Federal Disability Retirement for Postal Employees: Does the NRP Guarantee Success?
Editorial by Attorney Robert R. McGill, an exclusive to PostalReporter.com
In preparing, formulating and filing for Federal Disability Retirement benefits under FERS or CSRS, one of the issues which always must be confronted is whether or not the U.S. Postal Service can accommodate an individual’s medical conditions, and the letters which are issued by the U.S. Postal Service as a result of the National Reassessment Process, might give some comfort to the Postal Worker that the issue of accommodation might be satisfied, and therefore that the chances of obtaining an approval of a Federal Disability Retirement application might be greatly enhanced. Such a belief, however, might result not only in a potential miscalculation, but lead one into a fatal error based upon wrong assumptions. Read more
Injured postal worker fights for medical benefits
Filed under: Injured On Duty, mail handlers, owcp, postal, postal news, usps
“Jerome Garrett is fighting for federal medical benefits.Garrett had been working at the Hapeville postal facility for 16 years. Then, in April 2009, a 100-pound box full of mail fell from an overhead conveyor belt and hit him in the head.The incident left Garrett with a broken neck that went unnoticed for some time, he said.Garrett told Channel 2′s Erica Byfield that it took six months for doctors to realize that the accident had broken his neck.Garrett said his surgeon cleared him to go back to work. But his wife showed Byfield paperwork from other spinal specialists who said he is not ready to return to work.The Department of Labor handles benefits for postal employees. The Garretts want them to reinstate him.”
Full story from WSB-TV Atlanta, Georgia
Two Texas Letter Carriers Indicted For Falsifying OWCP Medical Travel Reimbursement
One Defendant Admits Receiving Nearly $175,000 by Submitting/False Fraudulent Mileage Claims
DALLAS — Two former U.S. Postal Service letter carriers from the Dallas area have been indicted, in unrelated cases, on charges of stealing government funds with regard to the Office of Workers’ Compensation Program (OWCP) claims they filed, announced U.S. Attorney James T. Jacks of the Northern District of Texas.
In the most recent case, Keldrick Hamilton, 33, was indicted by a federal grand jury in Dallas last week on one count of mail fraud and one count of theft of government money. He has pleaded not guilty to the charges and was released on a personal recognizance bond. If convicted, however, the maximum statutory sentence for mail fraud is 20 years in prison and a $250,000 fine. The maximum statutory sentence for theft of government money is 10 years in prison and a $250,000 fine. Restitution could also be ordered. Trial is set for August 8, 2011.
The OWCP allows federal employees who sustain on-the-job injuries to receive medical payments and compensation benefits, including reimbursement for medically-related travel. According to the indictment charging Hamilton, from July 2002 to January 2003, he worked as a letter carrier at the Joe Pool Station in Dallas. Citing an injury that occurred while delivering mail, in 2002 he filed a Federal Employee’s Claim for Continuation of Pay/Compensation. The indictment alleges that from January 2007 through mid-November 2010, he ran a scheme to defraud the Department of Labor (DOL) and OWCP by fraudulently claiming mileage reimbursements for physician and rehabilitation appointments which he did not attend.
In the other case, Shuntreciya Anderson, 28, a former letter carrier at the Caesar Clark Station in Dallas, pleaded guilty in April 2011 to one count of theft of government property. In 2005, she filed a claim for workers’ compensation citing an injury that occurred while delivering mail. She admitted that she filed claims for mileage reimbursement for medical appointments she did not attend, thereby defrauding the DOL and OWCP of more than $173,000 which she received as a result of her fraudulent claims. She is scheduled to be sentenced on August 1, 2011, and faces a maximum statutory sentence of 10 years in prison, a $250,000 fine and restitution.
