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SCHEDULE AWARDS In order to file a claim for a Scheduled Award you must file Form CA-7. Obtain that form here.
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OWCP Knowledge Base What OWCP Doesn't Want You to Know NOTE: OWCP uses the AMA Guides 6th Edition If you have ever been injured at work or you suffer any type of medical problem that affects your job or employment then you may be aware of the problems that confront you in regard to filing workman's compensation claims and forms. In order to help you with your claim we have generated this knowledge base composed of articles, sources, links, and related material that we have gathered from OWCP websites, Dept. of Labor sources, and other valuable Internet resources. We hope you benefit from our special section. Please use this knowledge base in addition to our Injury - Medical Section. Make certain to Read Our Disclaimer.
1. See this page at the Dept. of Labor: http://www.dol.gov/esa/regs/compliance/owcp/ca-11.htm 2. In Case of Injury, obtain first aid or medical treatment even if the injury is minor. While many minor injuries heal without treatment, a few result in serious prolonged disability that could have been prevented had the employee received treatment when the injury occurred. For traumatic injuries, ask your employer to authorize medical treatment on Form CA-16 BEFORE you go to the doctor. Take Form CA-16 when you go to the doctor, along with Form OWCP-1500, which the doctor must use to submit bills to OWCP. Your employer may authorize medical treatment for occupational disease ONLY if OWCP gives prior approval. Submit bills promptly, as bills for medical treatment may not be paid if submitted to OWCP more than one year after the calendar year in which you received the treatment or in which the condition was accepted as compensable. 3. Report Every Injury to your supervisor. Submit written notice of your injury on Form CA-1 if you sustained a traumatic injury, or Form CA-2 if the injury was an occupational disease or illness. (Forms CA-1 and CA-2 may be obtained from your employing agency or OWCP.) Form CA-1 must be filed within 30 days of the date of injury to receive continuation of pay (COP) for a disabling traumatic injury. COP may be terminated if medical evidence of the injury- related disability is not submitted to your employer within 10 workdays. YOU ARE RESPONSIBLE FOR ENSURING THAT SUCH MEDICAL EVIDENCE IS SUBMITTED TO YOUR EMPLOYING AGENCY. Form CA-2 should also be filed within 30 days. Any claim which is not submitted within 3 years will be barred by statutory time limitations unless the immediate superior had actual knowledge of the injury or death within 30 days of occurrence. 4. Establish the Essential Elements of Your Claim. You must provide the evidence needed to show that you filed for benefits in a timely manner; that you are a civil employee; that the injury occurred as reported and in the performance of duty; and that your condition or disability is related to the injury or factors of your Federal employment. OWCP will assist you in meeting this responsibility, which is called burden of proof, by requesting evidence needed to fulfill the requirements of your claim. 5. File a Claim for Compensation. File Form CA-7, Claim for Compensation on Account of Traumatic Injury or Occupational Disease, if you cannot return to work because of your injury and you are losing (or expect to lose) pay for more than three days. Give the form to your supervisor seven to ten days before the end of the COP period, if you received COP. If you are not entitled to COP, submit Form CA-7 when you enter or expect to enter a leave without pay status. All wage loss claims must be supported by medical evidence of injury-related disability for the period of the claim. If you continue to lose pay after the dates claimed on Form CA-7, submit Forms CA-8 Claim for Continuing Compensation on Account of Disability, through your employer to claim additional compensation until you return to work or until OWCP advises they are no longer needed. You are not required to use your sick or annual leave before you claim compensation. If you choose to use your leave, you may, with your agency's concurrence, request leave buy-back by submitting Form CA-7 to OWCP through your employing agency. Any compensation payment is to be used to partially reimburse your agency for the leave pay. You must also arrange to pay your agency the 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 agency will then recredit the leave to your leave record. 6. Return To Work As Soon As your Doctor Allows You To Do So. If your employing agency gives you a written description of a light duty job, you must provide a copy to your doctor and ask if and when you can perform the duties described. If your agency is willing to provide light work, you must ask your doctor to specify your work restrictions. In either case, you must advise your agency immediately of your doctor's instructions concerning return to work, and arrange for your agency to receive written verification of this information. COP or compensation may be terminated if you refuse work which is within your medical restrictions without good cause, or if you do not respond within specified time limits to a job offer from your agency. In appropriate cases, OWCP provides assistance in arranging for reassignment to lighter duties in cooperation with the employing agency. In addition, injured employees have certain other specified rights under the jurisdiction of the Office of Personnel Management, such as reemployment rights if the disability has been overcome within one year. 7. Tell Your Family about the benefits they are entitled to in the event
of your death. For assistance in filing a claim they may contact your
