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"The punishment which the wise suffer who refuse to take part in government, is to live under the government of worse men" - Plato 427-347 BC |
| As noted above, in commenting on the development of the evidence, the Employees' Compensation Appeals Board (ECAB) has stated that proceedings under the FECA are not adversarial in nature and that DFEC is not a disinterested arbiter.(*129) While a Claimant has the ultimate burden of persuasion, DFEC shares the responsibility in going forward with the evidence, particularly when such evidence is of the character normally obtained from the employing establishment or other government source. DFEC has an obligation to see that justice is done. The ECAB has also stated that once DFEC has begun investigation of a claim, it must pursue the evidence as far as reasonably possible. In addition to eliminating any discussion of the "true doubt" rule, the revised chapter has also de-emphasized the Claims Examiner's responsibility to assist in the development of the evidence and the obligation to see that justice is done. Prior to its revision the SOAF chapter contained the following explicit instructions regarding the responsibilities of the Claims Examiner in developing and evaluating the factual evidence:
___________________________________________________ *130 FECA PM ch. 2-809.5e (1984) (emphasis added). This obligation to assist in the development of the evidence is consistent with ECAB case law and is reflected in the current regulations: "The Office may, in its discretion, undertake to develop either factual or medical evidence for determination of the claim." 20 C.F.R. § 10.110(b). Page 54
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The revisions to the SOAF chapter have allowed this document to change from a written summary of the evidence into a biased evaluation of the facts. This effort is directly contrary to established case law and is another example of how DFEC does not treat Claimants in a fair and equitable manner. DFEC's response to requests from Claimant's and their attorney to review the SOAF and questions being sent to the second opinion physician (SECOP) is revealing. In an October 21, 1997, letter, Director, DFEC Markey wrote:
As with his response to the pre-hearing remand recommendation,(*132) Director Markey once again responds with conclusory statements and irrelevant objections. In discussing the responsibilities of the Claims Examiner (CE) during preparation of the SOAF, the Procedure Manual states: ___________________________________________________ *132 See n.88 supra and accompanying text. Page 55
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It appears to be a distinction without a difference to distinguish the period before the preparation of the SOAF from the period after its preparation, for purposes of obtaining Claimant input. If providing Claimants with an opportunity to review the SOAF would be helpful in "ensuring that the facts are known to the parties . . .[and] refining the issues for the CE," what is the objection? Giving Claimants this opportunity is especially important since "[t]he SOAF is one of the most important documents a Claims Examiner (CE) prepares.' However, Director Markey states that doing so may result in needless questions, confusion and sometimes disputes." What questions are needless when their purpose is to clarify the factual evidence? What disputes are needless when their purpose is to insure that the SOAF is accurate and complete? Because the outcome of a claim may depend on its completeness and accuracy, the SOAF must clearly and fairly address the relevant information." (*134) Fairness and equity demand that every effort be employed to guarantee this. ___________________________________________________ Page 56
============================================================= Director Markey also alleges that legitimate questions and disputes will slow the adjudication process and delay the timely payment of compensation. This concern is strange coming from a program which routinely engages in practices which slow the adjudication process and delay the timely payment of benefits. The flawed procedures employed in developing SOAFs also have significant repercussions on development of the medical evidence since
Manipulation of the Medical Evidence DFEC's handling of medical evidence is unfair and inequitable. It weighs the medical evidence to determine which opinion has the most probative value. However, as noted above, DFEC routinely discounts medical evidence submitted by Claimants since it does not establish causal relationship beyond a reasonable doubt. DFEC further diminishes the Claimant's medical evidence by resorting to paid consultants (second opinion physicians or SECOPS) who produce medical reports which include opinions requested by DFEC solely to deny claims. These SECOPs base their opinions on flawed SOAFs and leading questions from Claims Examiners. Although the Act requires DFEC to obtain a third opinion when there is any disagreement between the SECOP and the Claimant's physician, DFEC has characterized this as "a time-consuming process which is not always necessary." It avoids its statutory obligation by investing the SECOP's opinion with exaggerated weight and, through spurious reasoning, by diminishing the weight of the Claimant's medical evidence. DFEC has adopted its questionable policy by ignoring a clear statutory mandate Page 57
============================================================= As presently written, § 8124 of the Federal Employees' Compensation Act (*136) states: "[i]f there is disagreement between the physician making the examination for the United States and the physician of the employee, the Secretary shall appoint a third physician who shall make an examination. However, when passed in 1916,(*137) § 22 of the Federal Employees' Compensation Act read: "[t]hat in case of any disagreement between the physician making an examination on the part of the United States and the employee's physician the commission shall appoint a third physician, duly qualified, who shall make an examination." (*138) This language remained undisturbed until 1966, when Title 5, United States Code, was re-enacted "codifying the general and permanent laws relating to the organization of the Government of the United States and to its civilian Officers and employees."(*139) As recodified, § 22 became part of 5 U.S.C. § 8123(a). It then read: ___________________________________________________ *135 FECA PM ch. 2-809.4b (1995). *136 5 U.S.C. § 8123(a) *137 An Act of September 7, 1916, ch. 458, 39 Stat. 742. *138 39 Stat. 747, § 22 (codified at 5 U.S.C. § 771) (emphasis added). *139 Pub. L. No. 89-554, 80 Stat. 378 (1966). Page 58
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Section 7, of Pub. L. 89-554, stated:Therefore, the phrase "disagreement" in present § 8123(a) cannot be a substantive change from the phrase "any disagreement" used in § 22 of the 1916 Act and later codified, with de minimis change, at 5 U.S.C. § 771. This means that "[i]f there is [any] disagreement between the physician making an examination on the part of the United States and the physician of the employee, the Secretary shall appoint a third physician who shall make an examination." Where statutory language is clear and unambiguous, it must be applied as written.(*141) Where a statute is silent or ambiguous, courts will defer to an agency's legal interpretation where it is a permissible interpretation.(*142) The language of current § 8123(a) is clear, unambiguous, and, as noted above, has been in the Act since it was passed. ___________________________________________________ *142 Chevron USA, Inc. v. NRDC, 467 U.S. 837, 842-3 (1984)(When a court reviews an agency's construction of the statute which it administers, it is confronted with two questions. First, as always, is the question whether Congress has directly spoken to the precise question at issue. If the intent of Congress is clear, that is the end of the matter; for the court, as well as the agency,must give effect to the unambiguously expressed intent of Congress. If the statute is silent or ambiguous with respect to the specific issue, the question for the court is whether the agency's answer is based on a permissible construction of the statute.) Page 59
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