U.S. Department of Labor - Office of Workers' Compensation Programs (OWCP) - Division of Federal Employees' Compensation (DFEC) - Federal Employees' Compensation Act This is a link to a lot of rules for injured Feds, but its similar throughout the USA for those under state regulated workers comp laws, which also have many same or similar federal laws that affect it.
Some of the horrific problems we are having with getting medical care and for e an oxygen supplier is many who are good people, but very misinformed about the laws and rules. Then they go and do what they are told. And in many of these cases the one 'telling' the misinformation here and there and every where leads right back to President Lynn Blodgett of Xerox Management Services and he as owner of over 100 companies that has control of our entire health care system from one conflicting end to another as ALL IN THE USA are now under government contractors for our health care and there is no money from congress for any internal audit control nor criminal investigations or prosecutions when laws are broken and huge money amounts are stolen from our precious health care dollars including form Medicare which is going on daily from 'INSIDE.; Many may not be under Pres Blodgett, nor intend to do wrong, but once wrong info get into the process , it has a way of going on and one and on and never ending. and REPORTED AS FACT WHEN ITS GOSSIP AND RUMOR RUN AMOK . A wise attorney who came in one day years, go representing a claimant for SSA said to me. Check the law. And I pulled out my book of the law of the matter and fund that SSA had diverted from original interpretation into current policies in our Program Operating ManualS. So even rumor gets into the written and the instructions given to use in our work Only an * ignored can cause real harm and CHAOS for many.
What some may not know, ,is that case, written up by me including the reference to the divergence of opinion went forward to a class action law suit and became standard policy that many now receive benefits because of it. I did not know of the issue. But I DID LISTEN TO THE ONE POINTING IT OUT . and addressed the legal issue when writing up my reports for the file. Humans can make mistakes and we have a system of appeals to correct these. not everything has had to go to a big court case, but errors pointed out in the lower appeals process can correct things IF THE AGENCY HEADS LISTEN and change the written policies or amend regulations. The power of the individual case is in our system Its called equal rights and fairness for all. and 'intent of Congress; which is harder to discern now when so much is made law with out a hearing to quote in our reports at the lowest level of what the testimony in want to those who passed the laws.
It also requires doing away with ARROGANCE BY THOSE IN CHARGE THAT SOME 70 YEAR OLD DISABLED WOMAN SHOULD BE LISTENED TO AND CHECK OUT WHAT SHE HAS TO SHARE. with her lap top on a bed side table sharing what she has learned over the years being on the inside of the government since 6/68 and on the outside as patients her whole life and wife, mother and daughter etc. of other patients.
.I have seen government work , when all in it were doing the work. And many lower level appeals are now contacted out and the WORK OF GOVERNMENT IS NOT GETTING DONE AS we all expect it to be as contractors do not have the legal authority to do the work. and the training to go with it which is being shorted also to the detriment of all of us. CHAOS AND WRONG INFO LEFT TO RUN AMOK GOES ON AND BENEFITS GET CUT to off set the money being used to pay for what is not the bills they should be paying, and not recovered back ,either when they do,
If Congress wishes to pass Medicare for all including paying for all job injuries, then pass it. otherwise, give the budget needed to stop those helping themselves to the money for only those who are to have it and get back what is due back. And audit controls is to see all have the right info and training to do their jobs.
Its why ALL TRAINING MATERIALS AND PROGRAMS PROCEDURES AND POLICES used to be reviewed by the general counsel (lawyers) of each agencies and OPM, too /To make sure it adhered to law and regulation and see to it changes made in the info to be given out for all to use if it did not..
It was after a phone conversation with one of the key persons inside one of the claims paying companies for Medicare that I realized nether of us were 'on the same page.' This person was quoting that after 6 months, Medicine is primary after one is on disability.
There is a chart being circulated with the letterhead as coming from the insurance industry. of course most if not all of these kinds of things are some of President Blodgett company's creations. rare;y is one every given a corporate or organizational name and address any more with these.
those who have any kind of health insurance now, as an employer group health plan, will find such in a category of what occurs when one also has a Medicare card.
It does say this, BUT there is an * to this.
DISABILITY IS NOT ANY DISABILITY.
The chart does indicate in the contest of this that we are referring to a workers compensation case./
BUT ITS NOT CLEAR to be understand without knowing more of the laws. And that ;misinformation; is spawned by OMISSION of a few more details.
