Feca owcp what comes after lwec

Procedure Manual

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1. Purpose and scope. This chapter furnishes the information and instructions necessary for the Claims Examiner (CE) to understand and implement the provisions of the Federal Employees' Compensation Act (FECA) pertaining to continuation of pay (COP), which are found at 5 U.S.C. 8118, and to process initial claims for compensation in a timely manner.

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2. Statutory Authority. Effective September 7, 1974, the FECA was amended to authorize the employing agency to continue an employee's pay for a period not to exceed 45 days, pending the OWCP's adjudication of the employee's claim for compensation. COP applies only to traumatic injuries occurring on or after November 6, 1974 and reported on an OWCP claim form within 30 days. The intent of the COP provision is to eliminate interruption in the employee's income for the period immediately following a job-related traumatic injury. The COP provision eliminates interruption of pay for the great majority of employees injured on or after November 6, 1974. See 5 U.S.C. 8118.

Effective December 20, 2006, the FECA was amended by Title IX of the Postal Service Accountability and Enhancement Act to establish a three-day waiting period before COP may be granted to employees of the United States Postal Service.

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3. COP Defined. COP is the continuance of the employee's regular pay for a period not to exceed 45 calendar days of disability. Lake 20 C.F.R. §10.200.

a. Disability. The employee is entitled to continued pay when he or she is totally disabled for work or partially disabled for work, including reassignment by personnel action to a lower grade or position with lower rate of pay.

b. Medical care. The employee is entitled to continued pay when he or she loses time from work due to the need for medical examination and treatment for the work injury.

c. Lost Elements of Pay. If the effects of the injury require that an employee lose elements of pay (eg, the assignment of a night shift worker to a day shift in order to perform prescribed light duty), COP should be granted for the lost elements of pay (eg, the night differential).

d. Light duty. Informal assignment of light or restricted duties, without a personnel action and without loss of pay, is not counted as continued pay under 5 U.S.C. 8118 and does not decrease the number of days available to the claimant. Lake 20 C.F.R. §10.217.

e. Relationship to Compensation. COP during the 45-day period is not considered compensation as defined by 5 U.S.C. 8101 (12) and therefore is subject to income tax, retirement and other deductions. Lake 20 C.F.R. §10.200 (a).

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4. Employee status. The policies and procedures for determining whether the injured or deceased individual was a civil employee of the United States within the meaning of 5 U.S.C. 8101 (1) are found in FECA PM 2-0802. The eligibility of certain groups of these civil employees to receive COP is determined by statute and regulation.

a. Statutory Exclusions. Persons appointed to serve on the office staff of a former President are considered to be Federal employees, but they are specifically excluded from entitlement to COP. Persons listed in subsections "i" through "iv" of 5 U.S.C. 8101 (1) (E) are expressly excluded from COP because they are not employees within the meaning of the FECA.

b. Separate legislation. Persons whose entitlement to FECA benefits depends upon separate legislation are also excluded from COP. In many of these cases, entitlement to compensation begins from the date such persons are discharged from the programs in which they are enrolled, such as the Peace Corps, Job Corps, and Youth Conservation Corps. In other instances, the employment status and / or pay rate is too uncertain to make specific determinations (e.g., Work Study students, Civil Air Patrol Volunteers, and non-Federal law enforcement officers). Lake 20 C.F.R. §10.200 (d).

c. Individuals Serving Without Pay or for Nominal Pay. Persons whose employment status for compensation purposes is determined under 5 U.S.C. 8101 (1) (B) (e.g., consultants and volunteers) work without pay or for nominal pay, and they are generally not carried in a regular, continuing-pay status. While these individuals render personal service to the United States similar to civil officers and employees, they are not entitled to COP, per 20 C.F.R. §10.200 (d).

d. Non-Citizens and Non-Residents. Persons who are not citizens or residents of the United States or Canada, and who are injured while working outside the continental United States or Canada, are covered under the provisions of 5 U.S.C. 8137 and are excluded from COP, per 20 C.F.R. §10.220 (b).

Panamanian nationals employed by any agency of the U.S. government, including the Panama Canal Commission, before October 1, 1979 are entitled to COP. Those hired on or after that date, however, are not entitled to COP.

e. Jurors. Any person serving as a petit or grand juror subject to Chapter 121 of Title 28 is entitled to coverage under the FECA, whether or not he / she is also a Federal employee. In order to be entitled to COP, however, the juror must be a Federal employee, per 20 C.F.R. §10.200 (d). If the juror is not a Federal employee, he / she is not entitled to COP.

f. Temporary Employees. Persons in this category are civil employees of the Federal government and are included under the provisions of 5 U.S.C. 8118. The fact that their employment would not have continued is not considered sufficient reason to exclude them from coverage, subject to the conditions noted in paragraph 10b below. Like any other employee, however, a temporary employee who first reports a traumatic injury after the employment is terminated is not entitled to COP, per 20 C.F.R. §10.220 (d).

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5. Employee Responsibilities. Per 20 CFR §10.205, to be eligible for COP, the injured employee must meet three requirements: 1) sustain a traumatic injury which is job-related and the cause of the disability and / or the cause of lost time due to the need for medical examination and treatment; 2) provide timely written notice of such injury on Form CA-1 or other OWCP-approved form; and 3) begin losing time from work due to the traumatic injury within 45 days of the injury. In addition to those three requirements, the employee must also present medical evidence in support of any claimed disability. The injured employee is also responsible for advising his or her physician of any available modified duties and for returning to duty upon release to any available work, whether regular or modified.

a. Traumatic Injury. A traumatic injury is defined as a condition of the body caused by a specific event or incident, or series of events or incidents, within a single workday or shift. Such condition must be caused by external force, including stress or strain, which is identifiable as to time and place of occurrence and member or function of the body affected. Lake 20 C.F.R. §10.5 (ee). Such an injury is distinguishable from an occupational disease or illness in that the latter is a condition produced by the work environment over a period longer than a single work day or shift. Lake 20 C.F.R. §10.5 (q).

b. Timely Notice of Injury. The injured employee, or someone acting on his or her behalf, must provide a written report on Form CA-1 (Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay / Compensation) to the employing agency within 30 days of the injury. Lake 20 C.F.R. §10.210 (a). Another OWCP-approved form, such as Form CA-2 (Notice of Occupational Disease and Claim for Compensation), CA-2a (Notice of Recurrence), or CA-7 (Claim for Compensation on Account of Traumatic Injury or Occupational Disease), which contains words of claim, can be used to satisfy timely filing requirements.

(1) The employee's submission of a sick leave slip or any form of leave request other than Form CA-1 or CA-2 to the employing agency may not be construed as an election of personal leave over COP for disability resulting from a traumatic injury.

(2) The Employees' Compensation Appeals Board (ECAB) held in the case of William E. Easter Day, 33 ECAB 1925 (1982), that 5 U.S.C. 8122 (d) (3), which provides that failure to file claim in a timely fashion may be excused for exceptional circumstances, does not apply to claims for COP. See, P.L., Docket No. 11-493 (issued September 22, 2011) (ECAB stated: "Because the FECA makes no provision for an exception to the time limitation in section 8118 (a), no exceptional or mitigating circumstance, including error by the employing establishment, can entitle a claimant to continuation of pay who has not filed a written claim within 30 days of the date of injury. ")

c. The employee's first work stoppage must occur within 45 days of the date of injury in order for the employee to be entitled to continued pay. If the employee's work stoppage occurs more than 45 days after the injury, the employee may claim compensation for leave without pay or leave buy back on Form CA-7.

d. Medical Evidence