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  • Members: 118
  • Category: Peace Corps
  • Founded: Mar 11, 2004
  • Language: English
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#218 From: FourDirect@...
Date: Wed Sep 14, 2005 1:06 am
Subject: group question
FourDirect@...
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Deal all,

I have a reimbursement question for any of you out there. As many of you know, I've had a Peace Corps illness for about 21 years. In years back I used to have to pay my bills up front and then attempt to get reimbursed, which was sometimes successful and many times not.

During intervening years I've had direct payment to practitioners (when that has worked). However, now with ACS and the need for practitioners to "enroll" I am finding that most of my NY physicians will not cooperate with this system and justifiably so, as their payment is erratic and slow.

I cannot pay out of pocket for all my needs but I need very particular specialists and can't afford to lose them, either. When ACS first took over it didn't seem possible to seek personal reimbursement for payments I had made. But now the issue is again critical for my care. If I pay a practitioner up front I wonder if I can submit a HCFA 1500 and receive payment to myself. Has anyone had experience in the past year with ACS for obtaining retroactive reimbursement to themselves (assuming I get preapproval and prior authorization and all of that) and if so, how to do so and what forms are needed?

Thanks for your help.

Best,
Nancy T.
NYC

#219 From: "lajarvis78" <RPCVLAJarvis@...>
Date: Wed Sep 14, 2005 4:40 pm
Subject: Re: group question
lajarvis78
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This has been my problem over the past year.  I was told when I was
medically separated in January, to just pay for doctor bills out of
my pocket and I would be reimbursed by FECA or Corps Care depending
on whether my case was accepted.  It was and now I have been
fighting to get my money back.  Luckily have gotten most of it back,
but they still owe me almost $700!

Here is the thing that you have to know...they have a pay fee
schedule, but won't tell you what it is.  As far as I can tell the
fee schedule is a percentage of anything you pay.  For example...I
was put on a very powerful antibiotic that cost about $125 for 10
day of the med at CVS.  For this they reimbursed me about $113.  I
needed the antibiotics again, this time I went to Target and only
paid around $85.  You would think according to the fee schedule the
entire second since it paid $113 the first time, but no, they still
docked the reimbursement and only paid around $83.

I also saw this one doctor 4 times for $100 each time.  Two of those
they paid the full $100, the other 2 they used their "fee schedule"
excuse and wouldn't pay the full amount.

Here is my advice, though it is not all that legal.  Hopefully if
you explain this to your doctor s/he will understand.  See if you
can pay one amount and then get a bill for a higher amount...then
hopefully you will actually get the amount that you paid reimbursed.

Reimbursements take about a month to 2 in order for you to get the
check.  That is, if you fill out the paperwork "properly."  The main
form that you need is an OWCP-915.  It is a really easy form to fill
out and then you attach your bills to that.  These bills need to be
impeccable!  What I mean by that is that they need to say paid by
patient or something to that effect and have the exact codes for the
procedure the doctor did, even a check up has a certain code.  They
like to tell you that the codes are "wrong."  Can't tell you how
many times they have told me that.  Once they even made me "prove"
to them that I paid the bill and someone else didn't pay it for me.

Advice #2...be patient and don't give into to their games and crap!
I have had many tears over the crap they have put me through.  I
actually just sent more paperwork to them yesterday to still try and
get my money back.  As long as you have more patients than them, you
will see your money again, probably not all of it, but most.

Best of luck!
--Lauralee


--- In owcp@yahoogroups.com, FourDirect@a... wrote:
> Deal all,
>
> I have a reimbursement question for any of you out there. As many
of you
> know, I've had a Peace Corps illness for about 21 years. In years
back I used to
> have to pay my bills up front and then attempt to get reimbursed,
which was
> sometimes successful and many times not.
>
> During intervening years I've had direct payment to practitioners
(when that
> has worked). However, now with ACS and the need for practitioners
to "enroll"
> I am finding that most of my NY physicians will not cooperate with
this system
> and justifiably so, as their payment is erratic and slow.
>
> I cannot pay out of pocket for all my needs but I need very
particular
> specialists and can't afford to lose them, either. When ACS first
took over it
> didn't seem possible to seek personal reimbursement for payments I
had made. But
> now the issue is again critical for my care. If I pay a
practitioner up front I
> wonder if I can submit a HCFA 1500 and receive payment to myself.
Has anyone
> had experience in the past year with ACS for obtaining retroactive
> reimbursement to themselves (assuming I get preapproval and prior
authorization and all of
> that) and if so, how to do so and what forms are needed?
>
> Thanks for your help.
>
> Best,
> Nancy T.
> NYC

#220 From: "donaldweaks" <donaldweaks@...>
Date: Wed Sep 14, 2005 5:31 pm
Subject: copy of letter to OIG
donaldweaks
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2 September 2005


Peace Corps
Office of Inspector General
1111 20th Street NW
Washington, DC

					 RE: Donald J. Weaks – xxx-xx-
xxxx

To Whom It May Concern:

I was a Peace Corps Volunteer in Cote d'Ivoire and Togo from 12 June
2002 to 7 May 2005.
On 7 May I was medically separated in Washington, DC after being
medevac'd from Togo on 17 April 2005. The attached letter to the
Office of Medical Services dated 7 August 2005 addresses the time
line and issues involved in my current medical situation.