Its not clear to even those in charge of getting all of our claims paid correctly and not have over payments to patients ad medical sources. and this means getting the needed medical care, also. Ones doctor has to know which health plan is your primary. Your doctor has been medically trained to know what you need, but IF YOU CANNOT PAY FOR IT, few will ever get it. Its what that 'LINE OF MISINFORMATION' that circulated a few years ago to get us all under the taxpayer subsidized and government contractor run health care that ALL SHOULD BE ABLE TO SEE A DOCTOR. does in no way mean one will be able to afford the care. And which entity is to pay first, which is going to determine what the treatment plans turns out to be.
Over 25 years ago, as a result of many studies, the health insurance trend went to paying for the care differently. One could see a doctor and pay a small co pay , even if the yearly deductible was not met. Many who had health insurance were not using is and getting sicker as they did not have the money for even the first visit which to day for the initial intake could be hundreds of dollars if a lot is done at that visit and often is when one is very sick and the clinic one goes to has a lot of medical testing on site. This led to many doctors, sending one to hospitals for these kinds of test, as the equipment is not cheap and it has to be paid for. So patients get referred to owe others separately and then patients did not go as they did not have the money.
Seeing the doctor, is a beginning is one is ill and more is needed to be done and usually is. Its why the yearly wellness visit is so crucial, to catch illness early when treatment outcomes can be cures, or lessen an progressive disease from leading to a more premature death. or in the case of diabetes prevent blindness and loss of limbs, etc. Sometime treatable at minimal cost is far cheaper than treating more serious issues due to no early treatment.
OUR RIGHT TO LIFE BY GETTING HEALTH CARE IS TIED TO WHO IS PAYING THE BILL
There is a Common Working File billing system at Medicare that is privately owned as a contract since 1999 by Group Health ( GHI) now Emblem Health International . The software protocols were not put in place to stop grave hacking in to the system by those who are not to go in an alter info. That is called hacking as no one is allowed to change certain data on the system. whether it be what ones doctor puts down as ones diagnosis or what ones health insurance is and which pays first.
In 1994, Sec of Health and Human Services decided that the government would no longer enforce the Medicare conditional payment law. And this , in itself , led to a collapse of our health care system as its an underpinning law that makes the whole health care industry obey the rules. the ripple effect of Medicare has permeated the whole for decades now as in setting things up to be paid by Medicare all surrounding setup as and system comply and that leads to all obeying all the rules, etc. even in private health insurance cases.
Part of the 'executive order' from 1994 was that the government was no longer going to get embroiled in employment disputes. And they should never have been. The good thing was that employers and agencies would post direct to the Common Working File and when it became a contract, it forbid any one to alter what was posted by those entities. If wrongdoing was being done by an employer, then they could be reported to authorities to handle. But the safety protocols were not there to block any one from going in an changing the posting. Even well- intentioned persons at 1-800 Medicare and at Medicare Coordination and Recovery unit are able to do so as they are also government contractors. the former is now owned by General Dynamics and the later by Emblem Health International . an all the others like the person I spoke to sending in a correction to have it changed because they are following faulty info that CMS should never have let be passed around and mould not have as part of any internal audit is seeing to it all have the right info. . And my phones lines are blocked so I can call neither from home, as when I would find my Federal Blues deleted off the system they would add it back in and them their management would delete it again as they had secret illegal deals to have an 'illegal dump on to Medicare" THEFT THAT CONGRESS WILL NOT GIVE ANY BUDGET TO STOP IT. Nor allow an auditor to get in and check the software system to make sure no one can go in and alter the bi weekly posting that they CMS contract says is not to be going on .
There is no reason why its not programmed in. And block any attempt to alter it by any one, Whether for good intention through not knowing the rules, etc. or evil intention to steal or cause obstruction of life sustaining medical treatment... When we Medicare card holders get yearly letters to complete as to what our other insurance is. THOSE OF US WITH POSTINGS FROM OTHER ENTITLES SHOULD NOT GET THE SAME LETTER. Instead we should be getting a summary of what that enter posts and where it came from with the name , address, contact phone number, etc of whom to call at that employer or agency to make any corrections.
MEDICARE IS STILL NOT INVOLVED IN EMPLOYMENT OR OTHER DISPUTES ONE MAY HAVE WITH THE ONES PROVIDING OUR HEALTH CARE PLANS. OR EMPLOYER.
In my case the official records at the US Department of Labor that post to the Common working file for my elf and those on my plan who also have a Medicare are accurate. Its just that the local FECA office does not have access, and neither does my Federal Blue Cross Blue Shield all of which are under the info management of President Lynn Blodgett who either is ignorant a of all the laws , or intentionally passing around and ordering illegal acts to be done to alter things, etc. WHO IS HIS BOSS?
