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Introduction
The Federal Employees' Compensation Act (FECA) (5 U.S.C. 8101 et seq.) is
administered by the Office of Workers' Compensation Programs (OWCP) of the U.S.
Department of Labor. It provides compensation benefits to civilian employees of
the United States for disability due to personal injury sustained while in the
performance of duty or to employment-related disease. The FECA also provides
for the payment of benefits to dependents if the injury or disease causes the
employee's death. Benefits cannot be paid if the injury or death is caused by
the willful misconduct of the employee or by the employee's intention to bring
about his or her injury or death or that of another, or if intoxication (by
alcohol or drugs) is the proximate cause of the injury or death.
Medical Benefits
An employee is entitled to medical, surgical and hospital services and
supplies needed for treatment of an injury as well as transportation for
obtaining care. The injured employee has initial choice of physician and may
select any qualified local physician or hospital to provide necessary treatment
or may use agency medical facilities if available. Except for referral by the
attending physician, any change in treating physician after the initial choice
must be authorized by OWCP. Otherwise, OWCP will not be liable for the expenses
of treatment.
The term "physician" includes surgeons, osteopathic practitioners,
podiatrists, dentists, clinical psychologists, optometrists and chiropractors
within the scope of their practice as defined by State law. Payment for
chiropractic services is limited to treatment consisting of manual manipulation
of the spine to correct a subluxation as demonstrated by x-ray to exist. If the
physician selected has been excluded from participating in the Compensation
Program the OWCP District Office will advise the employee of the exclusion and
the need to select another physician.
Compensation for Temporary Total Disability
An employee who sustains a disabling, job-related traumatic injury may
request continuation of regular pay for the period of disability not to exceed
45 calendar days or sick or annual leave. If disability continues beyond 45
days or the employee is not entitled to continuation of pay, the employee may
use sick or annual leave or enter a leave without pay status and claim
compensation from OWCP.
When disability results from an occupational disease, the employing agency
is not authorized to continue the employee's pay. The employee may use sick or
annual leave or enter a leave without pay status and claim compensation.
Compensation for loss of wages may not be paid until after a three-day
waiting period, except when permanent effects result from the injury or where
the disability causing wage loss exceeds 14 calendar days. Compensation is
generally paid at the rate of 2/3 of the salary if the employee has no
dependents and 3/4 of the salary if one or more dependents are claimed.
The term "dependent" includes a husband, wife, unmarried child
under 18 years of age, and a wholly dependent parent. An unmarried child may
qualify as a dependent after reaching the age of 18 if incapable of self-support
by reason of mental or physical disability, or as long as the child continues to
be a full-time student at an accredited institution, until he or she reaches the
age of 23 or has completed four years of education beyond the high school level.
Compensation for Permanent Effects of Injury
The Act provides a schedule of benefits for permanent impairment of certain
members, functions and organs of the body such as the eye, arm, or kidney and
for serious disfigurement of the head, face or neck. For example, an award of
160 weeks of compensation is payable for total loss of vision in one eye.
In addition, compensation for loss of earning capacity may be paid if the
employee is unable to resume regular work because of injury-related disability.
This compensation is paid on the basis of the difference between the employee's
capacity to earn wages after an injury and the wages of the job he or she held
when injured.
OWCP may arrange for vocational rehabilitation and provide a maintenance
allowance not to exceed $200 per month. A disabled employee participating in an
OWCP-approved training or vocational rehabilitation program is paid at the
compensation rate for total disability.
If the employee's condition requires a constant attendant, an additional
amount not to exceed $1500 per month may be allowed.
Compensation for Death
If no child is eligible for benefits, the widow or widower's compensation is
50 percent of the employee's pay at the time of death, if death was due to the
employment-related injury or disease. If a child or children are eligible for
benefits, the widow or widower is entitled to 45 percent of the pay and each
child is entitled to 15 percent. If children are the sole survivors, 40 percent
is paid for the first child and 15 percent for each additional child, to be
shared equally. Other persons such as dependent parents, brothers, sisters,
grandparents, and grandchildren may also be entitled to benefits. The total
compensation may not exceed 75 percent of the employee's pay or the pay of the
highest step for GS-15 of the General Schedule, except when such excess is
created by authorized cost-of-living increases.
Compensation to an employee's surviving spouse terminates upon his or her
death or remarriage. A widow or widower's benefits continue, however, if the
remarriage takes place after the age of 55. Awards to children, brothers,
sisters and grandchildren terminate at the age of 18, unless the dependent is
incapable of self-support, or continues to be a full-time student at an
accredited institution, until he or she reaches the age of 23, or has completed
four years of education beyond the high school level.
Burial expenses not to exceed $800 are payable. Transportation of the body
to the employee's former residence in the United States is provided where death
occurs away from the employee's home station. In addition to any burial
expenses or transportation costs, a $200 allowance is paid for the
administrative costs of terminating an employee's status with the Federal
Government.
Cost-of-Living Increases
Compensation payments on account of a disability or death which occurred
more than one year before March 1 of each year, are increased on that date by
any percentage change in the Consumer Price Index published for December of the
preceding year.
Settlements With Third Parties
Where an employee's injury or death in the performance of duty occurs under
circumstances placing a legal liability on a party other than the United States,
a portion of the cost of compensation and other benefits paid by OWCP must be
refunded from any settlement obtained. OWCP will assist in obtaining the
settlement and the Act guarantees that the employee may retain a certain
proportion of the settlement (after any attorney fees and costs are deducted)
even when the cost of compensation and other benefits exceeds the amount of the
settlement.
Appeal Rights
An employee or survivor who disagrees with a final determination of OWCP may
request an oral hearing or a review of the written record from the Branch of
Hearings and Review. Oral and/or written evidence in further support of the
claim may be presented. The employee may also request a reconsideration of a
decision by submitting a written request to the
District Office which issued the
decision. The request must be accompanied by evidence not previously submitted.
If reconsideration has been requested, a hearing on the same issue may not be
granted. The employee or survivor may also request review by the Employees'
Compensation Appeals Board (ECAB). Because the ECAB rules solely on the
evidence of record at the time the decision was issued, no additional evidence
may be presented.
More Detailed Information
More detailed information about the requirements for coverage and benefits
under the Federal Employees' Compensation Act may be obtained from Federal
Personnel Manual Chapter 810, Injury Compensation [now
OWCP Publication CA-810],
and booklet CA-550,
Questions and Answers About the Federal Employees'
Compensation Act, which answers questions commonly asked about compensation
benefits.
What To Do...
1. Keep This Pamphlet. It is important that you know what you are
entitled to, since benefits are not paid automatically. You or your survivors
must claim them.
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.
For Additional Information or When in Doubt About Your Compensation
Benefits Write to the
Office of Workers' Compensation Programs.
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