The cases are being investigated by DOL-Office of Inspector General and the U.S. Postal Service – Office of Inspector General. Assistant U.S. Attorney Aaron Wiley and Special Assistant U.S. Attorney Stephanie Toussaint are prosecuting.
source: United States Attorney’s Office, Northern District of Texas
Chiropactor Who Treated Mostly Postal Workers Gets Prison For OWCP Fraud
And Defrauding Other Insurers Out $1.4 MILLION
The following is a press release from the United States Attorney’s Office,Northern District of Illinois
CHICAGO — A chiropractor who owned and operated a clinic in Maywood for more than a decade was sentenced today to 70 months in federal prison after pleading guilty last year to healthcare fraud. The defendant, Darwin Minnis, admitted that he and others submitted false claims to obtain payments from workers’ compensation and other insurers for services that were not provided and inflated claims for services that were provided, which resulted in an intended loss of at least $3 million and an actual loss of more than $1.4 million. Read more
OWCP Director: Proposals To Amend Federal Employees Compensation Act
The Office Of Workers’ Compensation Programs has laid out several reforms for FECA. Below is the prepared testimony of Acting Director Gary Steinberg for April 13, 2011 House Subcommittee Hearing On FECA: Read more
USPS IG: Postal Service Would Benefit From Its Own Workers Comp Program
USPS IG says Federal Employees Compensation Act (FECA) has become a ‘lucrative retirement plan’
The USPS Office of the Inspector General David C. Williams prepared testimony for April 13, 2011 hearing before the Subcommittee on Federal Workforce, U.S. Postal Service and Labor Policy Committee on Oversight and Government Reform House of Representatives on “Federal Employees’ Compensation Act: A Fair Approach? (1:30 PM – 3:30 PM).”
Mr. Chairman and members of the subcommittee, thank you for the opportunity to discuss workers’ compensation issues and reform. The Federal Employees Compensation Act (FECA) requires federal agencies to participate in the Department of Labor’s (DOL) FECA program. DOL bills each agency annually for compensation paid and non-appropriated agencies also must pay DOL an annual administrative fee.
Eligible disabled employees receive 66 2/3 percent (or 75 percent with dependents) of their basic salary, tax-free plus, medical-related expenses. Also, FECA places no age limit on receiving benefits. This is substantially more than other employees receive when they retire. Though unintended, FECA has become a lucrative retirement plan.
The Postal Service is the largest FECA participant, paying more than $1 billion in benefits and $60 million in administrative fees annually, creating a long-term liability of $12.6 billion. As of February 2011, the Postal Service had about 15,800 disabled employees. Over 8,700 were at least age 55, about 3,100 were at least age 65, and about 900 were between age 80 and 98.
Certain aspects of the program make it susceptible to fraud:
* The claimant’s ability to change their story until their claim qualifies;
* The claimant’s ability to hire a physician rather than use a plan physician to assess their injuries and condition;
* The program incentivizes DOL to collect larger fees if they approve more claims and lose budget dollars if they deny them;
* The lack of effective DOL case management; and
* Employers not being allowed to present or respond to evidence at hearings.
DOL has some fraud detection responsibility, but it’s unclear to what extent. They advise agencies to actively manage their own programs, while still charging administrative fees. There is not a clear delineation of responsibility between (1) agency program managers and (2) their OIGs and (3) DOL and (4) its OIG in detecting fraud. Accordingly, there is significant risk that program oversight will be duplicative or not done.
Since October 2008, we have removed 476 claimants based on disability fraud, recovered $83.5 million in medical and disability judgments, and halted significant future losses. In one investigation, a fraudulent claimant received $142,000 in benefits while she was working as a real estate agent, and we had pictures of her hiking and bungee jumping. She even bought a boat named “Free Ride.” Other investigations have found fraudulent claimants working as martial arts instructors, landscapers, hairdressers and mechanics.
Working with DOL is difficult. They control needed documents, but are often not responsive when we investigate cases. Additionally, they do not take timely action when told that a claimant no longer qualifies for benefits. Even when a claimant is convicted, DOL is slow to terminate benefits.
* We gave DOL an investigative report in 2006 which found a claimant was exceeding his limitations. Even though the employee was willing to return to work, DOL did not reduce his benefits until 2011.