My primary reason for writing your office is because of the absence
of a response to that letter. It has been four months since I was
medically separated and I still have undiagnosed and unresolved
medical issues. Among some of the unanswered diagnostic issues is a
127C that I requested on 7 August 2005 for a follow-up CAT Scan that
was recommended after nodules were identified in my lungs; that 127C
has never been issued.

I have the following additional examples of patient disregard,
harassment, case mismanagement and just plain incompetence by the
Office of Medical Services:

Evaluation of Nodules on Lungs: The 127C issued to the infectious
disease doctor provided for a diagnosis and treatment plan without
any provision for testing. The doctor found this authorization for
treatment so vague he thought it was joke.

Phlebotomy treatments: As a result of some of my testing a doctor
diagnosed me with hemochromatosis. This is a potentially deadly iron
overload of the circulation system, especially if left untreated. I
decided to begin treatments before the OMS submitted the paperwork to
the Department of Labor for a workers' compensation claim. I did this
for two reasons; one, I had been told by the OMS that IF my claim was
approved it might take 8 to 10 weeks to do so. Secondly, because I
saw no reason to delay the treatment if it is in fact life
threatening. The day after I began the treatments I received a
surprise phone call from the OMS chastising me for starting the
treatments without prior approval. It appears that the Department of
Labor is going to deny my claim. I have attached a copy of their
letter and my response.

Emergency Room visit 1 July: I experienced tightness in my chest and
shortness of breath, a symptom of hemochromatosis and a possible
indication that I was having hypertensive problems. My doctor
directed me to go to the ER as quickly as possible. I called the OMS
for approval and got an answering machine. I left a message and went
to the hospital; later in the day I was told I should not have gone
to the emergency room without permission. It took nearly three weeks
to get the 127C issued for the hospital visit.

Hospital and Specialist Bills: I made two trips to Deaconess Hospital
in Cincinnati on 31 May and 23 June 2005 for hypertension and
gastroenterology testing. Both times doctors, laboratories,
specialist and the hospital were involved in supplying services for
these tests and they billed for their services separately. So far
there has been 3 occasions the bills were returned unpaid because the
particular provider did not have a copy of the 127C attached to their
bill. It is obvious that these services rendered on the same day for
the same testing procedure should have been covered by the single
127C which I was provided.

Close of Service Dental Evaluation: The Health Benefit Program has
requested additional information 2 times. I am certain that the
request for information was satisfied after the first request.

The Regional Peace Corps Medical Officer, Dr. Patricia Ruze, who
medevac'd me to Washington is still questioning why no one has
pursued the renal failure problems I was encountering in April. It's
conceivable that all of my conditions are the result of a viral or
bacterial infection that I contracted early in March 2005.

I am sick and I am not getting appropriate and reasonable medical
attention. I am sure there is an argument to be made that volunteers
and former volunteers are ultimately responsible for their own health
care and course of treatment but at the same time some of our health
issues are a result of our Peace Corps service overseas and it is
unfair to ask doctors in the US who are unfamiliar with that
experience to make life and death evaluation regarding our health.

I have attached a note from David Snyder the Executive Director of
the American Hemochromatosis Society making reference to the
Executive Order issued by President Clinton disallowing any federal
agency the ability to discriminate against federal employees that
have genetic disorders. I think this situation is worthy of your
attention and I am willing to allow you to use this information in
conjunction with other complaints that you have received regarding
the practices of the Office of Medical Service.

	 In conclusion, I still believe in the role the Peace Corps
can play in the world today. I am a firm believer that older
volunteers can play a part in that role; but if this is an example of
how the Peace Corps treats those older volunteers in return for their
efforts, then I have completely lost faith in the Peace Corps and the
United States government to look after its own who are willing to go
the extra mile and make an effort to better our world.

Sincerely,


Donald J. Weaks

5 Bluebill Avenue #604
Naples, FL 34018

Phone: 239.598.3467

#221 From: "immelodyone" <sjmel@...>
Date: Sat Sep 10, 2005 11:34 am
Subject: Help & Guidance Requested Regarding Filing OWCP
immelodyone
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I was diagnosed with Post Traumatic Stress Disorder (PTSD) in
September of 2004 triggered by the abuse and hostile work site at
EPA Seattle, WA.  I did not file a OWCP claim and now I am
unemployed forced out due to denial of reasonable accomodation to
work away from my former abuser "Quid Pro Quo", Physically
Threatening me, publicly humiliating me.  Retaliation by EPA for
filling a formal complaint removal of my job and denied reasonable
accomodation to work away from my former abuser supervsior in a safe
work site.  I was forced to resign from EPA after 18 years civil
service outstanding employee and 11 years EPA seattle.  EPA sent me
a letter stating they would place me on AWOL and fire me.  I applied
for unemployment and EPA denied me.  I appealed and won
unemployment.  My unemployment runs out in the middle of Nov 05.

