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July 2006

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Workers Compensation

Question: Under the Federal Employees' Compensation Act, what requirements must a claim for workers' compensation meet?
Answer: The employee must provide medical and factual evidence to establish five basic elements:
1. The claim was filed within the time limits set by the FECA;
2. The injured or deceased person was an employee within the meaning of the FECA:
3. The employee actually developed a medical condition (or damaged a prosthesis) in a particular way;
4. The employee was in the performance of duty when the event(s) leading to the claim occurred; and
5. The medical condition found resulted from the event(s) leading to the claim.
Question: How do employees file for workers' compensation if they work for a private company or state or local government ?
Answer: Individuals injured on the job while employed by private companies or state or local government should contact their state workers' compensation board. At http://www.dol.gov/esa/regs/compliance/owcp/wc.htm
Question: Who is covered under the Federal Employees' Compensation Act (FECA)?
Answer: All civilian employees of the United States, except those paid from non-appropriated funds, are covered. Special legislation provides coverage to Peace Corps and VISTA volunteers; federal petit or grand jurors; volunteer members of the Civil Air Patrol; Reserve Officer Training Corps cadets; Job Corps, Neighborhood Youth Corps, and Youth Conservation Corps enrollees; and non-federal law enforcement officers under certain circumstances involving crimes against the United States.
Question: What is the time limit for filing notice of injury and claim for federal workers' compensation?
Answer: A notice must be filed within three years of the date of injury. However, if a claim is not filed within three years, compensation may still be paid if written notice of injury was given within 30 days, or the employer had actual knowledge of the injury within 30 days after it occurred.
Question: How does the Office of Workers' Compensation Programs (OWCP) decide whether a federal employee's worker's compensation case can be accepted?
Answer: Some very simple cases with medical expenses below a set threshold are accepted automatically. In most cases, however, OWCP claims staff consider the factual and medical evidence sent by the employee and the employer.
OWCP claims staff apply the law, the regulations, and the procedures to this factual and medical evidence. They also apply decisions of the Employees' Compensation Appeals Board and administrative decisions of OWCP as set forth in Federal Employees' Compensation Act (FECA) Program Memoranda.
Question: What must a federal employee do when injured at work?
a. Report the injury to the supervisor right away and obtain first aid as necessary;
b. Complete a written report (Form CA-1 http://www.dol.gov/esa/regs/compliance/owcp/ca-1.pdf or CA-2 http://www.dol.gov/esa/regs/compliance/owcp/ca-2.pdf) and give it to the supervisor;
c. If a traumatic injury is involved, and further medical treatment is needed, obtain authorization (Form CA-16) from the supervisor for treatment by a physician of the employee's choice. If that physician is not available, the employee still has the right to choose a treating physician and should therefore select another;
d. If a traumatic injury is involved, furnish the supervisor with medical evidence of any disability within 10 calendar days of claiming continuation of pay.

Question: For purposes of federal workers' compensation, how is "performance of duty" established?
Answer: Usually, the injury or illness must occur on the employer's premises during working hours while the employee is performing assigned duties or engaging in an activity which is reasonably associated with the employment. Workers who perform assigned duties away from the employer's premises are also covered.
Question: May someone other than the federal employee fill out a notice of injury, illness or death to receive compensation?
Answer: Yes. Another person, including the supervisor, may act on behalf of an injured employee or survivor and fill out the employee's portion of Form CA-1, CA-2, CA-5, or CA-5b. The person making the report should complete and sign the form and then submit it to the employee's supervisor.
Question: What is the Energy Employees Occupational Illness Compensation Program ?
Answer: The Energy Employees Occupational Illness Compensation Program provides benefits authorized by the Energy Employees Occupational Illness Compensation Program Act. The Program went into effect on July 31, 2001. The Department of Labor’s Office of Workers’ Compensation Programs is responsible for adjudicating and administering claims filed by employees or former employees or certain qualified survivors under the Act.
Compensation of $150,000 and payment of medical expenses from the date a claim is filed is available to:
? Employees of the Department of Energy, its contractors or subcontractors with radiation-related cancer if:
? the employee developed cancer after working at a facility of the Department of Energy, its contractors and subcontractors; and
? the employee’s cancer is determined at least as likely as not related to that employment in accordance with guidelines issued by the Department of Health and Human Services, or
? the employee is determined to be a member of the Special Exposure Cohort (employees who worked at least 250 days before February 1, 1992, for the Department of Energy or its contractors or subcontractors at one or more of the three Gaseous Diffusion Plants located at Oak Ridge, TN, Paducah, KY or Portsmouth, OH or who were exposed to radiation related to certain underground nuclear tests at Amchitka, AK) and developed one of certain listed cancers;
? Employees of the Department of Energy or its contractors and subcontractors at facilities where they were exposed to beryllium produced or processed for the Department of Energy who developed Chronic Beryllium Disease; and
? Employees of the Department of Energy or its contractors and subcontractors who worked at least 250 days during the mining of tunnels at underground nuclear weapons test sites in Nevada or Alaska and who developed Chronic Silicosis.
Compensation of $50,000 and payment of medical expenses from the date a claim is filed is available for:
? Uranium Employees previously awarded benefits by the Department of Justice under Section 5 of the Radiation Exposure Compensation Act.
Employees of the Department of Energy, its contractors and subcontractors who were exposed to beryllium on the job and now have beryllium sensitivity will receive medical monitoring to check for Chronic Beryllium Disease.

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