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owcp success

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  • ellem1ch
    Hello, all. I just joined this group, no doubt as a result of Kevin s trolling. I m here to offer info on a now-completed small success with the OWCP process.
    Message 1 of 3 , Jun 16, 2005
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      Hello, all. I just joined this group, no doubt as a result of Kevin's
      trolling.

      I'm here to offer info on a now-completed small success with the OWCP
      process.

      My 64th birthday is coming up on Sunday. I was a PCV 2000-2002. The
      summer before my service ended, I lugged too much stuff from PC HQ in
      the capital back to my site for HCNs (like lots of us, I should
      think), and developed shoulder pain. When I eventually had it checked
      out, the PC nurse said I was fine. At my age, one learns that what
      they say is fine doesn't always mean one feels fine. However, the
      fact that I'd asked, and explained exactly when the pain began & what
      I thought it related to, meant it was all in my PC health record.

      To make a long story short, after I got home, I learned I'd
      significant rotator cuff tears, and applied to OWCP for approval,
      which was granted, and embarked on physio. As I live in Canada, the
      process was a little different. I had to advance payment, then get
      reimbursed.

      If anyone's interested, I will explain why Canuck public health
      insurance coverage wasn't optimal for this situation, and what I did,
      and how I got my money back, which took a lot of effort and a very
      long time.

      If you like, I can offer some advice on how to negotiate the OWCP
      bureaucracy.

      It wasn't that all much money - in the two-thousand-dollar range - but
      it was certainly nice to get it. Eventually. Best from Ellen
    • Kevin
      Ellen, Welcome! Any advice that you have for negotiating the muddy waters of the OWCP bureacracy is welcome. Not every approach works for every person, nor
      Message 2 of 3 , Jun 17, 2005
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        Ellen,

        Welcome!

        Any advice that you have for negotiating the muddy waters of the OWCP
        bureacracy is welcome. Not every approach works for every person,
        nor does the same approach work twice for the same person, but it's
        still nice to have a few extra items in one's bag of tricks. Thanks.

        Kevin


        --- In owcp@yahoogroups.com, "ellem1ch" <ellem1ch@y...> wrote:
        > Hello, all. I just joined this group, no doubt as a result of
        Kevin's
        > trolling.
        >
        > I'm here to offer info on a now-completed small success with the
        OWCP
        > process.
        >
        > My 64th birthday is coming up on Sunday. I was a PCV 2000-2002. The
        > summer before my service ended, I lugged too much stuff from PC HQ
        in
        > the capital back to my site for HCNs (like lots of us, I should
        > think), and developed shoulder pain. When I eventually had it
        checked
        > out, the PC nurse said I was fine. At my age, one learns that what
        > they say is fine doesn't always mean one feels fine. However, the
        > fact that I'd asked, and explained exactly when the pain began &
        what
        > I thought it related to, meant it was all in my PC health record.
        >
        > To make a long story short, after I got home, I learned I'd
        > significant rotator cuff tears, and applied to OWCP for approval,
        > which was granted, and embarked on physio. As I live in Canada, the
        > process was a little different. I had to advance payment, then get
        > reimbursed.
        >
        > If anyone's interested, I will explain why Canuck public health
        > insurance coverage wasn't optimal for this situation, and what I
        did,
        > and how I got my money back, which took a lot of effort and a very
        > long time.
        >
        > If you like, I can offer some advice on how to negotiate the OWCP
        > bureaucracy.
        >
        > It wasn't that all much money - in the two-thousand-dollar range -
        but
        > it was certainly nice to get it. Eventually. Best from Ellen
      • Ellen Michelson
        Hi again. Kevin has encouraged me. 1.I remember having trouble understanding the forms I had to fill out, and remember phoning for advice several times (which
        Message 3 of 3 , Jun 17, 2005
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          Hi again. Kevin has encouraged me.

          1.I remember having trouble understanding the forms I
          had to fill out, and remember phoning for advice
          several times (which isn't easy from Canada - the
          non-800 numbers are hard to learn).

          2.I tried to be terse but found the requirements
          necessitated repetition.

          One concern was what was imho an error in my record.
          We had 2 nurse-practitioners from the US in country,
          and one HCN physician. We all adored the physician,
          who was a superb professional and of course thought
          he'd died & gone to heaven - he was being paid well to
          work humane hours to treat a population of pretty
          healthy people and had the resources to deal with
          anything medical they developed, i.e. nothing like his
          colleagues' practices with their HCN patients. I
          spoke to him at our COS conference the summer before
          my completion of service, and he noted in my file that
          my backpack had been causing the shoulder pain,
          whereas I'd said I noticed it e.g. particularly when
          getting my backpack on & off. (I'd been using a
          backpack constantly for some while before becoming a
          PCV, had never had the problem before, which I duly
          noted in my application for coverage.)

