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"Can I talk to a specific Claims Examiner?"
All of the Jacksonville District Office's Customer Service phone lines are staffed by a qualified Customer Service Team made up of Customer Service Representatives and Claims Examiners. Each Customer Service Representative or Claims Examiner has direct access to detailed information specifically related to the claim. In most instances, it is not necessary to speak directly with a specific Claims Examiner, such as the one assigned to a case you may be calling specifically about. Any member of the Customer Service team is able to assist you.
If for some reason, the Customer Service Team is unable to respond directly to the issue raised, he or she will relay an electronic message to the appropriate Claims Examiner and/or our Claims Support staff so that the issue is resolved.
If you have information you would like to relay directly to the Claims Examiner for a specific case, you should submit it in writing.
"I've received a postcard. What does it mean?"
Postcards are issued to the injured worker and employing agency as soon as a newly filed claim has been created. This postcard provides the case file number that has been assigned to the newly created claim. It also provides contact information for our office, such as the address and phone number. Learn how to contact our office HERE.
The post card does not necessarily mean that the claim has been accepted.
"I have documents to mail to your office. What address do I use?"
All of the DFEC District Offices use a centralized mail facility so mail should NOT be sent to the physical address of the District Offices. Obtain full contact information for Jacksonville by clicking HERE.
"Do you have a toll-free number for your office?"
The Jacksonville office does not have a toll-free telephone number. Obtain full contact information for Jacksonville by clicking HERE.
"How do I obtain copies of documents in a case file?"
Injured workers may obtain copies of documents in their respective case files by submitting a written request to the office. The request should specify what documents are being requested and include the injured worker's case file number and signature.
Employing Agencies may also obtain copies of documents by writing to the office or by reviewing cases at the office. Please see below for additional information on case reviews.
Information about Agency Case Reviews and Privacy Act considerations
"Are there certain rules regarding Agency review of cases?"
The administration of the FECA is the sole responsibility of OWCP. Agency requests to review the case file or for copies of material in a case file should be consistent with the role of agency personnel described in the FECA's implementing regulations and the Privacy Act. Appropriate reasons for review are limited to verification that an employee worked for the agency, or to attempt reemployment of an injured worker. Routine review of case files to monitor OWCP's actions is not appropriate. We will consider a request for file review from an agency undergoing reorganization or other major change, which creates a one-time need for documents to be used in establishing agency files.
Agency investigators are subject to these same rules unless a criminal investigation is underway. We will require the agency's investigative file number to document the reason for exception. The investigator should also indicate the reason that criminal activity is suspected and the expected relevance of OWCP case file documents. The OWCP case file should not be the original source for an investigation.
"Can an Agency review cases for the purpose 'Return to Work Monitoring'?"
It is not appropriate to review a case on the periodic roll just because it may have job offer potential at some unknown future date. It is appropriate if you have some reason to believe that the claimant may have been released to duty with some limitations. For example, it would be invalid to request review for "possible job offer, claimant on rolls for 5 years". It would be valid to request review for "possible job offer, 6 months post surgery". In the second instance there is some indication that something may have changed medically and ultimately may allow for a job offer.
You may also monitor the employee's medical care through requests to the employee, or his or her physician, within certain guidelines contained in the FECA's regulations, specifically 20 CFR section 10.506. This section says, "The employer may monitor the employee's medical progress and duty status by obtaining periodic medical reports. Form CA-17 is usually adequate for this purpose. To aid in returning an injured employee to suitable employment, the employer may also contact the employee's physician in writing concerning the work limitations imposed by the effects of the injury and possible job assignments. (However, the employer shall not contact the physician by telephone or through personal visit.) When such contact is made, the employer shall send a copy of any such correspondence to OWCP and the employee, as well as a copy of the physician's response when received. The employer may also contact the employee at reasonable intervals to request periodic medical reports addressing his or her ability to return to work."
It is the job of the OWCP claims examiner to monitor cases with continuing disability, and to take appropriate action to return them to work. If you are interested in returning a particular employee to work, you should contact the claims examiner to determine the feasibility of this. If appropriate, the examiner will provide any medical reports in the case file indicating the employee's ability to return to work.
"How should an Agency schedule a case review with the Office?"
You should schedule a visit at least 2 weeks in advance. Approval is limited to space available. To schedule a case review, all Agencies should contact their designated Jacksonville office liaison. If an Agency does not know who their liaison is, contact the Jacksonville office at the telephone number provided HERE.
Your requests should include the following information: case file number, claimant's name, case status (AQS users), reason for review, and the number of times you have reviewed this case in the last six months. Each case requested must have a specific reason, i.e., if a possible job offer is your reason for review, please include information as to why you believe a job offer could be considered.
"What Privacy Act considerations should an Agency adhere to regarding case documents?"
Under the routine use provision of regulations governing release of information under the Privacy Act, employing agencies are entitled to obtain copies of materials in their employees' injury compensation files for uses consistent with the reason the information was collected. The agency's use must generally be connected in some way with the injury compensation claim. Such use may, for example, include examining medical reports prior to making an offer of reemployment.
OWCP case files contain material that is sensitive, such as medical reports discussing emotional conditions or substance abuse, and virtually all files contain a substantial amount of information which would likely be considered personal by the subject of the file. Both OWCP and agencies have responsibilities under the Privacy Act with respect to evaluating requests for information and releasing material. Agency personnel who work with OWCP cases must be familiar with the restrictions of the Privacy Act and the penalties for violations. OWCP's goal is to handle records in a manner that is consistent with the Privacy Act but does not impede agencies in their attempts to manage their workers' compensation programs. We encourage you to review the guidelines governing release of case file information to agencies. They are contained in Publication CA-810 (Rev. January 1999), Injury Compensation for Federal Employees - A Handbook for Employing Agency Personnel, Section 9-2 of Chapter 9, Agency Management of Compensation Claims
"I have a question that isn't addressed above. Where else can I look?"
Publication CA-550, "Questions and Answers about the Federal Employees' Compensation Act (FECA),"contains answers to many other questions often asked about the Federal Employees' Compensation Act. Click HERE to view this and other important documents in DFEC's on-line resource library.
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