skip navigational linksDOL Seal - Link to DOL Home Page
Photos representing the workforce - Digital Imagery© copyright 2001 PhotoDisc, Inc.
www.dol.gov/esa
November 4, 2008    DOL Home > ESA > OWCP > DLHWC > Procedure Manual > CHAPTER 1-300   

Office of Workers' Compensation Programs (OWCP)

Printer-Friendly Version

ESA OFCCP OLMS OWCP WHD
OWCP Administers disability compensation programs that provide benefits for certain workers or dependants who experience work-related injury or illness.
Black Lung Longshore Energy Federal Employees' Comp line graphic


Division of Longshore and Harbor Workers' Compensation (DLHWC)

CHAPTER 1-300 — INDEX AND CONTROL

  1. Purpose and Scope. This Chapter of the PM describes the methods by which communications are identified with related cases, how cases are located, and how various special situations are treated. The Longshore Case Management System (LCMS) provides various automated features, such as case search and case create, which are either essential to or particularly useful in accomplishing certain tasks in the mail and file section. Mail and file personnel must have a working knowledge of the LCMS.
  2. Searching For A Case File Number.
    1. Case File Number. The primary control on mail and case files is by the case file number assigned at the time the case is jacketed. The number distinguishes between similar accidents to the same employee or ones that have happened to individuals with similar names. It is important that unnumbered mail receive the correct file number, and that a new case be created only where a case for that employee and for that accident does not already exist.
    2. LCMS. To determine whether a case file already exists for a particular injury to a particular individual, and if so, the correct case number assigned, click on the "Find" button on the "Claim" screen of the LCMS. The "Select Case" screen will be displayed. You can search by case number, name, date of injury, etc. Since an unnumbered injury report form (LS-202, LS-201, LS-203, LS-208, and LS-262) may be a duplicate of or related to an already existing case file, it is recommended that these injury report forms be searched through the LCMS. This will avoid the effort expended in keying these reports into the LCMS Case Create function only to find that a case for that injury already exists. However, depending on staff, volume and workflow, all unnumbered injury report forms may be sent directly for processing through the LCMS Case Create function since this function will identify an already existing case. In using the LCMS Find function, in addition to the name on the document, check where possible for:
      • Possible variations in the spelling of the claimant's name.
      • The claimant's SSN and/or date of birth.
      • The date of injury.
      • The company involved (using the Employer Identification Number from the LCMS).

      A careful check before a number is assigned will avoid later problems for the claimant, the carrier and the DO.

  3. Unnumbered Correspondence. Unnumbered letter mail related to injuries or deaths should be searched against the LCMS. Unnumbered injury report forms are discussed in paragraph 5, below.
    1. Case Number Found. Mail for which a LCMS case search shows there is a case file number will be so marked by placing the number in the upper right corner of the mail. The numbered mail is then forwarded to the File Clerk to be combined with other numbered mail for attachment to the appropriate case files.
    2. Case Number Not Found. Mail for which no case number has been found will be so marked by placing the notation NR (for No Record) in the upper right corner of the mail. The mail will be forwarded to a Claims Examiner for a determination as to the disposition of the correspondence. A possible disposition is for the CE to return the correspondence to the Mail and Files Section for placement in a Pending Correspondence File (see paragraph 6, below).
  4. Unnumbered Injury Report Forms. Most cases start with the receipt of the LS-202 form; LS-201, LS-203, and LS-262 forms from employees or dependents and the LS-208 are generally matched with the LS-202 report when the case file is assembled. Separate the injury reports submitted on these forms into the categories discussed below. All new lost time or death reports, and Forms LS-201, LS-203, LS-208 and LS-262 (whether reported as no lost time injuries or not so reported at this time), will be processed as indicated in this paragraph, and docketed as described in PM 1-400.

    Also note that a case may be created based on receipt of an LS-207 or a medical report where there is information indicating that the case will present serious disputes or that lost time is likely.

