Office of the Workers’ Compensation Programs

(OWCP)

https://cacdiucs3.cpms.osd.mil/portal/portal.html

Agenda

• Introduction• Benefits and Provisions for Coverage• Traumatic Injury and related forms• Occupational Disease and related forms• Recurrence Injury and related forms• For Your Information• References• Review & Wrap-up

OWCP

Managed by the:

• United States Department of Labor (DOL) and the Division of Federal Employees’ Compensation Act (FECA)

• Administered by local Federal agencies (Human Resources Office)

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OWCP

Covered under the:

Federal Employees’ Compensation Act (FECA)• Passed in 1916, FECA provides compensation benefits to

employees of the U.S. Government • Provides for payment of benefits to dependents if a

work-related injury or disease causes an employee's death

**Does not cover State Employees to include Military personnel having incurred injuries during military service**

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Benefits

• Majority of medical and travel expenses are covered:– Rehabilitation– Chiropractic care (limited)– Hospitalization

• Continuation of Pay • CA-7 (Compensation for lost wages)• Light Duty• Scheduled Award (one time payment/permanent loss)• Death Benefits

Provisions of Coverage

•Permanent, Indefinite, and Temporary employees are covered by FECA. Federal Volunteers are covered under some circumstances

•Medical evidence proves incurred injury or disease is work related and occurred while in the performance of official duties.

•Time Frame submissions of claims . • Claims for must be filed within as soon as possible.• Claims must be filed within three years of an injury or

death.

Timely Submission of Claims

Agencies should submit claims within 7-10 working days to ICPA

Medical documentation WILL be submitted to the ICPA as soon as it is received

Late submission of claims and lack of medical documentation could result in the claimant absorbing the cost

CA-1

Traumatic Injuries• Traumatic Injury: a wound or other condition of the body caused

by external force, including stress or strain

– CA-1 Report of Injury

– CA-16 Authorization for Treatment

– CA-17 Duty Status Report

– CA-7 Claim for Compensation

– CA-20 Attending Physician’s Report

– All pertinent medical documentation supporting sustained injury

Continuation of Pay (COP)

•Continuation of an employee’s regular pay by the employing agency with no charge to sick or annual leave.•Applies to traumatic injuries ONLY.•Employees are entitled to receive 45 (business/work) days of COP when they are absent from work due to disability or medical treatments.•One full day of COP is counted towards a full or partial day of absence•For a routine medical appointment, a maximum of four hours of compensation is usually allowed.

•**Medical evidence within 10 calendar days (CA-1)

A condition produced over a period longer than one workday or shift:

systemic infections; continued or repeated stress or strain; regular exposure to toxins, poisons, fumes, etc.

Other exposure to conditions of the work environment for two or more work shifts.

Forms Used: CA-2 Notice of Occupational Disease. CA-35 Series Specialized Occupational Disease Checklists. All pertinent medical documentation supporting sustained

occupational disease.

**No CA-16 or COP will be issued.**

CA-2Occupational Diseases

CA-2aRecurrence of Injuries

• For Recurrence Injury Cases: a spontaneous return or increase of disability due to a previous injury or occupational disease

• Not to be confused as a new injury

• CA-2a Claim for Recurrence of Disability

• CA-7 Claim for Compensation– All pertinent medical documentation supporting the

recurrence of injury in relation to the original occurrence

Wage Loss - CA-7• Applies to Traumatic Injuries when COP has been exhausted• Applies to Occupational Disease when the employee requires medical

absence

• CA-7 procedures: – First page of CA-7 to be completed by employee– Medical documentation supporting absence– CA-20 Attending Physician’s Report (provides medical info.)– Compensation amount covered

– 75% with dependents– 66 2/3% without dependents

FOR YOUR INFORMATION

• All medical procedures (MRI, physical therapy, surgery) need to be pre-approved through the Accredited Computer Services– Fax for medical authorizations: 1-800-215-4901

• Contact ACS for billing issues/inquiries at (850) 558-1818

• All medical bills/documentations are now sent to JFHQ – HRO prior to being mailed to U.S. DOL, London, KY

• Contact the HRO for escalation guidance

For More Information Ms. Lisa Nagata lisa.g.nagata.civ@mail.mil

(916) 854-3601 – Direct Line(916) 854-3439 – Fax

SGT Mariana Palomaresmariana.palomares.mil@mail.mil(916) 854-3454 – Direct Line(916) 854-3439 - Fax