All I know is he is the one named by high officials, etc. as the one spewing out the misinformation and pray he would stop it. as he is causing me and mine grave physical and financial harm if he is not HIS OWN BOSS in this, Then he may well be like the 'RICH YOUNG RULER YAHUSHA, WHOM WE CHRISTIANS CALL CHRIST JESUS SPOKE OF . Who has to give it all up to gain his eternal soul. Common wisdom that one need not be of that faith or any faith to understand.
Christ never taught it was wrong to be wealthy or even powerful, but that with that comes many responsibilities to humanity as one must become the servant of all with that awesome power and wealth in order to save ones soul from temptations of the path of destruction and death of the soul, it self. We are created with free will and its our choice to choose the path of low and caring , or one of personal destruction and killing of our eternal soul. Those with great wealth and power got that due to all the rest of us buying something or doing something that led to it.
WHAT DOES DISABILITY MEAN FOR MEDICARE AND HEALTH INS PURPOSES WHEN WORKERS COMPENSATION IS INVOLVED.?
It does not have anything to do with Social Security DISABILITY , Veterans DISABILITY , state disability programs that some have for all, etc. ITS REFERRING TO WORKERS COMP DISABILITY AND PERMANENT DISABILITY NOT TEMPORARY.
All seem to eager to end our hard fought workers rights to job safety and benefits if injured in all of this. There are many laws and clearly won court cases on this. When one gets injured on the job, ONE DOES NOT LOSE THEIR 'EMPLOYMENT.' They have a job to return to when they are able to return and if they cannot do the same work due to handicaps from the injury, then other work is made available and the training to do it if needed. For those who will eventually return to work , they may still be given money for loss of use of part of their body, but get TEMPORARY DISABILITY PAY UNTIL they do return to work. ONE CANNOT VOLUNTARILY GIVE UP WORKERS COMP BENEFITS. as often there is coercion to do so and maybe even a 'payoff ' to do so. and not pursue. It can be fraud. etc.
Ones medical care related to the injury will always be workers comp responsibility, and its possible to give a huge sum of money designated for that, but in no way is any health care insurer or Medicare to pay the bills. One cannot take that kind of money for medical and then spend it for something else and turn around and ask for Medicare or any other health insurance to pay the bills.
ITS FRAUD.
ONE CANNOT VOLUNTARILY RETIRE AND EXPECT MEDICARE OR ANY OTHER PLAN TO PAY. You are caught in a legally defined path to pursue ones claims for benefits. even if you are asked to come up against Goliaths as I and my family have been asked to do since 1/10/89. The law is on our side, and the government is supposed to be on our side also.
CONGRESSES OF THE PAST AND PRESENT HAVE ABANDONED US as officials have to have budget to even call or drive to investigate these deadly abuses of power and theft of the taxpayers money that has been allowed to go on for far too long..
I HAVE NEVER BEEN GIVEN ANY MONEY FOR MY FUTURE MEDICAL BILLS. And know of no law to do so under FECA.
So that (*) is crucial and being ignored to need to go check the laws on this.
For we injured federal employees one is considered active duty when we are employed and we are transferred from our employing agency to US Department of Labor jurisdiction as I was the last time on 10/10/1994 and have not gone to work since then. BUT AM STILL EMPLOYED by the law even if temporary disability has stopped and one is appealing a reinstatement. As to do that would be a type of 'coercion.. A lot of the laws got passed to protect the worker from such coercive tactics that have been tried over and over. .\
For lung cases, it is usually 2 years, before a doctor signs if the maximum improvement is enough to return to work. Mine was not the last time out, and its a progressive disease that home liquid oxygen only slows the progression. But if on it early after injured, one can live a non exertional life for decades without good lungs, as the body will get oxygen to live. I cannot use the concentrators as its not the therapeutic dose, and INFLAMES THE LUNGS from the low level OZONE emissions. resulting in non allergic chemical induced pneumonitis. That is a different type of fluid than one gets for an allergy reaction I am not a doctor, but am repeating what my doctors have told me over the years, and its in agreement with many medical source articles publishes , some even by them in medical journals.
Attached to many of our appeals is a 2009 reminder letter from a former claims examiner of mine from the local Dallas regional FECA office. to get my medicals in for the permanent disability decision, which she would have done if she had had access to my records in the custody of President Lynn Blodgett. . SHE HAD NO ACCESS TO MY FILES OR DATA TO PROCESS IT AS PRESIDENT LYNN BLODGETT WILL NOT SET UP MY OFFICIAL SYSTEMS WORKERS COMP FILE AND POST MY CASE EVEN THOUGH JUDGES HAVE ORDERED IT DONE. And also ordered it be done from my records ( and ask me for the facts as gossip and rumor had run amok and no one seems to know what is going on any more.)
President Blodgett has had several sets we have provided and all seem to to have ' disappeared'. in his custody..
