|September 23, 2008|
Office of Workers' Compensation Programs (OWCP)
Division of Federal Employees' Compensation (DFEC)
Federal Employees' Compensation Frequently Asked Questions
The following Frequently Asked Questions (FAQs) are a supplement to Publication 550 " Questions and Answers About the Federal Employees' Compensation Act (FECA)" which is available on-line.
You need to complete either the CA-1, “Federal Employee’s Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation” or the CA-2 “Notice of Occupational Disease and Claim for Compensation”. A traumatic injury is one that can be pinpointed to have occurred during one particular work shift – falling down the steps for example. If the injury or medical condition developed over two or more work shifts, it’s an occupational disease claim. Both the CA-1 and the CA-2 are available for download.
If you are submitting a CA-2, you also need to complete the appropriate CA-35 "Evidence Required in Support of a Claim for Occupational Disease" form/checklist. There are several of these detailing the different sorts of documentation to be submitted depending on the type of occupational disease. They are all included in one document at the aforementioned site.
If you are still employed by the Federal agency where you worked when the injury occurred, submit the requested documentation to your employing agency. Be sure to keep a copy of everything for your records. Your agency will complete their portion of the CA-1 or CA-2 and submit the entire packet to the Office of Workers’ Compensation Programs (OWCP) district office. OWCP will advise you of the claim number which has been established. The district office will review the information submitted and will determine if there is sufficient information to adjudicate the claim. If there is, they will issue a decision on whether they can accept the claim or not. If there is insufficient information to adjudicate the claim, they will send you a letter advising of the additional information needed.
If you are no longer employed by the Federal Agency send the completed claim form along with supporting documentation directly to the OWCP district office. District office jurisdiction is determined by where you live. A listing of the district offices is on line. Include a cover letter advising that you are no longer employed by the agency. OWCP will contact your former agency regarding the completion of their portion of the claim form. OWCP will advise you of the claim number which has been established and will advise if additional information is needed to adjudicate your claim.
The Federal Employees’ Compensation Act (FECA) provides that a claim for compensation must be filed within 3 years of the date of injury. For a traumatic injury, the statutory time limitation begins to run from the date of injury. For a latent condition, it begins to run when an injured employee with a compensable disability becomes aware, or reasonably should have been aware, of a possible relationship between the medical condition and the employment. Where the exposure to the identified factors of employment continues after this knowledge, the time for filing begins to run on the date of the employee's last exposure to those factors. If a claim is not filed within 3 years, compensation may still be paid if written notice of injury was given within 30 days or if the employer had actual knowledge of the injury within 30 days after it occurred. There is nothing to prohibit you from filing the claim. Timeliness is determined by the OWCP district office as part of the adjudication process.
A Short Form Closure (SFC) case is a traumatic injury claim where: the employer supports injured employee’s description of injury; the injured employee is not disabled from regular job (or agency can accommodate any restrictions without loss of pay); and the claim is filed within 6 months of injury. In such cases, OWCP pays for limited medical treatment (up to $1500) for dates of service within 120 days of the date of injury without review by a claims examiner or acceptance of a specific medical condition. These claims are not adjudicated unless they are contested by the agency, there is time off from work beyond the Continuation of Pay (COP) period, or there is a surgery request. The purpose of this is to allow for medical treatment for short-term cases where there is no extended loss of time from work or need for medical care other than short-term, routine care without going through the adjudication process. If services requested require authorization or if submitted bills exceed $1,500, the claim moves from a SFC to a development status – the period during which the claims examiner collects and reviews documentation necessary to adjudicate the claim. While a claim is under development, authorizations can not be issued and bills can not be paid. Once the claim has been adjudicated and accepted, authorizations can be issued and bills paid.
If you have a loss of wages and are in Leave Without Pay (LWOP) status as a result of the accepted condition(s) on your claim, you need to file a CA-7 “Claim for Compensation” with your agency. If the period claimed on the CA-7 is intermittent, you need also to complete a CA-7a “Time Analysis Form”. Both of these forms are available on our forms website. You need to provide medical documentation supporting any periods of disability claimed. Your agency will complete their portion of the CA-7 and submit it and the medical documentation to OWCP. OWCP will determine if there is sufficient information on file to pay compensation for the periods claimed or if further information/development is needed.
If you used leave to cover period of disability resulting from the accepted injury, you can apply to your agency to buy back your leave. Each agency establishes its own rules for whether they allow leave buy back (LBB), timelines for submission, etc. If your agency does allow leave buy back, to request a LBB , you need to complete a complete a CA-7 and check box B in section 2. Also complete a form CA-7b “Leave Buy Back (LBB) Worksheet/Certification and Election”. If the period you claimed was intermittent (not a solid block of full days), you also need to complete a CA-7a "Time Analysis Form." Each of these forms are available on our forms website. Submit these forms to your employing agency. They will complete their portion and forward them to OWCP for processing. There needs to be medical documentation in the OWCP file supporting your inability to work as a result of your accepted medical condition for any period where LBB is claimed. You may submit the medical documentation to your employing agency along with your LBB packet. Or, you may submit it directly to OWCP at U.S. Department of Labor, DFEC Central Mailroom, London, KY, 40742-8300. Regardless of whether you submit it to your agency or directly to OWCP, please note your claim number on every page, send only single sided copies, and be sure to keep a copy for your records.