employing agency's personnel office or OWCP. Right to see own physician - Back to Topics Any employee who gets injured on the job has the right to see their own physician. (ELM Section 545.4) 545.4 Implementing Medical Care 545.41 Emergency Treatment An employee needing emergency treatment must be sent to the nearest available physician or hospital or to a physician or hospital chosen by the employee or the employee’s representative. The physician who provides emergency treatment is not considered the employee’s initial choice of physician. 545.44 Outside Treatment in a Nonemergency Situation In a nonemergency situation, if an employee does not accept treatment at a Postal Service occupational health services office or contract facility, the employee may select a physician or hospital within approximately 25 miles of his or her home or worksite. The physician’s office should be contacted by telephone by the control office or control point to determine if the physician is available and will accept the employee for treatment under FECA. If not, the employee must select another qualified physician or hospital. A postal supervisor is not authorized to accompany the employee to a medical facility or physician’s office in nonemergency situations Editor's note: Over the years I have witnessed many employees injured at work and fail to request to see their own physician. The people at medical units and US Postal Service contract physicians (in my opinion) are not acting in the best interest of the employee but in the interest of the USPS and that is, to get injured employees back to work as soon as possible regardless of the well-being of the an employee. TIMELINESS Federal agencies are required by regulation to submit an employee's Notice of Injury (Form CA-1 or CA-2) within 10 working days (or 14 calendar days) of receiving it from an employee, if lost time from work or medical expenses are claimed or anticipated [20 CFR 10.110(a)]. Regulations require that the CA-7 should be submitted no later than 5 working days (or 7 calendar days) after its receipt from the employee [20 CFR 10.112(b)]. This prompt submission is critical if OWCP is to be able to serve injured workers' needs, and especially to ensure that medical bills can be processed timely. Back to Topics
Traumatic,
Occupational, or Recurrence Injuries -
Back to Topics CA-35:
What is a CA-35? Doctor Shopping: What is Doctor
Shopping? USPS Contacting Your Doctor:
Can USPS contact my doctor? -
Back to Topics The Postal Service has received a slap on the wrist from the Office of Workers' Compensation Programs, following a USPS manager's instructions to staff that they could contact an employee's doctor by fax or e-mail in an apparent attempt to skirt a prohibition against "telephone contact" by postal officials with an injured worker's doctors. In a staff memo, USPS Manager for Safety and Risk Management Larry Anderson stated that Postal Service officials could communicate with an injured worker's doctor by fax or e-mail, and could even talk by phone or in person if the doctor's office initiated the contact. However, in July OWCP responded by reminding USPS that such contacts are prohibited. In a letter to Anderson, Sheila Williams, OWCP's Acting Director of Federal Employees' Compensation, stressed that faxes and e-mail "most certainly are written communications and are subject to the limitations outlined in 20 CFR 10.506." Williams also clarified that "any and all" such telephone contacts that are "initiated by the agency, regardless of the subject", even in response to follow-up requests are "entirely prohibited." Claimants need to impress upon their doctors that the agency is only allowed to communicate with them in writing [never verbally], concerning you work limitations imposed by the effects of the injury, possible job assignments, and when and/or if possible return to limited or full duty. This can be found in the regulations and a copy should be given to your doctor, see: 20 CFR Part 10, Section 10.506 "Written communication," she added, "regardless of how it is transmitted to the physician, is limited to information regarding fitness for duty." Also, Williams' said, "a copy of all written communications to and from a physician must be provided to OWCP and the employee." Williams' letter concluded by asking the Postal Service to "instruct staff to cease" all such communications with employees' doctors, and to provide "prompt documentation that this correction has been made." Back to Topics City Letter Carrier Duties:
If I am a city letter carrier how do I state my duties? -
Back to Topics OFFICE DUTIES: As a letter carrier, there are many physical duties and requirements. The day begins routing letters into a 6ft. shelf "U" shaped case, with approximately 540 deliveries, which are in route delivery sequence. On an average day this entails approximately 1.5 to 2.5 hours of continuous standing, twisting, turning, and reaching over the shoulder. A carrier is also required to lift, from the floor, trays of unsorted mail weighing between 17 and 29 pounds. The handbook titled City Delivery Carriers'--Duties and Responsibilities, states that "the accurate and speedy routing of mail is one of the most important duties of a carrier; you must be proficient at this task". After routing letters, "flat-size" mail; magazines and small parcels are routed into the same "U" shaped mail case, with approximately 540 deliveries, which are in route delivery sequence. This is done for approximately .5 to 1.5 hours, this function also requires continuous reaching over the shoulder, bending, standing, stooping, twisting and lifting from ounces to 2 lbs. Parcels for the route are then taken from a wheeled hamper which stands 2 ft. 4 inches high, and put onto a 1 foot cart in delivery sequence order. The wood bottom of the hamper is supported