I have 4 medical providers stating I was injured on the job but I
did not know I should have filed OWCP within 30 days.  Any
suggestions are much appreciated.  My case is with EEOC in Seattle
and will most likely take another year.

GOD BLESS YOU ALL
Melody Johnson

#222 From: "Felicia" <felicia@...>
Date: Wed Sep 14, 2005 10:43 pm
Subject: Re: Help & Guidance Requested Regarding Filing OWCP
feliciapanixcom
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Please tell me you have seen a lawyer about this.  -- Felicia

> I was diagnosed with Post Traumatic Stress Disorder (PTSD)
> in
> September of 2004 triggered by the abuse and hostile work
> site at
> EPA Seattle, WA.  I did not file a OWCP claim and now I am
> unemployed forced out due to denial of reasonable
> accomodation to
> work away from my former abuser "Quid Pro Quo", Physically
> Threatening me, publicly humiliating me.  Retaliation by
> EPA for
> filling a formal complaint removal of my job and denied
> reasonable
> accomodation to work away from my former abuser supervsior
> in a safe
> work site.  I was forced to resign from EPA after 18 years
> civil
> service outstanding employee and 11 years EPA seattle.
> EPA sent me
> a letter stating they would place me on AWOL and fire me.
> I applied
> for unemployment and EPA denied me.  I appealed and won
> unemployment.  My unemployment runs out in the middle of
> Nov 05.
>
> I have 4 medical providers stating I was injured on the
> job but I
> did not know I should have filed OWCP within 30 days.  Any
> suggestions are much appreciated.  My case is with EEOC in
> Seattle
> and will most likely take another year.
>
> GOD BLESS YOU ALL
> Melody Johnson
>
>
>
>
>
>
> ------------------------ Yahoo! Groups Sponsor
>
>
> Yahoo! Groups Links
>
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>
>
>
>
>
>

#223 From: FourDirect@...
Date: Wed Sep 14, 2005 10:06 pm
Subject: Re: Re: group question
FourDirect@...
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In a message dated 9/14/2005 12:46:38 PM Eastern Standard Time, RPCVLAJarvis@... writes:


Reimbursements take about a month to 2 in order for you to get the
check.  That is, if you fill out the paperwork "properly."  The main
form that you need is an OWCP-915


Lauralee,

Thanks so much. I have the fee pay schedule and all that but where do I get the OWCP 915 form from? And you actually have gotten money when you've paid out of pocket?

You don't even want to know how many tens of thousands of dollars I and my family have paid to keep me alive in those early years with marginal reimbursement. I am just trying to move ahead now.

Nancy

#224 From: FourDirect@...
Date: Wed Sep 14, 2005 10:08 pm
Subject: Re: Help & Guidance Requested Regarding Filing OWCP
FourDirect@...
Send Email Send Email
 
I've never found a lawyer who knew as much as I did. Has anyone found that a useful route or a good lawyer re: OWCP? Just curious.

Nancy

#225 From: Donald Weaks <donaldweaks@...>
Date: Thu Sep 15, 2005 12:24 pm
Subject: Re: Help & Guidance Requested Regarding Filing OWCP
donaldweaks
Send Email Send Email
 
Great question, let me know what you find.

FourDirect@... wrote:
I've never found a lawyer who knew as much as I did. Has anyone found that a useful route or a good lawyer re: OWCP? Just curious.

Nancy


Visit our website at www.aedtogo.org or make your tax deductible contribution to: Hope through Health, PO Box 605, Medway, MA 02053-0605

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#226 From: "lajarvis78" <RPCVLAJarvis@...>
Date: Thu Sep 15, 2005 5:04 pm
Subject: Re: group question
lajarvis78
Send Email Send Email
 
> Thanks so much. I have the fee pay schedule and all that but where
do I get
> the OWCP 915 form from? And you actually have gotten money when
you've paid out
> of pocket?

The OWCP 915 form is on the department of labor website:
http://www.dol.gov/libraryforms/

Yes, you can get reimbursed...it just takes tons of patients.  I got
about $3k from them in reimbursements.  Be prepared for a fight and
know that you deserve to get that money back.  They will tell you
that you are stupid for spending your own money...they will tell you
that you filled out this form wrong...they will tell you that the
doctor put the wrong code on invoice...just be prepared!  Shed many
tears and have spent hours equalling many days talking to people and
filling out the paperwork, but it has paid off.  Just don't give up
and don't give in, that is what they are expecting, so then they
don't have to pay you!

