animal and plant health inspection service usda – aphis workers’ compensation incident...

Animal and Plant HealthInspection Service

USDA – APHISWorkers’ Compensation

Incident Management Team


Objectives

• Overview of the Federal Employees’ Compensation Act (FECA) and the Office of Workers Compensation Programs

• Conditions of coverage• Claim types • Claim submission process and responsibilities• Benefits • Additional information and resources


Federal Employees’ Compensation Act (FECA)

• Passed in 1916• Exclusive Remedy• Non-adversarial• Administered by Department of Labor (DOL), Office

of Workers Compensation Programs (OWCP)• Benefits paid by DOL• Not a retirement system


Office of Workers Compensation Programs (OWCP)

DOL’s OWCP administers workers compensation program.

OWCP Goals:• Ensure employees can receive quality medical assistance

if they sustain work related injuries or are involved in work related accidents

• Return employees to work as soon as medically feasible


Office of Workers Compensation Programs (OWCP)

OWCP provides benefits such as wage loss compensation benefits, medical treatment, vocational rehabilitation, and other benefits to employees or their dependents who experience work-related injury or occupational disease.


Conditions of CoverageAcceptance of claim requires satisfaction of five basics:

Timely Filing of Claim

Federal Civilian Employee

Fact of Injury

Performance of Duty (POD)

Causal Relationship

Employees has three years to file from date of (1) injury, (2) first awareness, or (3) last exposure.

Covers permanent or temporary employees excluding those from non-appropriated funds. Contract employees, volunteers, and loan employees covered in some circumstances.

Verification of factual and medical evidence that the injury occurred.

Injury or exposure occurred at work or because of employment versus a personal condition, non-work related, intoxication, misconduct, and/or intent to harm others or self.

Medical evidence shows a causal relationship between the work-related exposure and the condition. Causal relationships include direct cause, aggravation, acceleration, or precipitation.


Additional Performance of Duty InformationInjury covered when:• Occurred at work-site• Occurred during work hours and normal breaks• Performing work duties off-site• In travel status

Injury not covered when:• Off-site lunch• Normal commute to or from work• Caused by intoxication, misconduct, and/or intent to harm others or self

TDY Guidance:• 24/7 coverage for activities incidental to the mission• Coverage excluded when employee diverts from duty for a personal errand

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Types of Claims

• Traumatic Injury• Occupational Disease• Reoccurrence• Death


Types of Claims

Traumatic Injury – Injury caused by specific event or series of events occurring during one workday or shift.

Occupational Disease – Condition produced over a period longer than one work day or shift.


Types of ClaimsReoccurrence – Recurrence of disability caused by:

• Spontaneous return of the symptoms • Return or increase of disability due to a

consequential injury • Withdrawal of a specific light duty assignment

Death – Employees who die from job-related illness or injury where medical certification establishes a causal relationship between the employee’s death and his/her employment.


Claim Submission Overview

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Employee is injured and notifies supervisor

Employee seek medical attention

Employee complete claim form(s)

Incident Supervisor complete claim form(s)

Claim form(s) provided to Finance Section Chief

Claim form(s) provided to WC POC


Employee Responsibilities

1. See immediate medical attention if necessary2. Report all job-related injuries or illness to Incident

Supervisor as soon as possible 3 years for a claim, however 30 days for certain benefits; and Some benefits can start the next day

3. For a traumatic injury, obtain CA-16 from the Incident Supervisor if medical treatment is required


Employee Responsibilities

4. Complete forms in a timely manner Traumatic injury: CA-1 Occupational disease: CA-2 Reoccurrence: CA-2a

5. Provide all information requested by the Agency and OWCP promptly – this includes medical reports (see CA-35 checklist)

6. Maintain continuous contact with Incident Supervisor


Incident Supervisor Responsibilities1. Ensure employee is granted time off to seek and

receives immediate and appropriate medical attention

2. Fill out CA-16 within 48 hours of traumatic injury notification if medical attention is/was needed

Note that a CA-16 is not authorized for occupational disease claims

3. Provide CA-1, CA-2, and appropriate checklist from CA-35, to the employee within 1 day of request or notification of injury/illness


Incident Supervisor Responsibilities4. Fill out the “Official Supervisor’s Report” on either

the CA-1 or CA-2 and provide to Finance Section Chief within 3 days of receipt from the employee Obtain witness statements and/or responsible third party

contact information

5. Complete “Side A – Supervisor” section of CA-17 if the physician indicates that the employee’s injury/illness will result in 2 or more weeks of leave or limited/light duty


Incident Supervisor Responsibilities6. Maintain communication with recuperating

employee 7. Challenge a claim(s) and controvert benefits when

necessary or indicated


Finance Section Chief Responsibilities1. Ensure employee and supervisor have completed all forms

Any witness statements are included with CA-1 If a third party (non-Government entity with no business relationship

with the agency) caused the injury, the name and address of the party responsible is provided on the CA-1

2. Make two copies of the CA-1 or CA-2 and forward the original form to the Workers Compensation (WC) Point of Contact (POC) within 3 days of receipt from the employee

Copy 1 – Stays with the Incident Copy 2 – Provided to employees normal front line supervisor

3. Communicate situation and maintain contact with employee’s normal first line supervisor


Death Claims

• Incident Supervisor completes form CA-6

• The deceased employee’s family member(s) should complete within 3 years Form CA-5 – Widow/widower and/or children Form CA-5b – Parent, Brother, Sister,

Grandparents, or Grandchildren


Death Claims

Additional evidence must be submitted in addition to the claim form(s), to include:

• Death certificate• Name and address(es) of next of kin• Marriage certificate• Birth certificate for each child• Divorce decree or death certificate for prior marriages• Itemized burial bills• Medical certification establishing a causal relationship between the

employee’s death and his/her employment


Notes for Supervisors and ChiefsNo one may require an employee or other claimant to waive his/her right to claim benefits.

