Continuation of Pay COP

1
Continuation of Pay (COP)

• Presentation for Agency Representatives
• February 15, 2007
• Elizabeth Way
• U. S. Department of Labor
• Branch of Technical Assistance

2
Topics to Be Covered

• COP Defined
• Eligibility for COP
• Controverting COP
• Terminating COP
• Calculating COP
• Determining Dates
• Counting COP Days
• COP Examples
• Light Duty and COP
• References

3
COP Defined

• Continuation of regular pay for up to 45 calendar
  days of wage loss due to disability and/or
  medical treatment after a traumatic injury
• Intent is to avoid interruption of pay while the
  claim is adjudicated
• Subject to usual deductions from pay, such as
  income tax, retirement, allotments, etc.
• Decision to use leave over COP is not
  irrevocable. Employee who uses leave can later
  elect COP within one year of the leave usage or
  date the case is accepted by OWCP, whichever is
  later.

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Continuation of Pay - Eligibility

• Must be a traumatic injury
• Must file the CA-1(or notice of injury) within 30
  days of the date of injury
• Must begin losing time from work within 45 days
  of the injury.

5
Nine Reasons for Controverting COP

• Agency may controvert (not pay) COP ONLY if one
  of the following applies
• Disability is a result of occupational disease or
  illness
• Employee comes within the exclusions of 5 USC
  8101 (1) (B) or (E) (volunteers)
• Employee is neither a citizen nor resident of the
  US or Canada
• Injury occurred off the agencys premises and the
  employee was not engaged in official off
  premises duties

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Nine Reasons for Controverting COP - continued

• Employees willful misconduct, intentional harm
  or death, or proximate intoxication
• Injury not reported within 30 days of injury
• Work stoppage first occurred more than 45 days
  after the injury
• Employee reported injury after employment was
  terminated
• Employee is enrolled in Civil Air Patrol, Peace
  Corps, or other group covered by special
  legislation

7
Unacceptable Reasons for Controverting COP

• Injury was not witnessed
• Employee was careless
• Employee is a bad employee and doesnt deserve
  any benefits

8
Controverting COP

• Indicate controversion on CA-1 and attach
  narrative statement and specific evidence
  substantiating controversion
• Advise employee of controversion
• Can also terminate COP if no prima facie medical
  evidence received within ten calendar days
• OWCP reviews COP controversion and can overturn
  it and require that COP be paid. Agency is
  provided with explanation of basis for decision.

9
Terminating COP

• Where the employer has paid COP, it may be
  stopped only when at least one of the following
  occurs
• Medical evidence is not received within 10
  calendar days after the claim is submitted
• Medical evidence shows that the employee is not
  disabled from his/her regular position
• Medical evidence shows that the employee is
  capable of performing light duty, and the
  employee has refused a suitable written job offer

10
Terminating COP - continued

• Employee returns to work with no loss of pay
• Employees period of employment expires
• OWCP directs the employer to stop
• COP has been paid for 45 days

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Calculating COP

• The pay rate for COP purposes is equal to the
  employees regular weekly pay rate
• Excludes overtime pay, but includes other
  applicable extra pay except to the extent
  prohibited by law
• Changes in pay which would have otherwise
  occurred during the 45 day period are to be
  reflected. (i.e., promotion, demotion, step
  increases)

12
COP Regular Schedule

• For full or part time workers (permanent or
  temporary) who work the same number of hours each
  week of the year, the weekly pay rate is the
  hourly pay rate (A) in effect on the date of
  injury multiplied by (x) the number of hours
  worked each week (B)
• A x B Weekly Pay Rate

13
COP Irregular Schedule

• For part-time workers who do not work the same
  number of hours each week, but who do work each
  week of the year, the weekly pay rate is an
  average of the weekly earnings established by
  dividing (/) the total earnings from the year
  immediately preceding the injury (A) by the
  number of weeks worked in that year (B)
• A / B Weekly Pay Rate

14
COP Intermittent, Seasonal, On-Call

• The weekly pay rate is the average weekly
  earnings established by dividing (/) the total
  earnings during the full 12 month period
  immediately preceding the date of injury (A) by
  the number of weeks (or partial weeks) worked
  during the year (B) (that is A / B) or 150 times
  the average daily wage earned in the employment
  during the days employed within the full year
  immediately preceding the date of injury divided
  by 52 weeks, whichever is greater.