OWCP pays compensation at 66 2/3% of your pay rate (if you have no eligible dependents) or at 75% (if you have at least one eligible dependent), while official leave is paid at 100% of your pay rate. To buy back your leave, you have to pay your agency the difference between what you were paid and what you would have received for compensation. For example, if you have at least one eligible dependent and your pay rate was $1000 per week, OWCP would pay you $750 in compensation ($1000 x .75) if you took a week of leave. To buy back your 40 hours of leave, you need to pay your agency $250 ($1000 - $750).
OWCP has a toll-free automated system (IVR system), available 24 hours/day, 7 days/week, that provides information regarding specific claims. By calling 866-OWCP-IVR (866-692-7487), injured workers and their representatives may access information regarding case status and wage loss compensation payments. Injured workers should have their 9-digit case file or claim number and social security number when calling.
To receive compensation payments via Electronic Funds Transfer (EFT), please complete form SF-1199a “Direct Deposit Form” and mail it to U.S. Department of Labor, DFEC Central Mailroom, P.O. Box 8300, London, KY, 40742-8300. The SF-1199a is available on a variety of websites including the General Services Administration site.
When an injured worker has permanent loss of use of certain body parts or organs, and has reached maximum medical improvement, s/he may request a schedule award by submitting a CA-7 Claim for Schedule Award and an impairment rating completed by her/his treating physician. The impairment rating must be in accordance with the 5th Edition of the American Medical Association Guides to the Evaluation of Permanent Impairment, referencing the appropriate tables, and citing the date of maximum medical improvement. Impairment ratings are generally done in a narrative format. There is not a form to complete for the impairment rating unless the Claims Examiner has provided one in response to incomplete medical documentation previously submitted. The CA-7 is available on line.
If you are still employed by your Federal agency, complete your portion of the CA-7 and submit it to your employing agency’s Injury Compensation office. They will complete their portion and forward the CA-7 to OWCP. While your physician can submit the impairment rating directly to OWCP, it’s often helpful to submit a copy of the impairment rating to your agency along with your CA-7 so OWCP can receive all necessary documentation at once.
If you are no longer employed by your Federal Agency, complete your portion of the CA-7 and submit it to OWCP at U.S. Department of Labor, DFEC Central Mailroom, P.O. Box 8300, London, KY, 40742-8300. As is the case with anything you send to OWCP, please note your claim number on every page, send only single sided copies, and be sure to keep a copy for your records. Please include a note indicating you are separated from your agency. OWCP will work with your agency to have the employer portion of the CA-7 completed.
Once the completed CA-7 and the impairment rating have been received, reviewed, and determined to appear complete by the claims examiner, s/he forwards it to the district medical advisor (DMA) for review. This usually occurs within 30 days of the date it is received. The completed DMA review is typically received by the office in about 30 days. Following the receipt of the DMA review, it ordinarily takes another 30 days for the schedule award decision to be issued by the claims examiner. On average, it takes about 4 – 6 months from the time the CA-7 and impairment rating is received for a schedule award decision to be issued. This timeline is prolonged in cases where both the CA-7 and impairment rating are not submitted, the employer portion of the CA-7 was not completed, the impairment rating incomplete, or the impairment rating does not reference the AMA Guides or references an incorrect edition of the AMA Guides. In these situations, the Claims Examiner must develop the claim by contacting the claimant, employer, or rating physician for additional information. In some cases, the claimant must be referred to a second opinion medical examination to obtain a complete impairment rating.
The OWCP IVR only provides information regarding wage loss compensation payments. A Schedule Award is not wage loss compensation.
Claims are generally handled based on the geographical area in which the injured worker lives. A listing of the district offices and their contact information is available on line.
To learn your claim number, call the district office with jurisdiction over your claim. Provide your name, SSN, DOB, and date of injury. The office will be able to provide you with the claim number. Claims are generally handled based on the geographical area in which the injured worker lives. A listing of the district offices and their contact information is available on line.
There is no need to know your claims examiner’s name when you contact the district office. When you mail a document to the Central Mailroom, the document is scanned into the case record based on the claim number written on it. The information is made available in the computer system to the claims examiner assigned to your claim. When you call the district office and punch in your claim number, the call is routed to the claims examiner assigned to your claim. If you opt to press 0 or stay on the line, the Customer Service Representative who takes your call will be able to answer your question or if necessary leave an electronic notation for the claims examiner assigned to your case. While we know that injured workers often feel it is important to know the names of their claims examiners, since case assignments change with some regularity and since claims information is computerized, the name of the claims examiner is actually one less piece of information for an injured worker to maintain.