* Fourteen months ago we gave DOL an investigative report containing evidence of fraud by a disability claimant and a subsequent medical exam confirmed the claimant was able to return to work with no restrictions. Despite requests, DOL has taken no action and continues to pay benefits.
* Over a 5-year period one claimant submitted $190,000 in unsupported mileage reimbursements that DOL paid without question.
Stress claims in particular are at high risk for fraud. If a doctor sees a correlation between stress and a claimant’s work, the claim is often approved. In one instance, a claimant’s emotional reaction to a change in work schedule was enough for DOL approval.
The OIG also investigates medical providers involved in criminal matters, including disability fraud and we have recovered $78.5 million since FY 2009. Unfortunately, DOL provides no standardized billing guidelines for doctors, making it difficult to hold them accountable for fraudulent billings. If DOL instituted a system similar to Medicare’s, prosecutors would be more inclined to take these cases. From our reviews, the Postal Service would benefit from having its own workers’ compensation program. Savings would be in the areas of reduced administrative fees, accurate assessment of claims by plan physicians, buyout options, mandatory retirements, immediate access to records, and improved accountability over case management.
From our reviews, the Postal Service would benefit from having its own workers’ compensation program. Savings would be in the areas of reduced administrative fees, accurate assessment of claims by plan physicians, buyout options, mandatory retirements, immediate access to records, and improved accountability over case management.
FECA is in need of significant reform. Such reform could reduce the substantial risk for fraud and improve program efficiency and effectiveness, while protecting reasonable benefits for legitimate claimants.
Postal Supervisor Loses Lawsuit on Hostile Work Environment
Filed under: legal cases, owcp, postal, postal news, postal supervisors, usps
Postal Supervisor Claimed A Hostile Work Environment aggravated his medical condition and USPS failed to investigate.
The following facts are based upon the allegations in John Pell’s amended complaint filed in the United States District Court and information from the EEOC case.
Pell is a former employee of the USPS who worked at the Framingham, Massachusetts Post Office. In 2003, while employed as a supervisor at the USPS, Pell was diagnosed with Post-Traumatic Stress Disorder (“PTSD”) and a psychiatric condition called Transient Global Amnesia (“TGA”). After these initial diagnoses, he remained out of work until his doctors released him to return to work. Pell’s doctors allowed him to return to work in 2005 on the condition that the USPS provide “strict enforcement” of USPS regulations and policies in Pell’s work environment, specifically those regulations and policies that prohibited workplace threats, harassment, bullying, intimidation and that contain a “zero tolerance” policy for unacceptable levels of workplace stress. Pell claims that he sought such “strict enforcement” as a “reasonable accommodation” [under the Rehabilitation Act] of his condition to enable him to perform the essential duties of his job. From the time he returned to work at some point in 2005 until September 5, 2006, Pell alleges the USPS strictly enforced USPS regulations and policies in his work environment and as a result he was able to perform all of the essential functions of his job.
However, on September 5, 2006, Framingham Postmaster William Harris approached Pell at the beginning of his shift, accused Pell of sexual harassment, and told him he had three choices: (1) accept a demotion; (2) transfer out of the Framingham Post Office; or (3) “I’ll throw you out.” Pell alleges that Harris’ conduct towards him violated USPS regulations and policies against bullying, harassment, threats, and intimidation. As a result of Harris’ conduct towards him, Pell suffered a TGA episode, left the workplace and has not returned to work since that day. He has since retired from the USPS.
Pell was unhappy with the USPS’s handling of his complaint about the September 5, 2006 incident. Pell alleges that, in connection with a worker’s compensation claim he filed when he was out of work, Harris completed two forms related to the September 5, 2006 incident that were inconsistent and incomplete. Pell also claims that Harris failed to investigate the September 5, 2006 incident fully because he did not interview Pell or other witnesses. Pell further alleges that he requested that Harris be investigated for violating USPS policies and regulations in connection with the September 5, 2006 incident, but that USPS District Manager John Powers chose not to do so. In early 2008, Pell reported Harris’ violations of USPS policies and regulations to USPS Northeast Area Vice President Haney , but Haney refused to investigate Harris’ conduct and refused to refer the alleged violations to the Office of the Inspector General .
