Tuesday, September 14, 2021

Put On Your Swimming Cap, You're About to Float Down a Not-River in Egypt

Get ready! Might as well hold your nose, too. I am about to reveal info that will make your head swim. Make it spin, like Linda Blair's noggin in The Exorcist. Pop a Dramamine while you're at it. You must be in full possession of your faculties to grasp the technicalities. Here's the basic outline:

The Pony's Workman's Compensation claim was denied last Wednesday.
The Pony's broken ankle is healed.
The Pony went back to work yesterday.

The Pony, Dean of Denial

The Pony's broken ankle, and quest for compensation, could be termed a comedy of errors... if it was funny. Which it is not. The pain from his work-acquired injury, plus loss of wages, is in no way humorous. At least it was not devastating, what with having Hick and Val as a safety net. 
The Pony broke his ankle when he tripped on a sidewalk during the last hour of his mail route on July 15. In a perfect world, The Pony would have reported it to his supervisor, been sent for medical evaluation and treatment within hours, and have started receiving his Continuation of Pay within a week or so. If he was out more than six weeks with the injury, Workman's Compensation would have paid him 60 percent wages until released back to work. Here's a litany of what really happened.

-Reported injury, supervisor took pictures and completed forms, sent him to urgent care
-Urgent care was closed by the time Pony got there, went to a different urgent care
-Forms faxed by the supervisor to urgent care wouldn't go through
-Supervisor left on a previously scheduled vacation after work that night
-Day 2, acting supervisor emailed Pony the forms, to print out and take [ON A BROKEN ANKLE] back to urgent care
-Urgent care refused to fill out one form, saying they couldn't give a diagnosis, only a specialist could. Yet they couldn't refer him to a specialist without that form!
-Day 5 and 6, urgent care and acting supervisor both denied responsibility for that form
-Days 7-13, The Pony got the runaround concerning that form, and couldn't get an orthopedic specialist's appointment without it.
-Days 7-13, a former manager working elsewhere, and a regional specialist in KC, had to be consulted to find the missing form from the vacationing supervisor, to allow The Pony an appointment for his still-broken LEFT ankle, which had been in a soft splint this whole time. The original form, once found, listed the RIGHT ankle.
-Day 13, The Pony got a notice from the Department of Labor that his Workman's Compensation claim was lacking documentation of a form signed by a DOCTOR, not a nurse practitioner.
-Day 14, The Pony discussed the forms with the podiatrist treating his broken ankle, and left assured that they do this all the time, and they would get the forms sent in
-Days 15-35, The Pony continued his healing in a walking boot, still making 2-3 attempts per day to contact supervisory personnel about his lack of pay that should have started
-Day 36, The Pony had a 3-week checkup with the podiatrist. Healing. New appointment in 3 weeks.
-Sometime between Day 36 and 56, The Pony was paid 1 week of Continuation of Pay.
-Day 56, The Pony received a letter from the Department of Labor denying his Workman's Compensation claim for lack of documentation. He will have to pay back any money given on his claim (that one week, safely sitting in his bank account) if the decision is not reversed.
-Day 57, The Pony went to his podiatrist appointment, where he informed them of the denial, because their forms were never send in [or at least never received by the Dept of Labor] He got copies of all the forms, to sent in a request for a Reconsideration. Looking them over at home, ONE BOX was marked wrong.
-Day 58, The Pony returned to the podiatrist to get the box corrected. The doctor was out in another town.
-Day 62, TODAY, The Pony is missing work to go back for the paperwork correction

If that was confusing to you to read, or even SKIM OVER, imagine your medical bills and wages depending on it! The Pony's main form of communication was text and email, for an electronic record of his efforts to get medical care in a timely manner. Besides, you can't just pick up the phone and call somebody at the post office and expect to get a live person.
Good thing his union shop steward kept pushing to spur on management. It did not seem to be a deliberate effort to thwart The Pony's claim, but rather a matter of the left hand not knowing what the right hand was doing. Or in this case, the left ANKLE... At no time was there any dispute from the USPS about The Pony's work-related injury.