That 2009 reminder letter ts PROOF THAT NO PERMANENT DISABILITY HAS BEEN DONE AND PROOF THERE IS AN ACTIVE AND OPEN CASE.
Not setting up the computer file, does not mean its not legally open and active as the official system says it is. THAT POSTS TO THE COMMON WORKING FILE.
So the first step in the process has been done. I filed for a schedule award for loss of use of body parts and when its a total and includes internal organs, its a negotiated amount that 4 parties have to sign off on . That is !my employing agency SSA or is it HHS as that is the name on the W2 back on 1/10/89? as SSA was part of them and by the time I got my last one for 1994 it still was? , 2. US Department of Labor, 3. myself and 4.my attorney if one has one.Then if one is found to be disabled so they cannot return to any kind of work, the injured worker DECIDES IF THEY WISH A BUY OUT OR TO RECEIVE CHECKS FOR LIFE. WITH SURVIVOR BENEFITS IF APPLICABLE. if ones agency cannot find work they might still be able to do then Office of Personal Management gets involved to see if there is some place in he entire government for placement. without all the records OPM did try and more CHAOS GOT CREATED for me again. as HHS or SSA had not been sending all the paper work required to OPM. all under President Lynn Blodgett's companies as info management etc. and partnerships deals. Very few officials are in charge of much of any govt today.. And too often its become a CHAOTIC FREE FOR ALL MONEY GRAB.
THEN ONE IS RETIRED and Medicare can pay first for anything not under workers comp and be primary for any one family member on ones employer group health plan who also has a Medicare card. Feds get to keep their same health policy in to retirement, it just does not [pay first. Others will find themselves being offered COBRA or having to find another kind of Medicare supplemental policy of go to Medicare Advantage plan just as any other retired person has to do in private industry where the employer does not offer life time coverage, even after retirement as some do but not primary any more, etc. They could but none I know of has picked up total care any more. for their retirees.
THAT ALL IMPORTANT( *) REFERS TO PERMANENT DISABILITY for workers comp cases.. as one is not retired, until that kind occurs. . IF ONE IS INJURED ON THE JOB ONE DOES NOT LOSE THE BENEFITS AND RIGHTS THAT GO WITH THEIR JOB. AND HEALTH INSURANCE AS A PRIMARY PAYER IS PART OF THEM. Do you wish to give up all your rights when injured on the job?
I am one that tried to work several times since 1/10/89 and under those who did nothing to help accommodate my disabilities as they promised to do. and with out oxygen as my body suffocated and angina from heart not getting enough oxygen without overworking was excruciating at times, trying to work . But I did get through it until the Philly FECA office beefed up security and the rifling (theft) of my files stopped long enough to get me to a board certified pulmonologist with a Green Peace banner on his wall. and they got me out of a life threatening situation that the last two days I went to work in 1994, I ended up in intensive care and before that was stopping off at ER's in the area and getting a couple of hours of oxygen to stabilize my vitals to be able to drive on home. Even doing everything to stop me from getting to that consultant exam occurred. I had to take leave with out pay to go and other real blocking occurred to stop me from taking needed records with me as asked to bring.
Going to work on oxygen would have made an invisible disability , visible and a reminder of many of what occurred as the reasons for the deaths that would occur form among us 90 were not reported to all as related to their job injury back in 1/89.. And outside influences brought to bear in many ways. for my case not to go forward as I have written about and we have documented in detail. Some of those involved through ignorance of the truth or part of the problems are still in position of high leadership in my agency and in the government and we all live with the aftermath of cover ups by some at the highest levels as the twin towers went into the ground and the path of destruction began in our office in 7/88. when HHS OIG would not intervene in the biggest security breach in SSA history of the personal data on every one with an SSN.. and reports are long before that else where. and resulted in the ultimate cover up on 1/10/89. All of this has been well discussed in this blog. Just go to any 9/11 for any year to refresh the summary of events as eye witness to the beginnings and my two years to try and stop 9/11/01 when no one listened as no one had been given enough of the real facts to know or want to know. CHAOS CREATED BY THOSE WHO DO KNOW WHAT THEY ARE MISINFORMING TO LET EVIL GO RIGHT IN AND CAUSE REAL HARM TO BE DONE TO ALL OF US. . Prayers for all to check things out especially when it makes no common sense. the instructions one is given to follow.
Now Congress needs to pass a few simple and general laws to allow those who need to make sure security is in place on our data, and our constitutional rights of life and livelihood upheld and have been denied access to do so. as they are listening. and Congress needs to listen too. for their files and data and rights are in this CHAOS also.
Linda Joy Adams 9/27/15
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