes mark a significant step toward a fairer system that recognizes the full impact of workplace injuries, ultimately benefiting workers who rely on impairment ratings for their compensation and long-term financial stability.

1. Introduction of Forma new  CA-9 ( click on link for the form) I will provide the link on the podcast landing page. 

   - The Office of Workers' Compensation Programs (OWCP) has introduced Form CA-9, which must now be used to file for schedule awards. Form CA-7 will no longer be accepted for this purpose and will remain dedicated solely to filing for disability compensation.

   - This streamlined approach ensures clarity and precision in the schedule award claims process.

2. Flexibility in AMA Guides

   - OWCP now permits the use of either the Fifth Edition or the Sixth Edition of the American Medical Association's (AMA) Guides to the Evaluation of Permanent Impairment for impairment ratings.
For more information click on  transcript and links:
The podcast Dr. Taylor’s contact information is:

https://[email protected] If you need a medical provider or assistance with an OWCP /  DOL claim in Tampa, Pensacola Florida Mississippi or Mobile Alabama    you can make an appointment to see Dr. Taylor, or Dr. Sullivan   at the clinic at  FWC Medical Centers. To make a consultation with Dr. Taylor  call the clinic at 813-215-4356 or go  to our website at https://mrtherapycenter.com/or https://fedcompconsultants.com/

For responses email Dr. Taylor at [email protected]

FEEDSPOT TOP 10 National Workers Compensation Podcast:

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Podcast -Overview --- Obtaining and Successfully Submitting  a Claimant Reimbursement Form for : 

• Completing OWCP 915 for Medical Reimbursements
• Completing OWCP 915 for Pharmacy Reimbursements
• Completing OWCP 957A and 975B for Travel Reimbursements

This is an OWCP - DOL Medical, Pharmacy & Travel Reimbursement Form Submission tutorial. This is part two of a two part series on how to successfully obtain reimbursements of medical services, expenses, and travel.
                                                 
                                    Form OWCP-915 (click on link for form)

This form is used to claim reimbursement for out-of-pocket medical expenses pertaining to the treatment of an accepted condition covered by the Federal Employees' Compensation Act.  Use this form to request reimbursement for medical expenses, transportation costs, loss of wages, and incidental expenses.  Originally Form OWCP-915 cannot be submitted electronically; it was required  be mailed to OWCP or handed over to your supervisor so it can be submitted to the district office. 

 In addition, you are required to submit separate OWCP-915 forms if you received medical services from different physicians and/or medical centers. In submitting the form, make sure to send over ORIGINAL bills in order to be reimbursed as copies are not accepted with the exception of said copies having the provider’s signature, showing clearly that you paid for the service.

             OWCP 957A Travel Reimbursement-Mileage (click on link for form)

This form should be used for medically related travel covered by the Federal Employees' Compensation Act and the Energy Employees Occupational Illness Compensation Program Act.

              OWCP 957B Medical Travel Refund Request (click on link for form)

This form should be used for medically related travel refunds covered by the Federal Employees' Compensation Act and the Energy Employees Occupational Illness Compensation Program Act.

Under 50 Miles round trip: 

• File After Your Office Visit                                                       
• File Form OWCP-957: Medical Travel Refund Request.                                   
• Attach your physician’s ACS Web Bill Processing Portal approval

 Over 50 Miles round trip: File Before Your Office Visit (OK to try after your visit)

• Fax Transportation and Travel Authorization Request.
• Attach your physician’s ACS Web Bill Processing Portal approval.
• To get the form Google Authorization - Travel and Transportation 04-23-10"
• Or go to file:https://owcpmed.dol.gov/portal/Provider/Authorizations (click       on link above  

If you need an OWCP approved medical provider, You can make a  a consultation with me to discuss your case or if you know someone in Tampa or Pensacola Florida and south Mississippi, Georgia

For responses email Dr. Taylor at [email protected]

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