          My concern was to express my disagreement with my
          medical record as tactfully as possible, so as not to
          reflect badly on the physician. I didn't want
          anything negative to reflect on him, but I also
          thought that my avoiding criticism might help my
          cause. So I referred to it as a possible translation
          or language problem, even though, as I also noted,
          his English was excellent.

          I'm providing these details simply because it's been
          my impression, in the little I know about OWCP issues,
          that often the medical problems we present for
          coverage are greeted with unfair scepticism, sometimes
          due to incorrect or inadequate or disputed
          documentation.

          3.I recall receiving a postcard acknowledging receipt
          of my application, giving me a time frame as to when I
          would get feedback. I remember tracking the process
          by phone as well as I could.

          This is as good a place as any to mention that, on the
          whole, the secret of my success is simply tracking the
          process by phone and being unceasingly one hundred
          percent polite but extremely persistent. Never never
          never lose your cool! The impression you want to
          convey is that you >know< they're on your side and you
          want to learn from them exactly what the process is,
          so you can know exactly what to expect, so as to
          inconvenience them as little as possible, because you
          know how busy they are, as respected professionals
          doing an important job. Phone every time for a
          reason, following up on a previously-agreed-upon
          matter (which hasn't been resolved as promised or why
          would you be phoning?) and after the
          previously-agreed-upon interval (you're not bugging
          them randomly and you want to create the impression
          that you don't ever bug them randomly). That you
          would be least trouble to them if you never picked up
          the phone isn't ever mentioned!

          4.Meanwhile, I'd started government-funded
          physiotherapy. I learned over time that the
          treatments the government funds are based on the needs
          of car accident victims. However, the price was right
          (nothing after the initial fee which I can't remember
          exactly, but was plus/minus CAD$50) and I thought I
          might as well try something while waiting for approval
          and trying to learn more about rotator cuff injuries.

          5.In due course, I received approval. At that point,
          I submitted whatever bills I'd accumulated to date -
          about a hundred dollars from my physician (for the
          documentation for owcp) and the above physio fee.
          (The ultrasound was covered by the government
          insurance. I imagine stateside it wouldn't have been
          cheap. BTW I did have to wait a number of weeks for
          my appointment; perhaps you folks would be able to
          have ultrasounds on demand.)

          6.Meanwhile, I was starting to realize that private
          physio would probably be a better route. It took me
          many phone calls to learn that what I had to do was
          advance the money and submit bills to owcp, and that
          they'd pay whatever it cost. This sounds like carte
          blanche, and it was, although I am guessing that if I
          had billed for pain relief in the form of a tour of
          the Napa and Sonoma Valleys, a red flag could have
          been raised. I am also guessing that the procedure
          for you folks living in the US is somewhat different.


          7.At a regular shoulder checkup, my physician, charged
          me CAD$20 for a cortisone shot (is that what they cost
          in the US?) and told me that because teachers were
          better off than physicians, he was stopping my
          physiotherapy.

          Political interruption: there is a flip side to our
          health coverage up here. Physicians have big, big
          complaints, many more than justified. Teachers do,
          too. We've been at loggerheads with various
          governments for the better part of a decade, which has
          damaged the kids, and health care, bigtime. However,
          imho physician stress didn't excuse my physician's
          tirade, which turned him on the spot into my former
          physician.

          I then finally remembered that the mother of a former
          student was not only a former colleague (from my
          freelance writing days) but also one of Canada's top
          physiotherapists, so I reconnected with her. I had to
          pay zero to the physician she sent me to. His office
          also offered fee-for-service physio, but I chose to go
          to my old acquaintance.

          8.I decided it would be simpler to accumulate bills by
          the month and send them in once a month. After many
          phone calls (I had by now gotten to know the gal in
          charge of me, named, as I remember, Paula - she likes
          visiting Canada, she said), I learned the procedure.
          I was to send my bills to the attention of someone
          else in her department, even though she was going to
          deal with them.

          9.She also explained that they could only reimburse in
          US funds, so I duly opened a bank account in the US
          when visiting one of my kids.

          10.I sent my first receipts and covering letter,
          including the required EFT banking info, in March
          2004. I now was not only phoning OWCP every three
          weeks or so, I was phoning the automated bank account
          enquiry number.
          Note: log every phone call. Write the date you
          called and the name of whom you spoke to, and be sure
          to ask, and note the answer, what will happen next and
          when, and when you should phone again if it doesn't.
          e.g. When do you anticipate the reimbursement will be
          deposited into my account? Say thanks for every
          little nugget. No sarcasm. Mean it. It's your body
          and your money.

