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  1. #1
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    Oct 2015
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    Default Provisional Approval of a Scheduled Award

    Injury2/6/2009. My CA7 was sent in on 11/2013...still waiting. I was sent to a second opinion MD of their choosing in March of 2015. Two weeks ago the automated system said my claim for scheduled award had been provisionally approved and payment would be issued once final review and certification. What does this mean exactly and how much longer should I be waiting. Also on the automated system it tells me dates accepted are 10/25/2013 to 4/6/2014. Am I to assume that impairment for my lungs is roughly 6 months? I would appreciate any help. I'm frustrated and in need of answers.
    Thank you.

  2. #2
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    Oct 2015
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    Default Re: Provisional Approval of a Scheduled Award

    Quote Quoting missyjr View Post
    Injury2/6/2009. My CA7 was sent in on 11/2013...still waiting. I was sent to a second opinion MD of their choosing in March of 2015. Two weeks ago the automated system said my claim for scheduled award had been provisionally approved and payment would be issued once final review and certification. What does this mean exactly and how much longer should I be waiting. Also on the automated system it tells me dates accepted are 10/25/2013 to 4/6/2014. Am I to assume that impairment for my lungs is roughly 6 months? I would appreciate any help. I'm frustrated and in need of answers.
    Thank you.
    Received award letter for payment. However, I have a lung condition in both lungs. I had the understanding that because of that fact the 156 weeks would double to 312 weeks for figuring the compensation. Should I appeal? And if so how long does that usually take?
    Thanks

  3. #3
    Join Date
    Oct 1971
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    5,084

    Default Re: Provisional Approval of a Scheduled Award

    missyjr
    I have a lung condition in both lungs. I had the understanding that because of that fact the 156 weeks would double to 312
    Where did you get that info?
    I believe they base the rate on the Whole Person Impairment, not each lung.
    This is nothing to be guessing at, consult a lawyer who specializes in Federal comp cases to be sure you're getting a fair deal.

    Tony
    Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.

  4. #4
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    Default Re: Provisional Approval of a Scheduled Award

    Quote Quoting tony View Post
    missyjr Where did you get that info?
    I believe they base the rate on the Whole Person Impairment, not each lung.
    This is nothing to be guessing at, consult a lawyer who specializes in Federal comp cases to be sure you're getting a fair deal.

    Tony
    On the OWCP website..
    Special Considerations.

    (1)*Impairment to the lungs*should be evaluated in accordance with the*Guides*insofar as possible. The percentage of "whole man" impairment will be multiplied by 312 weeks (twice the award for loss of function of one lung) to obtain the number of weeks payable; all such awards will be based on the loss of use of both lungs.

    In cases involving anatomical loss by traumatic injury or surgery, the evaluation will also be based on loss of lung tissue by weight or volume, and the award will be based on these factors if it results in a greater percentage of loss than one based on loss of respiratory function. Anatomical loss awards will be made for one or both lungs as appropriate.

  5. #5
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    Oct 1971
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    5,084

    Default Re: Provisional Approval of a Scheduled Award

    Quote Quoting missyjr View Post
    On the OWCP website..
    Special Considerations.

    (1)*Impairment to the lungs*should be evaluated in accordance with the*Guides*insofar as possible. The percentage of "whole man" impairment will be multiplied by 312 weeks (twice the award for loss of function of one lung) to obtain the number of weeks payable; all such awards will be based on the loss of use of both lungs.

    In cases involving anatomical loss by traumatic injury or surgery, the evaluation will also be based on loss of lung tissue by weight or volume, and the award will be based on these factors if it results in a greater percentage of loss than one based on loss of respiratory function. Anatomical loss awards will be made for one or both lungs as appropriate.
    It says "The percentage of "whole man" impairment will be multiplied by 312 weeks (twice the award for loss of function of one lung) to obtain the number of weeks payable;
    You're not eligible for the full 312 weeks - just a percentage of the 312 weeks based on your "whole man" Impairment (Whole Person Impairment Rating) WPI.
    Be sure they figured your payment based on the 312 week max - if not definitely file an appeal.

