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Learn about FECA benefits for U.S. federal civilian employees due to work-related injuries or illnesses, including eligibility requirements, documentation needed, and the claims filing process.
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Ohio National Guard Human ResourcesBenefits Office of Worker’s Compensation (OWCP) 5 Jun 2018
OWCP Agenda • Overview of Federal Employee Compensation Act - FECA • Initial Response • Employees’ Compensation Operations & Management Portal - ECOMP • Continuation of Pay - CoP • Supervisor Responsibilities • OWCP Forms / Medical Documentation • Leave Codes • Group Activity 5 Jun 2018
FECA Overview • Provides compensation benefits to civilian employees of the U.S. federal government for disability due to traumatic injury or disease or illness in performance of duties • Provides payment of benefits to dependents for work-related death of an employee as a result of traumatic injury or occupational disease/illness 5 Jun 2018
FECA Overview Evidence Needed to Establish Claim 5 Basic Requirements • Federal Civil Employee • Timely Filed • Fact of Injury • Performance of Duty • Causal Relationship 5 Jun 2018
FECA Overview • Civil Employee: Persons must have been a Federal Technician at time of injury • Timeliness: Notice of injury/disease must be filed within statutory time (3 yrs from date of incident or exposure or date awareness of work relationship) • Fact of Injury: Must be able to identify the factors which caused the injury/disability 5 Jun 2018
FECA Overview • Performance of Duty: Must have been in performance of official duties at time of incident • Causal Relationship: Must prove federal employment cause – based on medical evidence from a physician who performed examination or provided treatment 5 Jun 2018
FECA Overview FECA Does Not Cover….. • State employees and State Active Duty • Submitted through BWC • Military Status personnel and Injuries incurred during drill • LOD process 5 Jun 2018
Initial Response Initial Response For a “Traumatic” On-The-Job Injury • Seek Medical Treatment for the injured technician if necessary! For emergencies, please accompany the technician to the emergency room andensure that they receive immediate care! • The following forms MUST be completed during the initial hospital/doctor’s visit and forwarded to the ICPA as soon as possible: • CA-16 (Authorization for Examination and/or Treatment) within the first 48 hours after the injury. • CA-20 (Attending Physician’s Report) if after the first 48 hours of injury • CA-17 (Duty Status Report) • Report the Injury to the designated Safety Official . • Complete a CA-1, Notice of Traumatic Injury, through ECOMP This step should be completed on the day of the injury or the following day, if at all possible. • All completed forms must be received at the Human Resources Office no later than 10 DAYS from the date of injury. This includes a signed copy of the CA-1, CA-16, CA-17, and any other medical documentation from the physician if applicable. • Contact the Injury Compensation Program Administrator (ICPA) if you need assistance with filing the claim. MOST FORMS ARE AVAILABLE TO PRINT AT: http://www.dol.gov/esa/owcp/dfec/regs/compliance/forms.htm * THE CA-16 IS A CONTROLLED FORM AND CAN ONLY BE OBTAINED BY THE ICPA OR YOUR OR YOUR HR REMOTE. 5 Jun 2018
Filing A Claim + = CA-1 Filing a claim for a Traumatic Injury • Wound or other condition of the body caused by external force, including stress or strain. • Identifiable by time and place of occurrence and member of the body affected. • Caused by a specific incident within a single day or work shift. 5 Jun 2018
ECOMP The Employees’ Compensation Operations & Management Portal (ECOMP) • A Department of Labor Application that allows DoD to file OSHA 301, CA-1, CA-2, and CA-7 forms electronically. • Replaced EDI effective 8 June 2015. • Two main changes for supervisors • No longer have to file claim together • Will need to provide certain information and submit the OSHA 301 to Safety 5 Jun 2018
ECOMP • Before an employee can file forms in ECOMP, they must first register for an account. • OSHA 301 Form must be filled out when a recordable work-related injury has occurred. • Instructions for Injured workers can be found at www.ecomp.dol.gov 5 Jun 2018
ECOMP Registration Employee Registration in ECOMP 5 Jun 2018
OSHA 301 Review 5 Jun 2018
OSHA 301 Review Joe Employee Supervisor 5 Jun 2018
OSHA 301 Review supervisor Joe Employee supervisor 5 Jun 2018
OSHA 301 Review Joe Employee Joe.employee@gmail.com Supervisor 5 Jun 2018
OSHA 301 Review Once completed, the form will be forwarded to the designated safety POC 5 Jun 2018
Supervisor CA-1 Review • The supervisor will be notified via email that an employee has filed a claim. • The DOI and date notice received are pre-populated from the employees submission. • You will need to complete all required fields before you can continue. 5 Jun 2018
Supervisor CA-1 Review • If not completed within 2 days the ICPA will receive notification of Supervisor’s Pending Review. • Timely Filed within 10 calendar Days 5 Jun 2018
Forms / Documentation OWCP Forms / Medical Documentation For Traumatic Injury Cases: • CA 1------------- Report of Injury (must be filed online) • CA 16----------- Authorization for Treatment (ONLY WITHIN FIRST 48HRS) • CA 17 -----------Duty Status Report • CA 20----------- Attending Physician’s Report • SUPPORTING MEDICAL DOCUMENTATION • Light Duty Memo 5 Jun 2018