by bungie cords which allows the hamper bottom to fall and rise as the weight is placed in or taken out This consists of bending, twisting, turning, stooping, and lifting parcels weighing from ounces up to 70 lbs. The mail is then withdrawn from the letter and flat case and bundled into separations for delivery. This entails standing, twisting, turning, bending, and reaching. The letters, flats, and small parcels are then put into 4.5 lbs plastic trays, the trays are placed onto a wheeled cart which stands 1 foot off the floor which consists of a lot of bending, standing, stooping, twisting and lifting. An average route, on an average day, has approximately 2-3 full, hand sorted plastic trays of mail (an average tray of mail weighs approximately 50 lbs, 3- 4 trays of pre-sorted (DIPS) mail and 25 to 50 parcels which can weigh up to 70lbs. The cart is then wheeled to the vehicle for loading. The trays and parcels are then lifted out of the hamper and loaded into the vehicle. This consists of bending, lifting, twisting, turning and stooping. DELIVERY DUTIES: The delivery part of the day then begins. The routes are park and loop routes, which consists of parking and "looping" delivering up one side of the blocks then back down the other side returning to the park point to pick up more mail and small parcels for delivery or moving to another park point. The delivery separation is put into a carrier satchel, which weighs 5 lbs (empty), for delivery. The satchel is carried on the shoulder supported only by the shoulder strap, which allows the satchel to swing freely. A delivery separation consists of 1 relay and weighs an average of approximately 15 lbs. However, this weight can and does weigh up to 35 lbs. on heavy volume days. The weight of the mail slowly decreases as it is delivered. Delivering mail consists of walking, walking up and down stairs, walking on uneven terrain, twisting, turning, bending, reaching, reaching above the shoulder and stooping. Some of the delivery separations have a larger saturation of deliveries, steps and mail than others. This is done for approximately 5 to 7 hours in all types of weather conditions. Mail trays are constantly being shifted around throughout the day as they are moved from the floor of the truck onto the delivery tray to be emptied which involves bending, lifting, twisting, turning, and stooping Letter carriers tend to lean to the opposite side of the satchel to balance the weight, which subjects the body to abnormal posture. The heavier the satchel the more force needed to compensate for the weight. Back to Topics Communicating With
Congressional Reps - Contacting Your Congressional Representatives - Back to Topics CONGRESSIONAL ETHICS MANUAL Members and staff of the House often assist constituents in their dealings with administrative agencies by acting as facilitators or ``ombudsmen.'' Members may properly communicate with agencies on behalf of constituents: * to request information or status reports; * to urge prompt consideration of a matter based on the merits of the case; * to arrange for appointments; * to express judgment on a matter (subject to ex parte communication rules); and/or * to ask for reconsideration, based on law and regulation, of an administrative decision. The Constitution guarantees all citizens the right to petition the Government for redress of grievances. The most logical point of contact is one's elected representative. Furthermore, Members of Congress continually must monitor Government programs and the administration of public laws. Given the unique role of a congressman in the American constitutional scheme, it is not surprising, as the Supreme Court has recognized, that ``serving constituents and supporting legislation that will benefit the district and individuals and groups therein is the everyday business of a legislator.'' >
Full Version of the Congressional Ethics Manual -
Back to Topics What are Consequential
Injuries? -
Back to Topics Mr. McNatt injury was accepted for an acute back strain and was later expanded to include a herniated Nucleus pulposus in the cervical spine with pain in the right shoulder. Surgery was authorized to repair his torn rotor cuff in his right shoulder. The claimant filed for a recurrence of disability after he was attempting to lift an empty propane tank form the back seat of his truck while he was not working. The Office denied the recurrence claim noting that this constituted a new injury that was non-work-related. The Board said that once it is accepted that the work connected character of any condition is established, the subsequent progression of that condition remains compensable under the FECA so long as the worsening is not shown to have been produced by an independent non-industrial cause. If a member weakened by an employment injury contributes to a later fall or another injury, the subsequent injury will be compensable as a consequential injury. If further complication flows from the compensable injury, i.e. so long as it is clear that the real operative factor is the progression of the compensable injury, with an exertion that in itself would not be unreasonable under the circumstances, the condition is compensable. The case was returned by the Board to the District Office so that the Office could determine whether Mr. McNatt's reaching behind the seat to lift an empty propane tank was reasonable in light of his work related shoulder injury and to further determine whether this constituted an intervening independent cause that contributed to the new injury. See also: * FECA Procedure Manual Part 2 Claims, Chapter 0805, Section 6 |
Legend NOTE: You will need the Adobe Reader for most forms. You can obtain the Reader FREE here: Adobe Acrobat Reader
In order to file a claim for a Scheduled Award you must file Form CA-7. Obtain that form here.