As for a lawyer...I talked to many about my case.  I wanted to do 2
things 1) sue PC for talking over 5 months to diagnose and treat me
and I am still not 100% over a year later (yes, I know a lot of you
have been dealing with your issues for much longer and you have much
worse medical problems...I am sorry for that, but I still have my
frustrations over my issue and how it was handled by my PCMO).  2) I
wanted to sue to get all my reimbursements back.  3) I wanted my
PCMO fired.  Sounds harsh, but she is not a nice woman and told me I
deserved to be sick.  She should not be treating Americans or anyone
for that matter!

I was told a lawyer who works in workman's comp claims is the best
to contact.  I contacted a few, but none would take my case.  They
felt going against the gov't was probably a loosing cause and I did
not stand to make enough to make it worth their time (I still have
not found a job and could not afford to pay a lawyer).

However, I do have a friend and she found lawyers to take her case
and have filed a large law suite against the PC.  Sounds like some
of you might have cases that a lawyer might take, I just couldn't
find one for mine and contacted probably about 50.  If any of you
are in California (other states too, not sure how all that
works)...maybe we could all ban together and make one huge law suit -
  I would help with that and be willing to share my story if it helps
and gets word out there...just a thought...

Best of luck everyone...
--Lauralee

#227 From: "Felicia" <felicia@...>
Date: Thu Sep 15, 2005 7:39 pm
Subject: Re: Help & Guidance Requested Regarding Filing OWCP
feliciapanixcom
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My response about the lawyer was less for owcp and more
because having to quit your job because someone is
hassling you sounds like it is probably a legal matter.
-- Felicia

> I've never found a lawyer who knew as much as I did. Has
> anyone found that a
> useful route or a good lawyer re: OWCP? Just curious.
>
> Nancy
>

#228 From: "Felicia" <felicia@...>
Date: Thu Sep 15, 2005 7:45 pm
Subject: Re: Re: group question
feliciapanixcom
Send Email Send Email
 
What I still don't understand is why my experience is so
different from everyone else's.  Sounds like lots of
people were medically separated from the Peace Corps.
When that happened to me, they filled out the initial
worker's comp forms right there.  Was this just because I
was nuttier than a fruitcake and hysterical?  Once my case
got accepted, I was assigned a nurse who has dealt with
everything for me.  Am I the only one on the list
suffering from Peace Corps related psychiatric problems?
There has to be a pattern here, and I'd like to know what
it is.  -- Felicia

>> Thanks so much. I have the fee pay schedule and all that
>> but where
> do I get
>> the OWCP 915 form from? And you actually have gotten
>> money when
> you've paid out
>> of pocket?
>
> The OWCP 915 form is on the department of labor website:
> http://www.dol.gov/libraryforms/
>
> Yes, you can get reimbursed...it just takes tons of
> patients.  I got
> about $3k from them in reimbursements.  Be prepared for a
> fight and
> know that you deserve to get that money back.  They will
> tell you
> that you are stupid for spending your own money...they
> will tell you
> that you filled out this form wrong...they will tell you
> that the
> doctor put the wrong code on invoice...just be prepared!
> Shed many
> tears and have spent hours equalling many days talking to
> people and
> filling out the paperwork, but it has paid off.  Just
> don't give up
> and don't give in, that is what they are expecting, so
> then they
> don't have to pay you!
>
> As for a lawyer...I talked to many about my case.  I
> wanted to do 2
> things 1) sue PC for talking over 5 months to diagnose and
> treat me
> and I am still not 100% over a year later (yes, I know a
> lot of you
> have been dealing with your issues for much longer and you
> have much
> worse medical problems...I am sorry for that, but I still
> have my
> frustrations over my issue and how it was handled by my
> PCMO).  2) I
> wanted to sue to get all my reimbursements back.  3) I
> wanted my
> PCMO fired.  Sounds harsh, but she is not a nice woman and
> told me I
> deserved to be sick.  She should not be treating Americans
> or anyone
> for that matter!
>
> I was told a lawyer who works in workman's comp claims is
> the best
> to contact.  I contacted a few, but none would take my
> case.  They
> felt going against the gov't was probably a loosing cause
> and I did
> not stand to make enough to make it worth their time (I
> still have
> not found a job and could not afford to pay a lawyer).
>
> However, I do have a friend and she found lawyers to take
> her case
> and have filed a large law suite against the PC.  Sounds
> like some
> of you might have cases that a lawyer might take, I just
> couldn't
> find one for mine and contacted probably about 50.  If any
> of you
> are in California (other states too, not sure how all that
> works)...maybe we could all ban together and make one huge
> law suit -
>  I would help with that and be willing to share my story
> if it helps
> and gets word out there...just a thought...
>
> Best of luck everyone...
> --Lauralee
>
>
>
>
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>
>
> Yahoo! Groups Links
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#229 From: Heidi Fassnacht <riverock5@...>
Date: Thu Sep 15, 2005 10:00 pm
Subject: Re: group question
riverock5
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Nancy,

I do have experience with retroactive authorization.
I started the process in 2003, and finally got paid
(not everything, of course, but enough that the rest
isn't worth the hassle to get) in 2005.

