We have a client who was rated at a 50% impairment by his doctor for his lower extremity injury. The District Medical Adviser at OWCP states that our client should only receive a 2% impairment rating but it should be rated at 50% if arthritis ever gets approved. The difference between 2% and 50% for this employee is the difference between a four figure tax free monetary award and a six figure tax free award. Needless to say we fought to include arthritis as part of the claim.
We eventually had to go to ECAB to show that either the arthritis was pre-existing (and thus it should be including or the doctor stated it was made worse and the arthritis should be included. We didn’t care which of these was found as either way the arthritis would be included in the award. ECAB found that the primary treating physician made the argument that the arthritis should be included and OWCP needs to respond to this.
The frustrating part both for us and the client, is that it has taken almost a year for OWCP to acknowledge what they were supposed to do from the start. There is no punishment for having them wait a year and I suspect in a similar circumstance they will make the same argument again even though it is an incorrect argument.
Having said all this, for the amount of money on the line, you bet we’ll fight for that extra 48% to be included.