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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.
We also have FAQs on our Medical
Authorization and Bill Pay processes for Injured Workers,
Medical Providers,
and Employing Agencies.
I was injured on the job. How do I file a claim?
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.
Is there a timeline
for filing a 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.
I was recently
injured and got my claim number. Now I
hear my claim is closed. How can that be?
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.
How do I file for
compensation for the time I missed from work due to my injury?
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.
How do I buy back the
leave I took for my injury?
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).
How can I find out
about the status of the CA-7 I filed for wage loss compensation?
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.
How do I receive my
compensation payment via direct deposit?
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.
How do I apply for a
Schedule Award?
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.
How long does it take
to get a Schedule Award?
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.
Why doesn’t the OWCP IVR
(866-692-7487) tell me the status of the CA-7 I filed for a Schedule Award?
The OWCP IVR only provides information regarding wage loss
compensation payments. A Schedule Award
is not wage loss compensation.
What office do I call
about my claim?
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.
How do I learn my claim number?
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.
How do I learn my
claims examiner’s name?
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.
What is my claims examiner’s or OWCP’s email
address?
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.
How do I change my
address with OWCP?
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.
Why is it so important
that my claim number be on every page of anything I send to OWCP?
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.
What form do I use to
let OWCP know that I have named someone as my authorized representative?
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.
How do I get a copy
of my OWCP file?
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.
How do I request a
change of physician?
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.
Can I receive my
medical transportation and mileage reimbursement payments via direct deposit?
No. At this time, these payments are issued via paper check.
Will OWCP reimburse
me for lunch or other meals when I have to travel for medical treatment?
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).
What is the mileage
reimbursement rate for medial transportation?
While you don’t need this information
to complete the OWCP-957, the following mileage rates are used to calculate
reimbursement:
|
January 1, 2005
to
August 31, 2005 |
40.5 cents per mile |
|
September 1, 2005
to
December 31, 2005 |
48.5 cents per mile |
|
January 1, 2006
to
January
31, 2007 |
44.5 cents per mile |
|
February 1, 2007
and after |
48.5 cents per mile |
Where can I get
copies of OWCP forms?
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.
Where is the CA-3
form I need to send because an injured employee has returned to work?
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.
How do I get copies of the CA-11 "
When Injured at Work Information Guide for Federal Employees"?
The CA-11 is available on our website. We no longer make this available in hard copy format.
How do I get copies of the CA-13 for my agency?
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.
How do I get a copy
of the CA-14?
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.
Why isn’t the CA-16
on the web? How do I get a 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.
Where is the AB-1
form I need to file an appeal with the ECAB?
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.
|