My application was the same as would be one for
regular authorization, but for services that happened
in the past and I titled my application as "request
for retroactive authorization.'  I have a list at home
of what they told me I needed on the authorization
request, if you are interested but it is from 2003 so
who knows if it is still valid.

After faxing in 20 pages of request plus supporting
documentation twice (they wouldn't accept anything but
fax, which costs a fortune) they finally received my
request.  Months later and after many many calls, they
said they had approved authorization first for part of
the time, then the rest.  One provider then submitted
paperwork, and got paid fairly quickly (and paid me
back since I'd already paid out of pocket).  The other
provider took a lot longer to have success.  I made
the mistake of putting all my providers on one
authorization request.  I guess even though everyone
was listed under the provider section of the request,
ACS just considered the first office to submit a
payment request to be the one the authorization
covered.  ACS didn't tell me this was the problem for
over a year (they had a whole list of other reasons
for why our claims were being denied).  Finally, ACS
told me I needed to write a letter asking for the
provider covered by the authorization to be switched,
which I did.

Of course I never got a letter saying anything had
happened, so I called to check in with ACS, and they
said they had indeed switched providers.  So we
submitted again; this time ACS denied they claim on
grounds of untimely filing!  Can you believe it?! I've
found in a couple circumstances that denial of a claim
for untimely filing to be ACS's last attempt when
they've run out of other possible reasons.  I called
ACS and explained the situation, and shortly after my
provider got paid.  As with the first, since I'd
already paid the provider out of pocket, the provider
sent me a reimbursement check.  I have not tried to be
paid back directly.

A side note - When I finally got someone to tell me
that I should have had different authorization for my
different providers the ACS person told me this
misunderstanding on my part shows why the providers
should really be submitting all this paperwork since
they understand how it all should be done.  Such a
joke!  The providers with whom I have been working
have been extremely patient with this process and in
working with me, but have no more clue than we do
about how this process works.  I was even told by one
provider (from a different reimbursement saga) that I
should come in and talk to their staff about how the
system works since I knew so much more about it than
they did.  This is why I thought setting up a listserv
would be so helpful.  We seem to be our own best
resource.

Hope that helps some.

Heidi


"In the end, our society will be defined not only by what we create, but also by
what we refuse to destroy."  John Sawhill



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#230 From: FourDirect@...
Date: Fri Sep 16, 2005 12:12 am
Subject: Re: group question
FourDirect@...
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Heidi,

Thanks so much for sharing your saga. My deal is that my providers won't take reimbursement even if it is sent to them. I have some that I have authorization for. My key question is if I still need a HCFA 1500 form and do I submit that bill completely filled out with proof of my own payment?

Nancy
PS How are you?

#231 From: FourDirect@...
Date: Fri Sep 16, 2005 12:16 am
Subject: Re: Re: group question
FourDirect@...
Send Email Send Email
 
Felicia,

I'm so pleased that you had a good experience. I think you are a rare and fortunate person. I was NOT medically separated and that was part of the problem in that my illness manifested itself after I returned home - bovine tuberculosis in the lymph nodes that then spread and wasn't diagnosed for a couple of years, along with a very rare form of meningitis and encehaplitis. So, proving the correlation was a challenge. But thereafter I've had to fight for every authorization, every bill and everything else.

Nancy

#232 From: FourDirect@...
Date: Fri Sep 16, 2005 12:18 am
Subject: Re: Re: group question
FourDirect@...
Send Email Send Email
 
Lauralee,

Okay. I know the scenario very well. It is like a "Who's on First" routine only it isn't funny after all these years but that is exactly the way the conversations with all of those people go.

So, I will download the form and hope for the best.

I had the same experience with workers' comp lawyers way back when. No one wanted to touch the feds with a 10 foot pole. And we honestly do know more than anyone else can. It's just power we need.

Best,
Nancy

#233 From: FourDirect@...
Date: Fri Sep 16, 2005 12:19 am
Subject: Re: Re: group question
FourDirect@...
Send Email Send Email
 
In a message dated 9/15/2005 1:06:05 PM Eastern Standard Time, RPCVLAJarvis@... writes:


If any of you
are in California (other states too, not sure how all that
works)...maybe we could all ban together and make one huge law suit -
I would help with that and be willing to share my story if it helps
and gets word out there...just a thought...

