Claims Examiners in the Department of Energy Employee Occupational Illness Compensation (DEEOIC) within the Office of Workers Compensation (OWCP) of the Department of Labor (DOL) often attempt to discourage claimants from engaging EEOICPA Counsel (an EEOICPA Attorney or an EEOICPA Lawyer) to assist with an EEOICPA claim. I think it is important for Energy Workers and their Survivors (EEOICPA Claimants) to hear the other side of the story. So here is a list of reasons to hire EEOICPA Counsel:
(1) Depending on the claim, it is worth somewhere between $150,000 and $400,000 plus extraordinary medical benefits. This is a relatively significant level of compensation and should not be managed by an amateur.
(2) The Claims Examiner works for the Department of Labor and is not necessarily interested in seeing your claim paid. He or she is actually prevented from advocating for you. If you failed to claim the condition that is most likely to lead to the most compensation in the shortest amount of time, the claims examiner is not encouraged to advise you of that fact. While some claims examiners are extra helpful and some are generally less than helpful, it is important to understand that their job is to adjudicate claims in an efficient manner. They are not paid based on how many claims are paid but are evaluated on the number of claims adjudicated and the timeliness of the adjudication. While there are times when it is in the interest of the claims examiner to help you, there are times when the timely adjudication of the claim is more easily accomplished with a denial.
(3) The Resource Center is paid for by the government. The employees working at the resource center are there to assist with the filing of claims. They are not there to give advice about the best way to file a claim. The role of the Resource Center is not necessarily to make sure your claim is approved. While the individuals who work for the Resource Centers are good people and try to help, like the Claims Examiners, their role is not to make sure you obtain compensation but that your claim is properly filed. The interests of the representatives of the Resource Center and the Claims Examiners are distinct from those of the Workers and their Survivors and there are times when a claim suffers because of something the Resource Center employee or the Claims Examiner has done.
(4) The only goal of EEOICPA counsel is to make sure you receive all the benefits you are entitled to as quickly as possible.
(5) The cost to the Energy Worker or his or her survivors is limited by the EEOICPA statute to 2% of the compensation paid on an initial claim plus 10% of the compensation paid on a claim that has been recommended for denial. This cost of EEOICPA counsel is paid only after the compensation is received by the claimant(s). A Worker or Survivor is not obligated to pay anything unless the compensation is paid and the Worker or Survivor is not obligated to pay anything until the compensation is paid.
(6) EEOICPA Counsel is licensed to practice law by the state bar where that attorney or lawyer practices. Since the EEOICPA is a federal program an attorney or lawyer who is admitted to the bar of any state can be an Authorized Representative for any claimant in the program no matter where that claimant happens to live.
(7) Most lawyers or attorneys have professional liability insurance that protects their clients in the event a mistake is made.
(8) EEOICPA Counsel is capable of assessing the potential that there may be other claims that arise out of the injuries or conditions that have caused you to file an EEOICPA claim. For example, certain workers can file personal injury lawsuits associated with the injury or condition that has caused them to make a claim. Many personal injury lawsuits are pursued in state court and require an attorney licensed in the state to pursue the state claim, but EEOICPA Counsel will be sensitive to these issues. Please make sure to raise this issue with your attorney so that he or she can assess the viability of any claim in addition to your EEOICPA claim.
(9) EEOICPA Counsel will be sensitive: (1) to the possibility of a state workers compensation claim arising out of the same injury or condition that caused you to file your EEOICPA claim, (2) to the interaction of your EEOICPA claim and your personal injury or workers compensation claim, as well as (3) to the impact your claim might have on Social Security Disability (SSD) payments, on Medicare eligibility, and on whether benefits are taxable. A surviving spouse might be struggling with medical bills and estate issues and may even be considering how the compensation would be treated in a bankruptcy.
(10) Last but perhaps most importantly, we know and work with occupational physicians who have experience within the Program. These doctors know how to write the types of reports that are necessary to the acceptance of certain claims. These physicians can also prepare proper Impairment Evaluations using the American Medical Association Guides to Whole Person Impairment (5th Edition). While some of the doctors, performing Impairment Evaluations for Claims Examiners, under contract with the Program, known as Contract Medical Consultants (CMCs), perform proper Impairment Evaluations, we have found that some Impairment Evaluations are poorly prepared and unnecessarily under assess the level of impairment. This has required us in some cases to have a second Impairment Evaluation prepared. In those cases the claimant was required to pay for the second Impairment Evaluation because the Department of Labor only pays for one Impairment Evaluation every two years. Claims Examiners are not generally at liberty to discuss the qualifications of a Contract Medical Consultant (CMC) or provide any information concerning whether that doctor tends to provide favorable or unfavorable impairment ratings or causation opinions and are often unwilling even to identify who that physician will be.
While there are “Professional” advocates assisting EEOICPA claimants, there are benefits to having your claim filed and managed by EEOICPA Counsel. As an attorney with federal litigation experience, I can file a lawsuit in federal court challenging a Final Decision on an EEOICPA claim. So far, I have found that the Program is managed by reasonable people who work hard to compensate claims that should be compensated and have not found it necessary to challenge their work in federal court. But for the reasons described above, we think we more than earn our modest fees and we would welcome your call. Thank you for your time and good luck with your claim. Hugh Stephens (716) 208-3525.