          11. The first reimbursement arrived as a cheque, in
          Canadian funds, while I was on holiday in July, (after
          a phone chat before I left). No comment.

          12.I duly sent receipts and covering letters every
          month after March, till I was pronounced as cured as I
          was going to get, at the beginning of August. (I'm
          happy. I've continued the exercises, now desultorily,
          and can once again write on the chalkboard easily and
          painlessly. I'm very cautious about lifting, but I
          wouldn't have gotten myself into this had I been
          cautious sooner.)

          13.Meanwhile, I relocated to the US for the fall
          semester, to help with a grandchild. Now - whoopee! -
          I could use the 800 numbers. So, as might have been
          expected, Paula disappeared and was replaced, in due
          course, by Annette. A reimbursement or two showed up
          after a while. Then Annette said things had gotten
          stuck in D.C. She gave me the name of a fellow to
          call there. So I got to know him, too. And he
          periodically said things had gotten stuck at the
          Annette end. Are we surprised?

          14.At one point or another, I was told that
          reimbursements could only be made by cheque in
          Canadian funds, EFTd to a stateside account only,
          could only originate from the office in the midwest,
          had to come from DC, etc. One must bear with these
          idiocies and never never never lose one's cool. An
          academic who studies bureaucracies explained to me
          that part of their job requirement is to frustrate
          folks like us. They are encouraged to hold the bottom
          line down as best they can. I sympathized with my
          ladies' workloads, asked how their holidays were,
          enquired of Annette how Paula was, hoped Paula's
          absence hadn't unduly stressed Annette, blah blah
          blah. They both sounded like nice people, and I wish
          them well, and I was happy to hear details of their
          lives, and working situations, but. Once (can't dare
          overuse this) I noted how confused and frustrated I
          was getting, in throwing myself on someone's mercy,
          asking what s/he could suggest I do. Clearly what
          s/he wanted to say was, "Stop phoning me. Get out of
          my life." But that could not be said. I tried to
          stay on the phone every time until I had gotten a
          statement of what to expect, and when, and a follow-up
          strategy agreed on. I am guessing that another part
          of their job description is never, never, never to
          insult a client. As long as you stay calm and
          coherent, they may not hang up on you or otherwise end
          the conversation.

          15.After a number of months, more than CAD$500 was
          still outstanding. Paula/Annette asked me to resubmit
          the bills. I, fortunately, had always kept copies of
          every piece of paper I sent, so this was not a
          problem. Then I had to start tracking that
          (re-)mailing - had it been received? What will happen
          now? How long will it take?

          16.At that point, when I'd already received
          reimbursements in the form both of a CAD cheque and
          USD EFTd, the DC guy, who knew I was then in the US,
          told me OWCP never was permitted to EFT funds and all
          he could do was snailmail a CAD cheque to my Canadian
          address of record. So why, you may ask, when I
          started the process in Canada, was I initially asked
          for US banking info, and given the reason that all
          they could do was EFT funds to a US account? I have
          my suspicions about his goal in saying that: they
          really want you to just give up. Don't!!

          17.The final reimbursement arrived just before I
          returned back here in January,2005 to resume at my
          school for spring semester. (I'd still be hanging out
          with my granddaughter except for Canada Pension Plan
          rules about the maximum amount of unpaid leave I can
          take - Peace Corps service was a lot of that.) Had I
          still been able to use the 800 numbers, I probably
          would have left a brief thanks message on at least one
          of my acquaintances' numbers, phoning at, say, 10 pm,
          so as not to interrupt daytime routine.

          18.I shudder to think of what I would have had to go
          thru had the cheque been stale-dated by the time I got
          back here, but it was just a matter of weeks. Phew.

          19.More important, I shudder to think of what it is
          like for some of you, who need a lot more help than I
          did, and a lot more money.

          20.My fallback was to contact my
          senator/congressperson, as a (finally, after all these
          years!) registered voter, before the November 2004
          election. I took what I thought was a calculated risk
          in continuing my persistent phoning, even though I was
          worried that I'd lose my clout when an election was no
          longer looming. However, folks have mentioned that
          state reps tend to be responsive even when an election
          isn't for a while. You know best who among your
          personal politicians is most responsive. And perhaps
          others in this group will comment on what happens when
          they are contacted.

          21.So my reimbursable physio was February-August 2004,
          and the reimbursement process was March 2004-January
          2005. There's definitely some advice above, but not
          really a whole lot. I hope it helps someone! Best
          from Ellen


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