Forms / Documentation CA-16 Issuance • Authorizes medical treatment for a traumatic injury for 60 days from the date of injury, unless terminated sooner by OWCP. Controlled item / Blank check. • This form is not automatic, criteria must be met • Agency questions the validity of a claim it can be indicated on the CA-16 • Only issued within the first 48 hours of the injury • Not issued on occupational disease claims 5 Jun 2018
Forms / Documentation CA-17 • Duty Status Report – interim medical report about employee’s fitness for duty and work capabilities. (see Light Duty Policy) • May be issued initially with CA-16 • Supervisor completes agency portion by describing physical requirements of the employee’s job and noting the availability of light or limited duty 5 Jun 2018
Continuation of Pay (COP) • COP is the continuation of an employee's regular pay for a period not to exceed 45 calendar days. • Time lost on the day or shift of the injury does not count toward COP. • The employee's regular pay includes any night or shift differential and various kinds of premium pay (but not Sunday or overtime pay). • To be eligible for COP the employee must: • File a Traumatic Injury Claim. Occupational Illness claims are not entitled to COP. • File the claim within 30 days from the DOI. • Begin any lost time within 45 days from the DOI. 5 Jun 2018
Continuation of Pay (COP) • COP is a calendar day entitlement. The employee is entitled to 45 calendar days of COP. This includes holidays and RDOs. • Time off covered under COP does not have to be continuous. • Any portion of a day charged to COP will count as one day of the entitlement. Special timekeeping codes are used for COP. 5 Jun 2018
Continuation of Pay (COP) • Time off covered by COP will be supported by medical documentation. • The employee initially has 10 calendar days to provide medical documentation supporting time off work. COP will be charged for this period of time. • If the employee does not provide the medical documentation within this time period, then COP can be stopped. • Once the employee provides the medical documentation, COP will be given retroactively to the date it was first stopped. 5 Jun 2018
CoP Tracking Continuation of Pay Tracking Worksheet Claimant Name:__________________________ OWCP Case Number:__________________________ Date of Injury:____________________________ Date of Notification:___________________________ Use this worksheet to track the dates and hours of Continuation of Pay (COP) authorized for this claimant as a result of the employee’s traumatic injury. Date of Injury is “Day Zero” and must be coded LU . *Day Type: W = Work Day; H = Holiday; N = Non-Scheduled Day 5 Jun 2018
Continuation of Pay (COP) • COP can be used for…. Surgery…. Recovery…. Doctor’s Visits/ Physical Therapy….. 5 Jun 2018
Leave Codes • LU Type Hour Code is used when the employee loses time on the date of injury • LT Type Hour Code is used when the employee loses time after the date of injury • KA Type Hour Code is used when the employee is in a Leave Without Pay (LWOP) status. They system will convert to this payroll code if employee is ineligible for COP and sick leave and annual leave balances have been exhausted. • KD Type Hour Code is used when the employee is requesting compensation from OWCP and a CA-7 has been filed. 5 Jun 2018
Supervisor Responsibilities • Provide a safe work environment • Enforce safety regulations • Ensure employees are aware of health and safety requirements • Encourage reporting of incidents • Must know what the employee’s responsibilities are so you can relay information 5 Jun 2018
Supervisor’s Responsibilities • Ensure accurate, complete, prompt submission of claims (to ICPA within 10 days of incident) • Investigate incidents; obtain statements; controvert questionable claims • Coordinate return to work with employee • Coordinate personnel actions with HRO 5 Jun 2018
OWCP Denial Process • Employee will receive denial letter from Department of Labor if claim is denied. • Employee will have 3 appeal options if they decide to move forward with an appeal process. • Employee has 30 calendar days from the date of their denial letter to request appeal 1 2 3 5 Jun 2018
OWCP Group Practical Exercise 5 Jun 2018
Scenario #1 – Dog Bite On 15 Oct Joe Smith was jogging during authorized PT (during the last hour of his work shift) in a residential neighborhood and was bitten by a dog. His co-worker, Mary Jane was with Joe and witnessed the incident. Joe notified his supervisor of the injury the next morning before his work shift was to begin. He told his supervisor that he was treated in the emergency room and was told to RTW on 17 Oct. The injury sustained was an open wound to the left hip. Joe RTW on 17 Oct with no restrictions but a follow-up appointment was scheduled on 28 Oct. 5 Jun 2018
Scenario #1 cont. • What should the supervisor do first? • Who will need to sign the CA-1? • Should the supervisor issue Joe a CA-16? • Can the employee use COP until his RTW date? Can he utilize COP for his follow up on 28 Oct? • What should Joe take with him to his appointment on 28 Oct? 5 Jun 2018
Workers Compensation Website for Filing Claims: https://www.ecomp.dol.gov/# HRO webpage: http://hr.ong.ohio.gov/HR.aspx 5 Jun 2018
Leave Administration Questions? 5 Jun 2018
Points of Contact Worker’s Compensation P.O.C’s Ms. Cieryra Feagin – Injury Compensation Program Administrator (ICPA) 614-336-1134 cieryra.d.feagin.civ@mail.mil Miss Kim Upchurch – NGB OWCP Regional Liaison 614-336-7257kimberly.m.upchurch.civ@mail.mil 5 Jun 2018