Pell sought EEO counseling on March 31, 2008 — nearly a year and a half after the alleged September 5, 2006 incident of discrimination. In contacting the EEO, Pell indicated that the date of the alleged discriminatory incident was March 4, 2008 — the date Pell became aware that Haney would not refer the alleged violations of USPS policies and regulations to OIG.
After receiving the EEO notice of right to file a formal complaint on June 23, 2008, Pell filed a complaint with the EEO on July 8, 2008. On July 28, 2008, the EEO dismissed Pell’s complaint for two reasons: (1) failure to state a claim because the Department of Labor is the proper forum to address the basis of Pell’s then pending worker’s compensation claim; and (2) untimely EEO counselor contact because Pell failed to contact an EEO counselor within 45 days of the September 5, 2006 incident.
Pell then timely appealed the dismissal of his EEO complaint to the EEOC Office of Federal Operations. The OFO upheld the Postal Service’s dismissal:
The Commission has held that an employee cannot use the EEO complaint process to lodge a collateral attack on another proceeding. See Wills v. Department of Defense, EEOC Request No. 05970596 (July 30, 1998); Kleinman v. United States Postal Service, EEOC Request No. 05940585 (September 22, 1994); Lingad v. United States Postal Service, EEOC Request No. 05930106 (June 25, 1993).
In this matter, we find that the instant complaint is a collateral attack on a proceeding before the Department of Labor, and the proper forum for complainant to raise any challenges regarding the agency’s
improper investigation of his injury is during that proceeding itself. The Commission agrees with the agency that complainant fails to state claim. See Hannon v. Treasury, Request No. 05A01149 (May 8, 2003).
After a review of the record, including statements and arguments not addressed herein, based on the reasons above, we find that the agency properly dismissed the complaint.
Reading the allegations in the Amended Complaint in the light most favorable to Pell, his claim is likewise barred by the Rehabilitation Act’s administrative exhaustion requirement. Pell alleges that Harris’ conduct on September 5, 2006 amounted to discrimination based on Pell’s psychiatric disability and caused Pell to suffer a recurrence of his TGA, forcing him to leave the workplace that very day. Like the plaintiff in Roman-Martinez who was required to contact the EEO counselor within 30 days of the alleged discriminatory actions, Pell was required to contact an EEO counselor within 45 days of the September 5, 2006 incident.2 It is uncontested that Pell failed to contact an EEO counselor within this required 45 day period and, therefore, his claim is barred for failure to exhaust his administrative remedies.
Pell does not argue that Haney’s March 4, 2008 denial of any further investigation of the September 5, 2006 incident constituted a new discriminatory action and thus became the triggering event for commencing EEO procedures nor would such argument be plausible on the basis of the facts alleged in the Amended Complaint. The Supreme Court has held, “the time for filing a charge of employment discrimination with the [EEOC] begins when the discriminatory act occurs . . . . A new violation does not occur, and a charging period does not commence, upon the occurrence of subsequent nondiscriminatory acts that entail adverse effects resulting from the past discrimination.” Ledbetter v. Goodyear Tire & Rubber Co., Inc., 550 U.S. 618, 628 (2007) (superceded on other grounds by Lilly Ledbetter Fair Pay Act of 2009, Pub. L. No. 111-2, 123 Stat. 5). “[T]he proper focus is upon the time of the discriminatory acts, not upon the time at which the consequences of the acts become the most painful.”
Even read in the light most favorable to Pell, March 4, 2008 was the date on which he learned that the USPS would not further investigate or refer his claim that the September 5, 2006 incident was discriminatory. That is, the September 5, 2006 allegedly discriminatory act triggered Pell’s obligation to contact the EEO
Having ruled that this matter must be dismissed because of Pell’s failure to exhaust administrative remedies, the Court need not reach Defendants’ further argument that dismissal under Fed. R. Civ. P. 12(b)(6) is also warranted because he has failed to establish a prima facie case of employment discrimination based on a disability.