    Again, consult a lawyer to protect your rights.

    Tony
    Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.

  6. #6
    Join Date
    Oct 2015
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    5

    Default Re: Provisional Approval of a Scheduled Award

    Quote Quoting tony View Post
    It says "The percentage of "whole man" impairment will be multiplied by 312 weeks (twice the award for loss of function of one lung) to obtain the number of weeks payable;
    You're not eligible for the full 312 weeks - just a percentage of the 312 weeks based on your "whole man" Impairment (Whole Person Impairment Rating) WPI.
    Be sure they figured your payment based on the 312 week max - if not definitely file an appeal.

    Again, consult a lawyer to protect your rights.

    Tony
    My whole body impairment was 15%. Weeks paid 23.4 which is 15% of 156....so no it wasn't figured on 312 week max.

    Wish me luck ....

  7. #7
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    Default Re: Provisional Approval of a Scheduled Award

    Quote Quoting tony View Post
    missyjr Where did you get that info?
    I believe they base the rate on the Whole Person Impairment, not each lung.
    This is nothing to be guessing at, consult a lawyer who specializes in Federal comp cases to be sure you're getting a fair deal.

    Tony
    Question with an impairment will this keep case open for medical care??

  8. #8
    Join Date
    Oct 1971
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    5,084

    Default Re: Provisional Approval of a Scheduled Award

    Quote Quoting missyjr View Post
    Question with an impairment will this keep case open for medical care??
    Yes, this payment is for the indemnity side only, medical stays open until you heal 100% or settle.
    You really need to consult a lawyer to be sure you're getting a fair deal.

    Tony
    Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.

  9. #9
    Join Date
    Jun 2016
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    4

    Default Re: Provisional Approval of a Scheduled Award

    Tony what happens when they give you provisional approval of an injury comp compensation claim haven't been paid since March

  10. #10
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    Default Re: Provisional Approval of a Scheduled Award

    Quote Quoting Namono View Post
    Tony what happens when they give you provisional approval of an injury comp compensation claim haven't been paid since March
    It means that your Claim for Compensation has been approved and waiting final review and certification.
    Give it 90 days, if you don't receive payment, submit a request in writing and ask why.
    Be sure to continue filing Form CA-7 every two weeks until you're advised that it's no longer necessary.

    Disability for Work
    The FECA provides wage loss benefits for periods of disability that are due to a work related injury or illness. All periods of wage loss must be supported by medical reports demonstrating that you are disabled for work.
    If compensation is approved and you begin receiving compensation payments from this Office, you should continue to submit Form CA-7 every two weeks, unless you are notified by this Office that this is no longer necessary.
    https://www.dol.gov/owcp/dfec/regs/c...New-Claims.htm

    Here's a good blog on this topic:
    Schedule Awards
    By: Snowed
    When claiming a schedule award, a claimant needs to submit a CA-7 and the appropriate medical report to OWCP. Schedule awards are often put on the “back burner” for claimants that are not without other income, therefore a claimant needs to be proactive in pushing their claim along. Although I have not found a guideline in OWCP literature, OWCP internal guides are 90 days for processing a schedule award. This is a rarity however, and suggests that if OWCP does not respond within the 90 days, then further action be taken such as writing to the District Director for the status of the claim and reason for the delay.
    http://theowcpclassroom.blogspot.com...resent_27.html

    Division of Federal Employees' Compensation (DFEC)
    Procedure Manual
    8. Schedule Award Decisions.
    After the payment has been certified, the CE should promptly issue a formal decision outlining the award details. Form CA-181 Award of Compensation (or equivalent) should be used.
    https://www.dol.gov/owcp/dfec/regs/c...oup2.htm#20808

    Tony
    Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.

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