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TIP OF THE WEEK - December 16, 2012. Have you heard the phrase , “ Administrative Closure” of a case? Do you know when and how this is applied?
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TIP OF THE WEEK - December 16, 2012 Have you heard the phrase, “Administrative Closure” of a case? Do you know when and how this is applied? • The Office (OWCP) should administratively close a case at the time of adjudication if the treating physician has released the claimant from care and/or advised the claimant to return only on an as-needed, or "prn," basis. This often occurs with minor conditions such as sprains/strains and contusions. Does this CA-1 meet the criteria to administratively close it?
Continued: • The CE should properly notify the claimant in the acceptance letter that the case has been closed. Appeal rights need not be attached, as such a closure is not a termination of benefits and would still allow the claimant to pursue reopening his or her claim (e.g. by filing Form CA-2a, Notice of Recurrence). For medical bill processing purposes, the case should first be adjudicated with appropriate case status and adjudication status codes and saved before updating the final coding to C5/AM.Sample language: On April 16, 2011, your physician released you from care to return on an as-needed (prn) basis. Therefore, your case has been administratively closed with no need for further medical care anticipated. This will allow authorized medical bills submitted for payment to be processed for a period of 120 days from the date of this letter. Form CA-2a, Notice of Recurrence, may be filed in the event further medical care is needed. REFERENCE: FECA Procedure Manual, Chapter 2-0806, para 6, “Accepting and Simultaneously Closing a Case” http://www.dol.gov/owcp/dfec/regs/compliance/DFECfolio/FECA-PT2/group1.htm#20806 Message (Calibri, Font Size 18)