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Publication CA 11 -- WHEN INJURED AT WORK
Information Guide = for=20 Federal Employees

Introduction=20

The Federal Employees' Compensation Act (FECA) Click here to review the actual code (5 U.S.C. 8101 = et=20 seq.) is administered by the Office of Workers' Compensation = Programs=20 (OWCP) of the U.S. Department of Labor. It provides compensation = benefits=20 to civilian employees of the United States for disability due to = personal=20 injury sustained while in the performance of duty or to = employment-related=20 disease. The FECA also provides for the payment of benefits to = dependents=20 if the injury or disease causes the employee's death. Benefits = cannot be=20 paid if the injury or death is caused by the willful misconduct of = the=20 employee or by the employee's intention to bring about his or her = injury=20 or death or that of another, or if intoxication (by alcohol or = drugs) is=20 the proximate cause of the injury or death.

Medical = Benefits=20

An employee is entitled to medical, surgical and hospital = services and=20 supplies needed for treatment of an injury as well as = transportation for=20 obtaining care. The injured employee has initial choice of = physician and=20 may select any qualified local physician or hospital to provide = necessary=20 treatment or may use agency medical facilities if available. = Except for=20 referral by the attending physician, any change in treating = physician=20 after the initial choice must be authorized by OWCP. Otherwise, = OWCP will=20 not be liable for the expenses of treatment.

The term "physician" includes surgeons, osteopathic = practitioners,=20 podiatrists, dentists, clinical psychologists, optometrists and=20 chiropractors within the scope of their practice as defined by = State law.=20 Payment for chiropractic services is limited to treatment = consisting of=20 manual manipulation of the spine to correct a subluxation as = demonstrated=20 by x-ray to exist. If the physician selected has been excluded = from=20 participating in the Compensation Program the OWCP District Office = will=20 advise the employee of the exclusion and the need to select = another=20 physician.

Compensation for Temporary Total Disability=20

An employee who sustains a disabling, job-related traumatic = injury may=20 request continuation of regular pay for the period of disability = not to=20 exceed 45 calendar days or sick or annual leave. If disability = continues=20 beyond 45 days or the employee is not entitled to continuation of = pay, the=20 employee may use sick or annual leave or enter a leave without pay = status=20 and claim compensation from OWCP.

When disability results from an occupational disease, the = employing=20 agency is not authorized to continue the employee's pay. The = employee may=20 use sick or annual leave or enter a leave without pay status and = claim=20 compensation.

Compensation for loss of wages may not be paid until after a = three-day=20 waiting period, except when permanent effects result from the = injury or=20 where the disability causing wage loss exceeds 14 calendar days.=20 Compensation is generally paid at the rate of 2/3 of the salary if = the=20 employee has no dependents and 3/4 of the salary if one or more = dependents=20 are claimed.

The term "dependent" includes a husband, wife, unmarried child = under 18=20 years of age, and a wholly dependent parent. An unmarried child = may=20 qualify as a dependent after reaching the age of 18 if incapable = of=20 self-support by reason of mental or physical disability, or as = long as the=20 child continues to be a full-time student at an accredited = institution,=20 until he or she reaches the age of 23 or has completed four years = of=20 education beyond the high school level.

Compensation for = Permanent=20 Effects of Injury=20

The Act provides a schedule of benefits for permanent = impairment of=20 certain members, functions and organs of the body such as the eye, = arm, or=20 kidney and for serious disfigurement of the head, face or neck. = For=20 example, an award of 160 weeks of compensation is payable for = total loss=20 of vision in one eye.

In addition, compensation for loss of earning capacity may be = paid if=20 the employee is unable to resume regular work because of = injury-related=20 disability. This compensation is paid on the basis of the = difference=20 between the employee's capacity to earn wages after an injury and = the=20 wages of the job he or she held when injured.

OWCP may arrange for vocational rehabilitation and provide a=20 maintenance allowance not to exceed $200 per month. A disabled = employee=20 participating in an OWCP-approved training or vocational = rehabilitation=20 program is paid at the compensation rate for total disability.

If the employee's condition requires a constant attendant, an=20 additional amount not to exceed $1500 per month may be=20 allowed.