Best of luck everyone...
--Lauralee


Lauralee,

I'm in NY but I'd join any lawsuit group in a New York minute!
Nancy

#234 From: FourDirect@...
Date: Fri Sep 16, 2005 12:20 am
Subject: Re: Help & Guidance Requested Regarding Filing OWCP
FourDirect@...
Send Email Send Email
 
In a message dated 9/15/2005 3:42:21 PM Eastern Standard Time, felicia@... writes:


My response about the lawyer was less for owcp and more
because having to quit your job because someone is
hassling you sounds like it is probably a legal matter.
-- Felicia


Felicia,
Yes, you are right about that. Didn't mean to dismiss the idea!
Nancy

#235 From: "Scott & Melody Johnson" <sjmel@...>
Date: Thu Sep 15, 2005 2:01 am
Subject: Re: Help & Guidance Requested Regarding Filing OWCP
immelodyone
Send Email Send Email
 
Yes, I have an attorney.
----- Original Message -----
From: Felicia
Sent: Wednesday, September 14, 2005 3:43 PM
Subject: Re: [owcp] Help & Guidance Requested Regarding Filing OWCP

Please tell me you have seen a lawyer about this.  -- Felicia

> I was diagnosed with Post Traumatic Stress Disorder (PTSD)
> in
> September of 2004 triggered by the abuse and hostile work
> site at
> EPA Seattle, WA.  I did not file a OWCP claim and now I am
> unemployed forced out due to denial of reasonable
> accomodation to
> work away from my former abuser "Quid Pro Quo", Physically
> Threatening me, publicly humiliating me.  Retaliation by
> EPA for
> filling a formal complaint removal of my job and denied
> reasonable
> accomodation to work away from my former abuser supervsior
> in a safe
> work site.  I was forced to resign from EPA after 18 years
> civil
> service outstanding employee and 11 years EPA seattle.
> EPA sent me
> a letter stating they would place me on AWOL and fire me.
> I applied
> for unemployment and EPA denied me.  I appealed and won
> unemployment.  My unemployment runs out in the middle of
> Nov 05.
>
> I have 4 medical providers stating I was injured on the
> job but I
> did not know I should have filed OWCP within 30 days.  Any
> suggestions are much appreciated.  My case is with EEOC in
> Seattle
> and will most likely take another year.
>
> GOD BLESS YOU ALL
> Melody Johnson
>
>
>
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>
>
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#236 From: "Felicia" <felicia@...>
Date: Fri Sep 16, 2005 5:36 pm
Subject: Re: Re: group question
feliciapanixcom
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Oh, yes, I'm very aware how lucky I have been.  I almost
wonder if it is because people who have had problems with
Lariam occasionally kill themselves and if I was sent home
from the Peace Corps with mental problems and then
promptly killed myself there would probably have been an
uproar.  Don't know if that had anything to do with it or
not.

Anyway, sounds like you have had a much harder time than I
have.  So sorry.  -- Felicia

> I'm so pleased that you had a good experience. I think you
> are a rare and
> fortunate person. I was NOT medically separated and that
> was part of the problem
> in that my illness manifested itself after I returned home
> - bovine
> tuberculosis in the lymph nodes that then spread and
> wasn't diagnosed for a couple of
> years, along with a very rare form of meningitis and
> encehaplitis. So, proving
> the correlation was a challenge. But thereafter I've had
> to fight for every
> authorization, every bill and everything else.
>
> Nancy
>

#237 From: Kaericsson@...
Date: Fri Sep 16, 2005 10:03 pm
Subject: Re: Re: group question
Kaericsson@...
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16 September 2005

Hi All:

Finally I, too am writing. It has been interesting following all of your
correspondense.

I was also separated from the Peace Corps in 1988 due to psychiatric
problems. Actually this did not develop from culture shock or job related
difficulties
while on site, but due to boyfriend problems. Coulda happened anywhere -- it
happened while I was in training in South America. I developed a sleeping
disorder. Of course, day to day stresses probably did aggravate the situation.
Peace Corps took responsibility for all aspects of your life -- kind of them! I
asked for counselling through Peace Corps right away, but the infrastructure
was not there. They provided it for me a year and a half later, but by then it
was too late. I was losing so much sleep I was hallucinating. I was sent home
after a year and nine months of service.

I felt the Peace Corps did their job once I was back stateside, and my
expenses for psychiatric care are still handled by US Dept. of Labor OWCP.
However,
even then OWCP was a dinosaur. I had to handle all the paper work for
reimbursement for medications. Finally OWCP got my pharmacy in the system, and I
don't
have to pay much attention to that any more. However, like with the rest of
you, it is getting more difficult in other ways.

In December 2004 the psychiatrist handling my medications retired. His
replacement was not considered a provider under OWCP. They would not pay him for
my
office visits. Now, I have had dozens of doctors treating my disorder since
1988, because I have moved a lot, and so have my doctors. This was the first
time OWCP had not accepted one as a provider, as far as I know. Finally he has
been paid for my three office visits, 10 months after I first saw him. He has
drummed it in to me that fewer doctors are taking OWCP patients for this very
reason -- it appears to be the most cumbersome health insurance agency in the
US.

Getting reimbursement for lab work has also become screwy this past year.
OWCP would not accept the diagnosis codes submitted by my current doctor for my
lab work -- they would not accept the specific code for my disorder, only a
"nonspecific diagnosis" code originally submitted when I originally returned
from
the Peace Corps, before my diagnosis was solidified. With the help of Rep.
James Oberstar those bills have now been paid, but I think still using that
"nonspecific" code. I know OWCP has codes available for my disorder -- and my
psychiatrist thinks it would be better to use them. Some of my doctors used them
successfully with OWCP earlier. (Go figure.)

