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Re: owcp success

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  • 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 1 of 3 , Jun 17, 2005


      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.


      --- In owcp@yahoogroups.com, "ellem1ch" <ellem1ch@y...> wrote:
      > Hello, all. I just joined this group, no doubt as a result of
      > trolling.
      > I'm here to offer info on a now-completed small success with the
      > 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
      > the capital back to my site for HCNs (like lots of us, I should
      > think), and developed shoulder pain. When I eventually had it
      > 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 &
      > 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
      > 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 -
      > 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 2 of 3 , Jun 17, 2005
        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

        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

        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

        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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