Compensation for Death=20

If no child is eligible for benefits, the widow or widower's=20 compensation is 50 percent of the employee's pay at the time of = death, if=20 death was due to the employment-related injury or disease. If a = child or=20 children are eligible for benefits, the widow or widower is = entitled to 45=20 percent of the pay and each child is entitled to 15 percent. If = children=20 are the sole survivors, 40 percent is paid for the first child and = 15=20 percent for each additional child, to be shared equally. Other = persons=20 such as dependent parents, brothers, sisters, grandparents, and=20 grandchildren may also be entitled to benefits. The total = compensation may=20 not exceed 75 percent of the employee's pay or the pay of the = highest step=20 for GS-15 of the General Schedule, except when such excess is = created by=20 authorized cost-of-living increases.

Compensation to an employee's surviving spouse terminates upon = his or=20 her death or remarriage. A widow or widower's benefits continue, = however,=20 if the remarriage takes place after the age of 55. Awards to = children,=20 brothers, sisters and grandchildren terminate at the age of 18, = unless the=20 dependent is incapable of self-support, or continues to be a = full-time=20 student at an accredited institution, until he or she reaches the = age of=20 23, or has completed four years of education beyond the high = school=20 level.

Burial expenses not to exceed $800 are payable. Transportation = of the=20 body to the employee's former residence in the United States is = provided=20 where death occurs away from the employee's home station. In = addition to=20 any burial expenses or transportation costs, a $200 allowance is = paid for=20 the administrative costs of terminating an employee's status with = the=20 Federal Government.

Cost-of-Living Increases=20

Compensation payments on account of a disability or death which = occurred more than one year before March 1 of each year, are = increased on=20 that date by any percentage change in the Consumer Price Index = published=20 for December of the preceding year.

Settlements With Third=20 Parties=20

Where an employee's injury or death in the performance of duty = occurs=20 under circumstances placing a legal liability on a party other = than the=20 United States, a portion of the cost of compensation and other = benefits=20 paid by OWCP must be refunded from any settlement obtained. OWCP = will=20 assist in obtaining the settlement and the Act guarantees that the = employee may retain a certain proportion of the settlement (after = any=20 attorney fees and costs are deducted) even when the cost of = compensation=20 and other benefits exceeds the amount of the = settlement.

Appeal=20 Rights=20

An employee or survivor who disagrees with a final = determination of=20 OWCP may request an oral hearing or a review of the written record = from=20 the Branch of Hearings and Review. Oral and/or written evidence in = further=20 support of the claim may be presented. The employee may also = request a=20 reconsideration of a decision by submitting a written request to = the District Office which issued the decision. The = request=20 must be accompanied by evidence not previously submitted. If=20 reconsideration has been requested, a hearing on the same issue = may not be=20 granted. The employee or survivor may also request review by the=20 Employees' Compensation Appeals Board (ECAB). Because the ECAB = rules=20 solely on the evidence of record at the time the decision was = issued, no=20 additional evidence may be presented.

More Detailed = Information=20

More detailed information about the requirements for coverage = and=20 benefits under the Federal Employees' Compensation Act may be = obtained=20 from Federal Personnel Manual Chapter 810, Injury Compensation = [now OWCP Publication CA-810], and booklet CA-550, Questions and Answers About the Federal = Employees' Compensation Act, which answers questions commonly = asked about=20 compensation benefits.

What To Do...=20

1. Keep This Pamphlet. It is important that you know = what you=20 are entitled to, since benefits are not paid automatically. You or = your=20 survivors must claim them.

2. In Case of Injury, = obtain=20 first aid or medical treatment even if the injury is minor. While = many=20 minor injuries heal without treatment, a few result in serious = prolonged=20 disability that could have been prevented had the employee = received=20 treatment when the injury occurred.

For traumatic injuries, = ask=20 your employer to authorize medical treatment on Form CA-16 BEFORE = you go=20 to the doctor. Take Form CA-16 when you go to the doctor, along = with Form=20 OWCP-1500, which the doctor must use to submit bills to OWCP. Your = employer may authorize medical treatment for occupational disease = ONLY if=20 OWCP gives prior approval.