Tomorrow Oberstar will be in my town at a fundraiser dinner and I believe
will be taking a moment to speak with me in person. I dropped off copies of some
of your letters at his area office yesterday so he'll have a chance to look
them over. We need to develop a unified approach to encourage US Dept. of Labor
OWCP to deal with its current and former employees in an equitable manner. I
know that their personnel are overstretched and subject to rapid burnout -- but
whose problem is that?!

This group serve is a good start. What's the next step?
I am open to suggestions.

Sincerely,

Kriste Ericsson
Paraguay 87-88
Minnesota

#238 From: FourDirect@...
Date: Sat Sep 17, 2005 12:09 am
Subject: Re: Re: group question
FourDirect@...
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I've heard of so many people having a terrible time with Larium. I am glad that you are still with all of us!

Nancy

#239 From: "Jessica" <jess428@...>
Date: Mon Sep 26, 2005 11:28 pm
Subject: health insurance
jess_smo
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I have a question about what everyone did about getting health
insurance if
they didnt have a job that provided it.  My current job doesnt
provide
health insurance, and I will be taken off my dad's policy in a few
mths
when I turn 25.  Unfortunately, no insurance company wants to give me
health insurance b/c of my pre-existing conditions--PC related stuff.
  Does
anyone have any suggestions?  I really need health insurance.

#240 From: FourDirect@...
Date: Mon Sep 26, 2005 8:34 pm
Subject: Re: health insurance
FourDirect@...
Send Email Send Email
 
In a message dated 9/26/2005 7:31:06 PM Eastern Standard Time, jess428@... writes:


Subj:[owcp] health insurance
Date:9/26/2005 7:31:06 PM Eastern Standard Time
From:jess428@...
Reply-to:owcp@yahoogroups.com
To:owcp@yahoogroups.com
Sent from the Internet



I have a question about what everyone did about getting health
insurance if
they didnt have a job that provided it.  My current job doesnt
provide
health insurance, and I will be taken off my dad's policy in a few
mths
when I turn 25.  Unfortunately, no insurance company wants to give me
health insurance b/c of my pre-existing conditions--PC related stuff.
Does
anyone have any suggestions?  I really need health insurance.



Yeah, this is a complete injustice for all of us. Many of us in the 1980's lobbied for insurance and finally PC did institute a group policy for a short amt of time after return of service. I have had to go on Social Security Disability so that I can now receive Medicare despite being well under age for that. I have had to NOT work in order to get health insurance. This system has done nothing right by us.

You can try slipping through the cracks by not necessarily listing any pre-existing issues and try for some insurance that way. After doing this for 20 years all I care about anymore is survival. I wish I had better information for you.

Do any of you out there have savvier ideas?

Nancy

#241 From: Kaericsson@...
Date: Mon Sep 26, 2005 10:15 pm
Subject: Re: health insurance
Kaericsson@...
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Hi Jess:

My medical condition does not allow me to go through most insurance agencies,
such as Blue Cross/Blue Shield. My only option in Minnesota is called
Minnesota Comprehensive Health Insurance, and is provided through Medica. Since
I
hold a couple of part  time jobs (totalling 36 hours a week) I pay for it myself
and it is cost-prohibitive, although good coverage. Right now I have a $670
quarterly payment staring me in the face. That is with a $2000 deductable, if I
remember right. Of course, I am 48 years old, not 25, so your payment would be
less. Hopefully you have other options.

The medical costs directly attributed to the disability I incurred during my
time with the Peace Corps are paid by US Dept. of Labor OWCP. MN Comprehensive
Health covers the rest.

Sincerely,

Kriste

In a message dated 9/26/05 6:32:19 PM Central Daylight Time,
jess428@... writes:

<<
  I have a question about what everyone did about getting health
  insurance if
  they didnt have a job that provided it.  My current job doesnt
  provide
  health insurance, and I will be taken off my dad's policy in a few
  mths
  when I turn 25.  Unfortunately, no insurance company wants to give me
  health insurance b/c of my pre-existing conditions--PC related stuff.
   Does
  anyone have any suggestions?  I really need health insurance.


   >>

#242 From: FourDirect@...
Date: Mon Sep 26, 2005 10:21 pm
Subject: Re: health insurance
FourDirect@...
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Kristie,

How were you able to get around the pre-existing issue? I've tried, myself with not much luck in the past and have paid much higher premiums than you. Sorry if I sounded so negative earlier. I'm tired.

I am eager to hear of ideas!
Nancy

#243 From: "Jessica" <jess428@...>
Date: Thu Sep 29, 2005 4:48 pm
Subject: making a feca claim
jess_smo
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While in Peace Corps I got very sick (shocking, I know, lol) and I was
medevac'd to Thailand, where they found out I had stomach ulcers.  I
never had any problem like that prior to my PC service.  The PC paid
for an evaluation during my 6 mths after service, but now that time
has expired and I KNOW that the ulcer(s) has returned.  So I need to
go to a doctor to get it checked out, and there may be possible tests
needed to be performed, as well as medication.  My questions are will
this be covered by FECA, and if so, what do I need to do in order to
get them to cover it?  I just can't understand their website and I
keep getting an automated system when I try to call.  Do I need
authorization first?