Pursuant to policy established by the Department of Labor, Employment Standards Administration, Office of Workers’ Compensation Programs, Division of Federal Employees' Compensation, email communication is prohibited to constituents regarding case specific concerns. Because email traffic travels via the internet, which is inherently insecure in nature, email may be unknowingly intercepted or copied by unintended parties. Therefore, in compliance with the Privacy Act of 1974, to protect the identities and personal information of claimants under the Federal Employees’ Compensation Act, we do not use email as part of our communication plan with parties outside the Department of Labor.
To correspond with OWCP, please send mail to U.S. Department of Labor, DFEC Central Mailroom, P.O. Box 8300, London, KY, 40742-8300. As is the case with anything you send to OWCP, please note your claim number on every page, send only single sided copies, and be sure to keep a copy for your records.
To change your address with OWCP, please send a signed letter/statement to OWCP at U.S. Department of Labor, DFEC Central Mailroom, P.O. Box 8300, London, KY, 40742-8300, advising of your new address. As is the case with anything you send to OWCP, please note your claim number on every page, send only single sided copies, and be sure to keep a copy for your records.
When mail is received in our Central Mailroom in London, KY, it is scanned into the appropriate file in our computer system based on the claim number listed on the incoming documentation. When there is no claim number, efforts are made to determine the correct claim based on other identifying information in the incoming correspondence. This can take some time, and, in many instances, mail can never be scanned into a claim because of lack of identifying information. To assure that correspondence you sent to OWCP is scanned into your claim in a timely fashion, it is imperative that you list your OWCP claim number on every page you send. Be sure to provide your claim number to all parties submitting documentation on your behalf.
There is no form used for naming someone as an injured worker’s authorized representative. If you wish to name someone (spouse, friend attorney, etc.) as your authorized representative, you need to send OWCP a signed statement naming that person as your authorized representative. This statement needs to list your claim number and should be sent to U.S. Department of Labor, DFEC Central Mailroom, P.O. Box 8300, London, KY, 40742-8300. As is the case with anything sent to OWCP, you need to note your claim number on every page, send only single sided copies, and keep a copy for your records.
To receive a copy of your OWCP file, please send a signed hard copy request to U.S. Department of Labor, DFEC Central Mailroom, P.O. Box 8300, London, KY, 40742-8300. As is the case with anything you send to OWCP, please put your claim number on the top of every page, send only single sided copies, and be sure to keep a copy for your records.
To request a change of physician, put the request in writing, detail the reason why you wish to change physicians, include the new physician’s name, specialty, and contact information, and sign the request. This needs to be mailed to U.S. Department of Labor, DFEC Central Mailroom, P.O. Box 8300, London, KY, 40742-8300. As is always the case, please be sure to include your claim number on every page you send. You will receive written notice of the approval of your request.
No. At this time, these payments are issued via paper check.
OWCP reimburses for travel based on the Federal Travel Regulation (41 C.F.R. 300-304). Per diem reimbursement is covered in Chapter 301-11.1.c. which specifies that you must be in a travel status for more than 12 hours to be eligible for per diem reimbursement (either actual cost or per diem).
While you don’t need this information to complete the OWCP-957, the following mileage rates are used to calculate reimbursement:
Our OWCP forms website contains many forms that you would need to initiate yourself. There are some forms (a CA-1032, for example) that are issued by a claims examiner. If you’ve been sent a form to complete, have misplaced it, and can’t find it at our forms website, please call your district office with jurisdiction over your claim to request a replacement.
The CA-3 form is no longer used. The employing agency needs to notify the claims examiner/district office when the injured worker returns to work. While a "heads up" call can be placed to the claims examiner, a letter also needs to be sent so it can be documented in writing from the employing agency in the file.
The CA-11 is available on our website. We no longer make this available in hard copy format.
The CA-13 is no longer published and is not available electronically. The CA-11 "When Injured at Work Information Guide for Federal Employees" which is similar is available on line.
The CA-14 pamphlet is issued by the district office when a claim is originally filed with OWCP. It is not a stand alone publication and is not issued absent the filing of a claim. Contact the district office for a replacement copy.
The CA-16 is not available on our website because it guarantees payment of medical expenses. We limit access to the form as it is to be issued by the employing agency and should be used only in certain circumstances.
If you are the injured worker, your agency will provide this form if it is appropriate.
If you are the supervisor of an injured worker, please contact your Workers' Compensation Unit for this form.
If you are with the Workers' Compensation unit, your Headquarters should have a supply of these forms. Even if a supply is unavailable, they should be able to provide you with one CA-16 that you can copy as needed. Federal agencies can purchase the revised CA-16 (revised 2/05) through the Government Printing Office.
The AB-1 form is available on the Employees’ Compensation Appeals Board (ECAB) site. It’s under the Library links on the right side of the page.