The one item that The Pony might have mishandled, contributing to his denial, was not responding to the Dept of Labor after the notice of lacking documentation. He ASSUMED the materials from the podiatrist (whose appointment he had the day after receiving that letter) would remedy the problem. Apparently, the Dept of Labor only sends out one notice like that per claim, and the claimant has to contact them about it, not just rely on the documents arriving.

Anyhoo... if The Pony gets that form corrected today, the whole packet is going in the mail on Wednesday. Even though he has 30 days from Sept 2 to file a Reconsideration, or 1 calendar year to file a different form of appeal. Good thing The Pony is stabled under the roof of Hick and Val, and strapping on their feedbag. It takes at least 90 days for a Reconsideration to process.

The Pony Returns

The podiatrist took more x-rays last Thursday, and said the ankle was good to go. He asked The Pony when he wanted to return to work. The Pony said, "Pretty soon, since I've been getting no money this whole time I was out of work." So the podiatrist released The Pony for full duty starting Monday, Sept 13. The Pony took the release to the post office, and they put him on the schedule for Monday. However...

The Pony went in to work at 9:00. Around noon, he called to tell them he was done with his first loop. Did they want him to come back to the office, or go help someone else with a route. Um. They needed him to come back, because they'd given him an LLV (Long Life Vehicle) that they shouldn't have. I was worried that it was not safe, but The Pony said it was designated for a Rural Carrier, but somehow the supervisor had the key, and assigned it to him. They told The Pony he could leave early, and that they might need him Tuesday after his podiatrist paperwork mission. 

Anyhoo... while The Pony was off with his injury, the 120-calendar-day period expired on his probationary period. So it looks like he's an actual CCA (City Carrier Assistant) now, and can only be let go for cause, not just because his probation isn't working out. So there's that. They've already worked him since that deadline passed. Good luck getting rid of him!

The only tragedy here is that The Pony went two weeks on a broken ankle, unable to see an actual doctor for treatment. Only ONE podiatrist/orthopedist office in our area takes Workman's Compensation claims, because they're so fraught with problems. They wouldn't take The Pony without that USPS form, and nobody else would even take him with insurance, once they heard it was a work-related injury that would be going through Workman's Compensation.
Thank goodness his fracture had minimal displacement, and The Pony didn't need surgery or a closed reduction. He can survive without the money, but it's over five grand, not including the medical bills. So you can bet The Pony will pursue every avenue available to recoup his compensation.


  1. What a tale. And imagine if they WERE trying to screw him out of money...

    1. Yeah, I imagine that is an area in which their efficiency would be exemplary!

  2. And yet so many crackpots know how to scam the system...grrr. This may end up needing a lawyer.

    1. That's what Hick thinks. The Pony got the needed documentation today. He's working on his letter of RECONSIDERATION. The packet will go out in the mail on Thursday. Hope it gets delivered properly!

      I DO like seeing surveillance video of those crackpots, tossing an ice cube on the floor, then lying down in agony beside it, calling for help!

  3. Send it by FedEx, USPS might lose it and then he has to start all over again. Oh and make copies of each page he is sending.

    1. I already copied the pages in quadruplicate! I wonder how the USPS would feel about a RECONSIDERATION sent by FedEx? It might be like sending a case of Coke to Pepsi headquarters!

      Although this goes directly to the Department of Labor in Kentucky, who then sends it to the USPS regional office in Kansas City, from the looks of the instructions.

  4. Whatever else happens I hope The Pony gets his compensation. Your medical system sounds totally screwy to me.
    I wonder what the time-line is for back injuries here in Australia? I sprained my back really badly at work back in 1986 and it still bothers me occasionally, necessitating a day in a chair with a hot water bottle to ease it.

    1. Back injuries are nothing to sneeze at! And it's hard to prove you DIDN'T injure a back.

      The USPS system is what's screwy. The medical system (at least the two entities that treated The Pony) is just rife with everyday people not doing their jobs correctly, like almost every other business I have dealings with these days.

      If not for all the VIRUS crap, The Pony would have gone to the hospital ER that night. But he didn't want to wait for hours in a petrie dish of germs.