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Denials & Appeals

When your claim is denied, you or your attorney must decide on one of three appeal options:

  • Request a hearing within 30 days;
  • Appeal to the Employees' Compensation Appeals Board (ECAB) within 180 days; or
  • Request reconsideration of the decision and submit further evidence and legal argument within one year.

Request a Hearing

**IMPORTANT** Always mail your request for hearing by certified mail. The request must be postmarked within 30 days of the decision

When you request a hearing, the OWCP district office transfers the claim file to the Branch of Hearings and Review in Washington, DC. You can still choose to have a hearing in person, but within the last few years the hearings office has been encouraging telephone hearings, which are scheduled faster and work well.

Your employer may not participate in the hearing but they are provided with a transcript of the hearing and the employer may comment on the transcript in writing.

The hearing representative will often make a decision remanding the claim back to the claims examiner with an order to obtain additional information (usually medical opinion) to decide the issues. Sometimes he will simply rule in your favor. Other times, he may agree with the claims examiner and deny the claim again. His decision will state a new set of appeal rights.

ECAB

  • An appeal to ECAB must reach the board by the 180th day, although reasons for being late will be considered.
  • You may not submit additional evidence to ECAB. Board members make a decision based on the claim's record. ECAB takes many months to render a decision, and then an unfavorable decision may be final with no further appeal rights.

Application for Reconsideration

  • When requesting reconsideration of a decision, you must submit new evidence and/or new legal argument to obtain a merit review of the case. A merit review is important, because, if OWCP issues an unfavorable decision on reconsideration, you retain appeal rights.
  • OWCP sends your employer a copy of the application for reconsideration, and the employer can comment on the appeal. Increasingly, supervisory or senior claims examiners are ordering second-opinion or referee medical examinations before deciding on the reconsiderations.
  • Once on wage-loss compensation and/or medical benefits, you should heed every written notice from OWCP and respond to requests for information. You need to attend OWCP-ordered medical examinations and cooperate with nurses and vocational experts assigned to your case.

**IMPORTANT** Finally, count the date of any decision or notice from OWCP as day one. For example, in requesting reconsideration of a decision dated November 4, 2006, one would need to postmark the application for reconsideration by November 3, 2007

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