    1. Lost Time (LT) Injury (Disabling Injury). A LT injury (reported on Forms LS-201, LS-202, LS-203, LS-208 and LS-262) is an injury which results in death or loss of time from work beyond the day or shift of injury. Unnumbered injury report forms should be checked through the LCMS Find function to see if the injury was previously reported.
      1. If a case file number is found, place the file number in the upper right corner of the form and send to the file unit to be attached to the case file.
      2. If the injury has not been previously reported, so indicate on the form by making the notation NR in the upper right corner and forward the form for docketing and jacketing.
    2. No Lost Time (NLT) Injury. These reports are considered not to qualify as claims or cases. Note, however, that where an injury results in no loss of time from work but leaves an employee with a permanent impairment compensable under the schedule (i.e., section 908(c)(1)-(20)), a case should be created (The rationale for this policy is explained in Industry Notice No. 63, May 8, 1987. Please call the National Office if you need a copy of Industry Notice No. 63). Where there is no time lost and no evidence of either disfigurement, PPD, or occupational disease, such injury reports should be destroyed. However, if it is the experience of the district office that a significant number of initial NLT reports received from a particular employer or carrier are subsequently reported as lost time injuries, the district office may file such NLT reports in a Pending Correspondence File (see paragraph 6, below). NLT injury reports filed in the Pending Correspondence File differ from the questionable reports described below in that for the NLT injury report there is no evidence indicating possible lost time, permanent partial disability, disfigurement, or occupational disease. Placement of these reports in the Pending Correspondence File should be based primarily on the DO's experience with particular employers and/or carriers subsequently submitting lost time reports.
    3. Questionable No Lost Time Injury. A questionable no lost time injury is one where the injury report shows no lost time, but other information or evidence gives reason to believe there may be justification for a lost time, permanent partial disability, and/or disfigurement case. Injury report forms for such injuries should be searched through the LCMS.
      1. If a case file number is found, place the file number in the upper right corner of the form and send to the file unit to be attached to the case file.
      2. If the injury has not been previously reported, so indicate on the form by making the notation NR in the upper right corner and forward the form for docketing and jacketing. In making the decision to forward the report for docketing and jacketing, it should be remembered that there should be evidence indicating a lost time, permanent partial disability and/or disfigurement case. If there is any question as to whether the report should be docketed and jacketed, the matter should be referred to the Mail and Files Supervisor or other designated individual for resolution.
  5. Pending Correspondence File. Depending on each DO's experience and need, correspondence for which there is no number, but where a case file is likely to be created, may be placed in a Pending Correspondence File. Correspondence should be filed alphabetically by the name of the potential claimant wherever possible, otherwise by the author of the correspondence. This file should be reviewed periodically to determine whether a case has been established for any of the correspondence; if so, the correspondence should be numbered and associated with the correct case file. The file should also be purged periodically (e.g., every six months) and correspondence older than six months, for which no case file exists, should be removed and destroyed. The types of correspondence which may be placed in this file include:
    1. No Lost Time Cases. Those NLT cases which the office believes will subsequently be reported as lost time (as discussed in subparagraph 5b, above) may be placed in this file.
    2. Unidentified Mail. There will be occasions when mail is received without the full name of the employee and the mail cannot be returned. This mail may be placed in the Pending Correspondence File. Usually, other correspondence will follow which will identify it and allow for the matter to be resolved. When searching for mail which may be needed and there is reason to believe that it has already been received by the office, refer to the Pending Correspondence File.
  6. LS-570 Insurance Cards. Insurance coverage by employers is recorded on LS-570 cards (Exhibit 52, PM 10-200). The file of LS-570 cards is kept by the individual designated by the DD to process or handle insurance-related matters. Authorization for issuance of the cards, their verification, and maintenance of the files is covered in Part 7 of the Procedure Manual. Where there is an individual designated to handle insurance-related matters, annotation of the carrier identification is the responsibility of that individual. All insurance correspondence is delivered to the individual designated by the DD to discharge this responsibility.

 



Phone Numbers