15
COP Determining Dates

• The first day of COP is the day following the
  date of injury (DOI) where there is immediate
  time loss
• If there is immediate time loss on the DOI and if
  the employee was injured during official work
  hours, time lost on DOI is charged to
  Administrative Leave
• If employee is injured before work hours and
  there is immediate time loss, the first day of
  COP is the DOI
• If disability wasnt immediate, the timeline
  begins on the first return to work date so long
  as that was within 45 days of the DOI 

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COP Determining Dates

• If continual disability for work begins within 45
  days after the first return to work, and all 45
  days of COP havent been used, COP continues
  until 45 days of COP have been used  
• If the disability for work was intermittent, COP
  can be used only up to 45 calendar days after the
  first return to work even if less than 45 days
  of COP have been used (Procedure Manual 2-0807-
  6)

17
COP - Counting Days

• COP looks at calendar days, not just work days
• Using any part of a day towards COP makes it a
  COP day (1 hr COP to see MD 1 day COP)
• Time lost must be certified by physician read
  medical carefully for disability for work dates
• COP is charged for weekends and holidays if
  medical evidence shows IW was disabled on those
  days
• Determining factors for COP are disability for
  work or absence for obtaining medical care for
  injury

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COP - Counting Days Example 1

• Worker is injured on 6/1
• Disability starts on 6/2
• Worker returns to full time limited duty on 6/14.
• Disability returns on 6/22 and is continual.

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COP Calendar Example 1
June
July
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COP - Counting Days Example 1

• Used 12 days COP for 6/2 6/13
• 6/14 is first RTW date
• 6/22 disability resumes and is continuous
• Can use balance of 33 days of COP because
  continual disability is within 45 days of first
  RTW
• 45th of COP is 7/24

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COP - Counting Days Example 2

• Worker is injured on 6/1.
• Disability starts on 6/1. Physician certifies IW
  disabled through 6/13.
• Worker returns to full time limited duty on 6/14.
  Physician wants IW to attend PT on Tuesdays and
  Thursdays for the next 2 weeks.
• Physician certifies another 10 days of disability
  starting 7/1.
• IW returns to full time limited duty on 7/12.
• Physician takes IW off work again starting 7/30.

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COP Calendar Example 2
June
July
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COP - Counting Days Example 2

• Used 12 days COP for 6/2 6/13
• 6/14 is first RTW date
• Uses 4 more days of COP for PT making 16 days
  of COP used through 6/24
• Uses 10 more days of COP 7/1 7/11 total of 26
  days of COP used through 7/12
• Not eligible for COP for period of disability
  starting 7/30 because 7/30 is more than 45 days
  after 1st RTW.

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Light Duty and COP

• IW may be charged COP when assigned to light duty
  if the light duty job is
• Assigned by a personnel action and
• Is a bonafide position with a job description
  and
• Is classified at a lower pay level than the pay
  level of the job the employee held when injured
  or a lower grade or rate of pay than IWs
  preinjury job or is on a different schedule
  which causes a loss of salary or premium pay
  authorized as part of the IWs normal work week
  (e.g. Sunday premium or night differential)

25
Light Duty and COP

• IW may not be charged COP if an agency assigns IW
  to limited or light duty in the absence of a
  personnel action unless it results in loss of
  salary or premium pay as a result of being on a
  different schedule

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COP References

• OWCP Procedure Manual Part 2 807 on web at
  http//www.dol.gov/esa/regs/compliance/owcp/INDEXo
  fResources.htmbookmark3
• CA-810 Chapter 5
• CA 550 Chapter D
• Injury Compensation Specialist Training on CD
  or on web at http//www.dol.gov/esa/owcp/share/Sha
  reppt/ppt.aspx