Incident Supervisors have ultimate responsibility for injury documentation and employee communication.

Another Incident Supervisor or Incident Command and General Staff member may sign documents on behalf of the Incident Supervisor if verbal consent is granted.


Notes for Supervisors and ChiefsCompleted claims must be forwarded to the Workers Compensation (WC) Point of Contact (POC) even if:

• No time is lost• Medical attention not sought • Claim is for First Aid

Depending on the injury, medical treatment/advice, and any duty limitations the incident should consider demobilizing the employee in accordance with the demobilization plan.


Benefits Provided under the FECA

• Medical Benefits• Continuation of Pay (COP)• Wage Loss Compensation• Schedule Awards• Vocational Rehabilitation• Death/Burial Expenses


BenefitsMedical – Authorizes treatment and payment or

reimbursement of medical expenses for up to 60 days.

Continuation of Pay (COP) – Provides pay compensation for medical disability and/or to seek medical treatment during the first 45 days of an employee’s disability when caused by a traumatic injury. Payable stating day after injury but medical evidence must be submitted within ten calendar days after the claim is submitted. To qualify for COP the injury must be reported on CA-1 within 30 days.


BenefitsWage Loss Compensation – Provides compensation for lost wages (following any Continuation of Pay, if applicable) after 45 days while the employee is in a Leave Without Pay (LWOP) status.

Employee and Incident or assigned Supervisor complete CA-7 Initial SF -52 containing remarks of OWCP LWOP

Schedule Awards – Monetary payments for a prescribed number of weeks to federal employees who suffer the permanent total or partial loss of use of anatomical members, functions, or organs.


Benefits (cont’d)

Vocational Rehabilitation – Assists injured or disabled employees become self-supporting and productive thus allowing employees return to suitable work, preferably with little or no loss of earnings.

Death/Burial Expenses – Authorizes compensation to dependents of an employee who dies from job-related illness or injury. Also includes funeral and burial costs as well as expenses for transportation of the body.


Privacy Act (DOL/GOVT-1)

• Covers appropriate and permissible routine uses of FECA records• DOL maintains the official record• The National Program Office (NPO) in connection with

designated field WC POCs are the custodian(s) of the agency copy

• Disclosures of any FECA documents requires signed consent from employee and requests should be directed to the WC POC

• Contact the NPO for guidance on all requests for OWCP documents


Workers’ Compensation ResourcesContent for this presentation taken from:

• http://www.federal-workers-comp.com/ • http://www.dol.gov/owcp/

OWCP Forms• http://www.dol.gov/owcp/dfec/regs/compliance/forms.htm

Medical Authorizations Unit (ACS) • 1-866-335-8319 (Interactive Voice Response)• 1-844-493-1966 (Customer Service)• 1-800-215-4901 (Fax)• https://owcp.dol.acs-inc.com/portal/main.do

http://www.federal-workers-comp.com/

http://www.federal-workers-comp.com/

http://www.dol.gov/owcp/

http://www.dol.gov/owcp/

http://www.dol.gov/owcp/dfec/regs/compliance/forms.htm

https://owcp.dol.acs-inc.com/portal/main.do


Workers’ Compensation ContactsAPHIS Program Unit Point of Contact Contact for Submitting Claims and Questions

Animal Care Marquess Commodore e:[email protected]: (301) 436-3152f: 301-734-7828

MRP-BS & Others Marquess Commodore e:[email protected]: (301) 436-3152f: 301-734-7828

Plant Protection & Quarantine (PPQ)

Adrienne Mckie e:[email protected]: (919)855-7361f: 919-855-7762

Ann Rivers e: [email protected]: (919) 855-7478F: (919) 8557474

Jeff Yarberry e: [email protected]: (970) 494-7554F: (970) 494-7501

Veterinary Services Marquess Commodore e:[email protected]: (301) 426-3152f: 301-734-7828

Wildlife Services

Mary Beth Kowalski e: Mary.B. [email protected]: (970) 4947437f: (970) 494-7432

Steve Greiner e: [email protected]: (970) 266-6169f: (970) 266-6010

Allen Boyer e: [email protected]: (919) 855-7208e: (970) 266-6010

mailto:[email protected]



USDA APHIS OWCP Help Desk Info

Phone: 855-804-7310 Email: [email protected]

NPO Mailing Address:USDA/APHIS/MRPBS

4700 River Road, Unit 124Riverdale, MD 20737



Questions?

animal and plant health inspection service usda – aphis workers’ compensation incident...

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employees death

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variety of benefits

types of benefits available

work related injury

owcp goals

workrelated injury