What is MMI -
Maximum Medical Improvement? -
Back to Topics What is Leave Buy-Back? -
Back to Topics 512.923 Leave Buy-Back - OWCP The following provisions concern leave buy-back: a. Under the provisions of the Injury Compensation Program (545.73b(6)), current employees may be permitted to buy back sick and annual leave they used while awaiting adjudication of their cases by OWCP. In traumatic injury cases, employees may be permitted to buy back only the leave that is used after the end of the 45-day continuation-of-pay period. b. When the employee buys back annual leave for a previous year that exceeds the applicable maximum (see 512.32), the excessive leave is automatically forfeited. Employees are allowed to buy back only those hours that can be carried forward. c. Some loss of leave may occur when the period of absence is changed to an LWOP status as a result of leave buy-back. For every 80 hours of paid leave bought back and changed to LWOP, both annual and sick leave are adjusted by the amount earned in 1 pay period. The employee must be informed of this so there will be no misunderstanding. See Exhibit 514.4, item e, for further information. 545.84 Leave Buy-Back An employee may use sick or annual leave after the COP period expires, or during a period of disability due to an occupational injury. In such cases, the employee may be entitled to buy back the leave with compensation payments (see 512.923). The control office is responsible for informing employee, in writing, that: a. The buy-back must be initiated within 1 year of the return to duty, or within 1 year of the date OWCP approved the claim, whichever is later. b. Employees who are being separated because of disability or other
reasons cannot buy back leave after they are off the rolls of the Postal
Service.
Injury Partially Overcome -
Back to Topics
Obligation When an employee has partially overcome the injury or disability,
the Postal Service has the following obligation:
(1)
To the extent that there is adequate work available within the employee’s
work limitation tolerances, within the employee’s craft, in the work
facility to which the employee is regularly assigned, and during the hours
when the employee regularly works, that work constitutes the limited duty to
which the employee is assigned. b. Former Employees. When a former employee has partially recovered from a compensable injury or disability, the Postal Service must make every effort toward reemployment consistent with medically defined work limitation tolerances. Such an employee may be returned to any position for which he or she is qualified, including a lower grade position than that which the employee held when compensation began.
NOTE: Placement priority for rehabilitation assignment is the same as for
limited duty. Leave Buy Back -
Back to Topics Maggie Moore Rights -
Back to Topics Some ECAB Decisions May Be Found Here:
http://www.dol.gov/ecab/cases/main.htm
Reinstatement and Limited Duty
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Back to Topics COMMONLY USED ABBREVIATIONS - Back to Topics COP - Continuation of Pay
Are only regular, full-time employees eligible for FECA benefits? -
Back to Topics
Are all
work-related injuries covered under the FECA? -
Back to Topics
Does the FECA cover a pre-existing medical condition that is aggravated by
factors of employment? -
Back to Topics
Is it necessary to report all injuries that occur at work, even minor ones
such as a cut finger or bumped knee? -
Back to Topics
Are
compensation payments subject to claims by creditors? -
Back to Topics
What is the difference between a "Traumatic Injury" and an "Occupational
Disease or Illness"? -
Back to Topics Traumatic injuries include damage solely to or destruction of prostheses, such as dentures or artificial limbs. Traumatic injuries also include damage to or destruction of personal appliances, such as eyeglasses or hearing aids, when a personal injury requiring medical services occurred. (See question A-8 concerning personal property.) An occupational disease or illness is a condition produced by the work environment over a period longer than one work day or shift. The condition may result from infection, repeated stress or strain, or repeated exposure to toxins, poisons, fumes or other continuing conditions of the work environment. The length of exposure, not the cause of the injury or the medical condition which results, determines whether an injury is traumatic or occupational. For instance, if an employee is exposed to toxic fumes for one day, the incident is considered a traumatic injury. If the employee is exposed to toxic fumes for two or more days, the incident is considered an occupational disease.
What can an employee do if his or her supervisor refuses to accept a notice
of injury, illness or death? -
Back to Topics
What is a recurrence of disability, and how does it differ from a new
injury? -
Back to Topics
What is the time limit for filing notice of injury and claim for
compensation? -
Back to Topics |
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