John Pell vs JOHN E. POTTER, POSTMASTER GENERAL and U.S. POSTAL SERVICE, March 1, 2011
New York Postal Worker Indicted On Workers Comp Fraud
SYRACUSE, New York — A former U.S. Postal Service employee from Prospect was indicted Wednesday on federal worker’s compensation charges, the U.S. Attorney’s Office in Syracuse said.
Kimberly Morris, 36, allegedly falsely claimed that a work-related injury prevented her from performing any duties with the Postal Service between April 4 and June 3, 2010, when she knew she was capable of working. As a result, she allegedly received more than $17,362 in undeserved worker’s compensation benefits for a sprained ankle, a news release stated.
According to the U.S. Attorney’s Office, federal agents videotaped Morris shopping, climbing stairs and driving while she was claiming to be unable to work. The case was investigated by the U.S. Postal Service Office of Inspector General and the U.S. Department of Labor Office of the Inspector General, the release stated.
Former postal worker indicted for worker’s comp fraud | The Observer-Dispatch, Utica, New York
Senator Collins Introduces Federal Workers’ Comp Reform
Filed under: Injured On Duty, owcp, postal, postal news, press releases, usps
Sen. Collins’ Bill Would End Perverse Incentives Keeping People on a More Lucrative System into Retirement Years
February 2, 2011
Senator Susan Collins, Ranking Member of the Senate Homeland Security and Governmental Affairs Committee today introduced legislation to stop the costly and escalating abuses of the federal workers’ compensation system.
The Federal Employment Compensation Act (FECA) is an important program intended to tide over employees who are injured and make sure they receive income while they recuperate pending their return to work.
FECA pays monthly benefits to about 49,000 federal employees who are on its “periodic roll.” From July 1, 2009 to June 30, 2010, the cost was $2.78 billion. Of that dollar amount, nearly half – or $1.1 billion – went to U.S. Postal Service employees.
“At the U.S. Postal Service, for example, more than 2,000 employees currently receiving federal workers’ compensation benefits are 70 years or older,” said Senator Collins. “Nearly 1,000 employees are 80 years or older. Incredibly, 132 of these individuals are 90 and older and there are three who are 98. This abuse may extend across the government. If recipients are gaming this crucial benefit at taxpayers’ expense, they must be exposed and the underlying program must be reformed.”
The bill would reduce workforce-related costs government wide by converting retirement eligible postal and federal employees on workers’ compensation to retirement when they reach retirement age.
OIG: What can the Postal Service do to reduce workers’ compensation costs?
The USPS Office Of Inspector General asked readers the following question:
What can the Postal Service do to reduce workers’ compensation costs?
In fiscal year 2009, the Postal Service workers’ compensation expense was approximately $2.2 billion, an 81 percent increase from $1.2 billion in FY 2008. These costs include $55 million in DOL administrative fees for FY 2009. About 72 percent ($718 million) was a non-cash charge related to changes in the estimated discount and inflation rates used to calculate the liability for future payments. At the end of FY 2009, the Postal Service estimated the total liability for future workers’ compensation cost was over $10 billion.
One of the contributing factors to the high cost of workers’ compensation payments is that FECA does not mandate a cut-off age for workers’ compensation benefits. Thus, injured workers can continue to receive workers’ compensation benefits well past the legal retirement age of 65, and in some cases employees over the age of 90 are still receiving workers’ compensation benefits.
Fraudulent workers’ compensation claims also result in higher overall costs. To combat workers’ compensation fraud the OIG launched its crime prevention and awareness campaign in September 2009 and a joint year-long initiative with the U.S. Postal Inspection Service in February 2010. The successful investigative efforts saved the Postal Service more than $400 million for fiscal years 2009 and 2010 combined.
Submit answers to poll at the USPS OIG blog
Related links:
USPS OIG, USPIS Launch Workers’ Comp Fraud Initative (January 18, 2010)
Senator Susan Collins Seeks Reforms To Federal Workers’ Comp Program (January 12, 2011)