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  • Wayne Johnson

You have received the Notice of Proposed Termination from OWCP. What do you do?

The first thing to know is that once OWCP accepts the claim it has the burden when it comes to terminating any benefits. This means that OWCP needs medical evidence. That medical evidence will either be from your treating doctor stating that your condition has resolved or, more likely, a second opinion examination saying your condition has resolved.

When OWCP sets a second opinion examination they are headed in one direction - that is, reducing your benefits if not completely eliminating them. After the examination has been done, you should check your E-Comp to see when the second opinion report is filed. There will be a lag between the filing of the report and your claims examiner writing up the notice of proposed termination letter.

The notice will state that you have 30 days to respond. If you already have begun your groundwork, you can get in a response before they terminate your benefits. You should discuss the second opinion report with your treating doctor. Your treating doctor can write a rebuttal report. Your medical treatment remains open during this 30-day window so your treating doctor can request testing. The OWCP rules state that a second opinion examination will no longer be probative evidence if there has been subsequent diagnostic testing that has not been reviewed. It is therefore important for your treating doctor to order testing such as a MRI or EMG/NCS that he can use to rebut the second opinion examiner.

When claims examiners set the second opinion, they are usually headed down one path. That is to use the report against you. Thus, sometimes even when your treating doctor does a strong rebuttal OWCP will issue the Notice of Final Termination anyway. You will have appeal rights. The best appeal to select is an oral hearing. An oral hearing allows you to testify regarding your medical condition. In addition, the oral hearing examiners are located in a different office then your claims examiner. They therefore do not have some of the same biases and pressures from the local agencies that the claims examiners do. Furthermore, the oral hearing examiners are the fairest and most impartial adjudicators in the OWCP system.

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