Submit bills promptly, as bills = for=20 medical treatment may not be paid if submitted to OWCP more than = one year=20 after the calendar year in which you received the treatment or in = which=20 the condition was accepted as compensable.

3. Report = Every=20 Injury to your supervisor. Submit written notice of your = injury on=20 Form CA-1 if you sustained a traumatic injury, or Form CA-2 if the = injury=20 was an occupational disease or illness. (Forms CA-1 and CA-2 may = be=20 obtained from your employing agency or OWCP.)

Form CA-1 = must be=20 filed within 30 days of the date of injury to receive continuation = of pay=20 (COP) for a disabling traumatic injury. COP may be terminated if = medical=20 evidence of the injury- related disability is not submitted to = your=20 employer within 10 workdays. YOU ARE RESPONSIBLE FOR ENSURING THAT = SUCH=20 MEDICAL EVIDENCE IS SUBMITTED TO YOUR EMPLOYING AGENCY. Form CA-2 = should=20 also be filed within 30 days. Any claim which is not submitted = within 3=20 years will be barred by statutory time limitations unless the = immediate=20 superior had actual knowledge of the injury or death within 30 = days of=20 occurrence.

4. Establish the Essential Elements of Your=20 Claim. You must provide the evidence needed to show that you = filed for=20 benefits in a timely manner; that you are a civil employee; that = the=20 injury occurred as reported and in the performance of duty; and = that your=20 condition or disability is related to the injury or factors of = your=20 Federal employment. OWCP will assist you in meeting this = responsibility,=20 which is called burden of proof, by requesting evidence needed to = fulfill=20 the requirements of your claim.

5. File a Claim for=20 Compensation. File Form CA-7, Claim for Compensation on = Account of=20 Traumatic Injury or Occupational Disease, if you cannot return to = work=20 because of your injury and you are losing (or expect to lose) pay = for more=20 than three days. Give the form to your supervisor seven to ten = days before=20 the end of the COP period, if you received COP. If you are not = entitled to=20 COP, submit Form CA-7 when you enter or expect to enter a leave = without=20 pay status. All wage loss claims must be supported by medical = evidence of=20 injury-related disability for the period of the claim.

If = you=20 continue to lose pay after the dates claimed on Form CA-7, submit = Forms=20 CA-8 Claim for Continuing Compensation on Account of Disability, = through=20 your employer to claim additional compensation until you return to = work or=20 until OWCP advises they are no longer needed. You are not required = to use=20 your sick or annual leave before you claim compensation.

If = you=20 choose to use your leave, you may, with your agency's concurrence, = request=20 leave buy-back by submitting Form CA-7 to OWCP through your = employing=20 agency. Any compensation payment is to be used to partially = reimburse your=20 agency for the leave pay. You must also arrange to pay your agency = the=20 difference between the leave pay based on your full salary and the = compensation payment that was paid at 2/3 or 3/4 of your salary. = Your=20 agency will then recredit the leave to your leave = record.

6.=20 Return To Work As Soon As your Doctor Allows You To Do So. If = your=20 employing agency gives you a written description of a light duty = job, you=20 must provide a copy to your doctor and ask if and when you can = perform the=20 duties described. If your agency is willing to provide light work, = you=20 must ask your doctor to specify your work restrictions. In either = case,=20 you must advise your agency immediately of your doctor's = instructions=20 concerning return to work, and arrange for your agency to receive = written=20 verification of this information. COP or compensation may be = terminated if=20 you refuse work which is within your medical restrictions without = good=20 cause, or if you do not respond within specified time limits to a = job=20 offer from your agency.

In appropriate cases, OWCP provides = assistance in arranging for reassignment to lighter duties in = cooperation=20 with the employing agency. In addition, injured employees have = certain=20 other specified rights under the jurisdiction of the Office of = Personnel=20 Management, such as reemployment rights if the disability has been = overcome within one year.

7. Tell Your Family about = the=20 benefits they are entitled to in the event of your death. For = assistance=20 in filing a claim they may contact your employing agency's = personnel=20 office or OWCP.



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Webmeister=20 Jennifer Amos. =A9 Western Michigan Area Local
E-mail Jennia1957@aol.com with comments = or=20 suggestions

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