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owcp success details

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  • 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 1 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

      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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