Publication CA 11 -- WHEN INJURED AT WORK
Information Guide for
Federal Employees

Introduction

The Federal Employees' Compensation Act (FECA) Click here to review the actual code (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.

Home

Webmeister
Jennifer Amos. © Western Michigan Area Local
E-mail [email-masked] with comments or
suggestions