#244 From: Donald Weaks <donaldweaks@...>
Date: Thu Sep 29, 2005 6:24 pm
Subject: Re: making a feca claim
donaldweaks
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It will only be covered by FECA if a worker's comp claim has been filed and I wouldn't do anything without prior approval as far as trying to get it covered by the OMS. If you have Corps Care talk to them, they are good at giving advice.

Jessica <jess428@...> wrote:
While in Peace Corps I got very sick (shocking, I know, lol) and I was
medevac'd to Thailand, where they found out I had stomach ulcers.  I
never had any problem like that prior to my PC service.  The PC paid
for an evaluation during my 6 mths after service, but now that time
has expired and I KNOW that the ulcer(s) has returned.  So I need to
go to a doctor to get it checked out, and there may be possible tests
needed to be performed, as well as medication.  My questions are will
this be covered by FECA, and if so, what do I need to do in order to
get them to cover it?  I just can't understand their website and I
keep getting an automated system when I try to call.  Do I need
authorization first? 




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#245 From: "Jessica" <jess428@...>
Date: Thu Sep 29, 2005 10:08 pm
Subject: Re: making a feca claim
jess_smo
Send Email Send Email
 
I don'thave Corps Care anymore, but I do have another insurance.  I
talked to Post Service and they are sending me the paperwork to file
a claim, but they said I have to go to a dr now and get him to say
that I do indeed need testing/treatment.  Then PC will send the DoL
my med records.  So basically its going to be a looooong process and
me having to wait to get treatment.  I love it.  Oh, and they told
me to just pay everything 'out of pocket' until then.  Ha Ha Ha Ha
Ha they are so funny.





--- In owcp@yahoogroups.com, Donald Weaks <donaldweaks@y...> wrote:
> It will only be covered by FECA if a worker's comp claim has been
filed and I wouldn't do anything without prior approval as far as
trying to get it covered by the OMS. If you have Corps Care talk to
them, they are good at giving advice.
>
> Jessica <jess428@h...> wrote:While in Peace Corps I got very sick
(shocking, I know, lol) and I was
> medevac'd to Thailand, where they found out I had stomach ulcers.
I
> never had any problem like that prior to my PC service.  The PC
paid
> for an evaluation during my 6 mths after service, but now that
time
> has expired and I KNOW that the ulcer(s) has returned.  So I need
to
> go to a doctor to get it checked out, and there may be possible
tests
> needed to be performed, as well as medication.  My questions are
will
> this be covered by FECA, and if so, what do I need to do in order
to
> get them to cover it?  I just can't understand their website and I
> keep getting an automated system when I try to call.  Do I need
> authorization first?
>
>
>
>
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0605
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#246 From: FourDirect@...
Date: Thu Sep 29, 2005 9:47 pm
Subject: Re: Re: making a feca claim
FourDirect@...
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So sorry you are having to deal with a post service health issue.

I think it is important to have an evaluation by a doctor as without that, it is nearly impossible to even file a claim - kind of a chicken or the egg deal. But if you have that, they you will have a practitioner who can complete her/his part of the filing of the claim, if need be. I filed mine so long ago I'm not clear on the details but doing things in the proper order actually is important. And in doing that, it can expedite the claim. What state are you in? Just keep ALL receipts related to anything you pay out of pocket and keep detailed records on your computer or calendar so that you know what conversations happened when and so forth so that you can detail that down the road. It is probably worth paying up front for this initial evaluation just in order to get your claim going and worth getting some kind of claim going in case you end up having a medical problem down the road (which I hope you don't have.)

There are quite a few of us out here who can try to guide you in the process.

Nancy

#247 From: FourDirect@...
Date: Thu Sep 29, 2005 9:53 pm
Subject: Re: health insurance
FourDirect@...
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Kristie,

You gave good advice to Jess. I think that MN is an exceptional state as far as services are concerned. Does anyone else out there know if there are similar services elsewhere? And Jess, have you found anything? I didn't mean to be so negative last week. I was in the midst of many of my own struggles. On a few occasions I was a bit less than forthright on my individual self-employed medical insurance applications and got accepted but never billed them for anything that was legitimately not Peace Corps related or pre-existing. Those bills I directly to USDOL and fought those battles out with them. It is a slippery road but I ultimately had to do what was necessary for me, right or wrong according to the system. Just one suggestion but not necessarily the best thing. Kevin, do you have any ideas? Don't know if you've had your own health insurance - or anyone else?

This is such a crucial issue and dilemma for all of us who can't or don't work full time in benefited positions who have had illnesses from the Peace Corps.

Best,
Nancy

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