Workers

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Workers Compensation Program

• Module 18
• National Guard
• Technician Personnel Management Course

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WORKERS COMPENSATION

• Covered under the
• -Federal Employees Compensation Act (FECA)
• Administered by the
• -Department of Labor (DOL)
• -Office of Workers Compensation Programs (OWCP)

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FECA

• Provides compensation benefits to civilian
  employees of the U.S. federal government for
  disability due to traumatic injury or disease or
  illness in performance of duties
• Provides payment of benefits to dependents for
  work-related death of an employee as a result of
  traumatic injury or occupational disease/illness
• Note FECA provides exclusive remedy for
  work-related injury, disease, or death

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PROVISIONS FOR COVERAGE

• Persons must have been a Technician employee at
  time of injury
• Notice of injury/disease must be filed within
  statutory time (3 yrs from date of incident or
  exposure or date awareness of work relationship)
• Must be able to identify the factors which caused
  the injury/disability

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continuedPROVISION FOR COVERAGE

• Must have been in performance of official duties
  at time of incident
• Must prove federal employment cause based on
  medical evidence from a physician who performed
  examination or provided treatment

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FECA DOES NOT COVER

• State employees
• Military Status personnel
• Injuries incurred during drill

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TRAUMATIC INJURY

• A traumatic injury is
• a wound or other condition of the body caused by
  external force, including stress or strain
• AND
• the injury must be identifiable by time and place
  of occurrence, and the member or function of body
  affected and be caused by a specific event or
  incident within a single day or work shift

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OCCUPATIONAL DISEASE/ILLNESS

• A condition produced by
• systemic infections
• continued or repeated stress or strain
• Exposure to toxins, poisons, fumes, etc
• other exposure to conditions of the work
  environment for two or more work shifts

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A CLEAR DIFFERENCE?

• Usually, but not always
• Back pain or strain could be either
• Injury Sudden pain or strain from activities
  not a part of normal job
• Disease/illness Gradual back pain and strain
  from normal job duties

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REQUIRED REPORTS/DOCUMENTATION

• For Traumatic Injury Cases
• CA 1 Report of Injury
• CA 16 Authorization for Treatment
• HCFA 1500 Claim for Reimbursement
• CA 7 Claim for Compensation
• CA-7a Time Analysis Form
• CA -7b Leave Buy Back Worksheet/
• Certification Election
• CA 17 Duty Status Report

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ALL CA-1s MUST BE FILED ONLINE

• OWCP will no longer accept hardcopy (manual) CA-1
  forms
• Electronic Data Interchange EDI Website

https//isdmid1.cpms.osd.mil/web_html/static_java_
edi_sup.html
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REQUIRED
REPORTS/DOCUMENTATION

• For Traumatic Injury Cases (continued)
• CA 20- Attending Physicians Report
• CA 2a- Notice of Recurrence
• CA 3- Termination of Disability

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REQUIRED REPORTS/DOCUMENTATION

• For Occupational Disease/Illness
• CA 2 - Notice of Occupational Disease
• CA 2a Notice of Recurrence
• CA 35 Series Specialized Occupational Disease
  Checklists

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HANDOUT
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Video
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RESPONSIBILITIES

• The Department of Labor (DOL)
• Administers the program for all federal agencies
• Accepts or denies claim
• Adjudicates all claims
• Provides for payment of claims

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RESPONSIBILITIES

• National Guard HROs
• Assists in submission of claims
• Acts as the liaison between employee, supervisor
  and the DOL
• Informs employees and supervisors of program
  benefits and requirements

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RESPONSIBILITIES

• Supervisors
• Provide a safe work environment
• Enforce safety regulations
• Ensure employees are aware of health and safety
  requirements
• Encourage reporting of incidents
• Publicize the OWCP and employees responsibilities

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RESPONSIBILITIES

• Supervisors (continued)
• File CA-1 online
• Ensure accurate, complete, prompt submission of
  claims (to OWCP within 14 days of incident)
• Investigate incidents obtain statements
  controvert questionable claims
• Coordinate return to work with doctor
• Coordinate personnel actions with HRO

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RESPONSIBILITIES

• Employees
• Observe health and safety regulations
• Report potential and actual health, safety and
  fire hazards
• Report all injuries to supervisor

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RESPONSIBILITIES

• Employees (continued)
• Obtain medical status reports from physician(s)
• Provide medical reports and bills to supervisor
  and/or HRO
• Cooperate with light duty placement

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OWCP BENEFITS

• Medical expenses (fee schedule)
• First aid expenses
• Rehabilitation
• Travel expenses to care provider
• Chiropractic care (limited)
• Early nurse intervention
• Assisted Reemployment Program

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OWCP BENEFITS

• Continuation of Pay (COP)
• Compensation for lost wages
• Scheduled benefits
• Permanent total disability
• Death benefits

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HANDOUT
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LIGHT DUTY

• Responsibility of
• the supervisor to try to accommodate the return
  of an employee on light duty
• the HRO to officially reassign an employee to
  another position if necessary
• the employee to cooperate

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HANDOUT
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Individual Exercises
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SUPERVISORS OWCP GOALS

• To minimize workplace hazards
• To minimize worker injuries
• disease
• To minimize agency costs

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Questions