OWCP File a Claim? File a Grievance? - National … · · 2016-08-26OWCP File a claim and File a...
Transcript of OWCP File a Claim? File a Grievance? - National … · · 2016-08-26OWCP File a claim and File a...
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OWCPFile a claim andFile a grievance!
Solidarity In Action
Kevin CardAssistant to the President for Workers’ Compensation
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LETTER CARRIER injuries by the numbersUSPS has the highest injury rate among federal employees
FY 2015
City Letter Carrier Injuries
12,000 + letter carriers reported injuries
Over 6,000 resulted in lost time from work
500 lost-time injuries/month
OWCP charged –back $1.4 billion to the USPS
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The NALC and OWCP
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NALC Regional Workers’ Compensation Assistants
Jeff Fultz: Region 1
Coby Jones: Regions 2, 4 & 10
Dave Teegarden: Regions 3, 5 & 7
Joanne Wright: Regions 8 & 9
Ron Adams: Regions 6 & 11
Joanne Wright: Regions 8 & 9
Leo Zachwieja: Regions 12, 13 and New Jersey
Bill Bothwell: Region 14, NYC, Long Island, PR & USVI
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RWCA’s provide advice and representation to NALC members at no cost
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Contact the RWCA’s at the OWCP Booth
Or
Call your NBA’s office
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FECAFederal Employees Compensation Act
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Signed into law on September 7, 1916
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The Grand Bargain
You cannot sue the Federal Government, or Postal Service for a workplace injury.
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FECA: The Law5 USC 81
20 CFR Part 10The Implementing Regulations
Both available on the Injured on the Job page at nalc.org
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20 CFR10.1 What rules govern the administration of the FECA and this chapter?
Except as otherwise provided by law, the Director, OWCP and his or her designees have the exclusive authority to administer, interpret and enforce the provisions of the Act.
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You cannot grieve a decision by OWCP
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FECA and the NALC Contract
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Article 21 Section 4. Injury Compensation
Employees covered by this Agreement shall be covered by Subchapter
I of Chapter 81 of Title 5, and any amendments thereto, relating to
compensation for work injuries.
The Employer will promulgate appropriate regulations which comply with
applicable regulations of the Office of Workers’ Compensation Programs
and any amendments thereto.
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Employee Labor Relations Manual ELM Section 540Injury Compensation Program
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Injury Compensation HandbookEL -505
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Article 19 provides that those postal handbookand manual provisions directly relating to wages, hours, or workingconditions are enforceable as though they were part of the NationalAgreement.
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You CAN grieve when the Postal Service fails to follow the regulations found in ELM 540 and EL - 505
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When a letter carrier suffers an on-the-job injury, they..
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Call their supervisor
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We don’t have that form!
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CA-1, CA-2, CA-2a, CA – 7, CA-7a, CA-16, CA-17, CA-20, CA-35 …
ELM 541.3 Forms
Each installation head ⁄ Health & Resource Management office must maintain an adequate supply of the following basic forms, which are needed for recording and reporting injuries.
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ELM 544.11 Immediate Supervisor Responsibility
When a notice of traumatic injury or occupational disease is filed, the immediate supervisor is responsible for doing the following:a. Immediately ensuring that appropriate medical care is provided.b. Providing the employee a Form CA–1 or a Form CA–2.c. Completing the receipt attached to Form CA–1 or CA–2 and giving the receipt to the employee or the employee’s representative.d. Investigating all reported job–related injuries and ⁄ or illnesses.e. Immediately notifying the control office or control point of an injury, disease, or illness.f. Prompt completion and forwarding of Form CA–1 or CA–2 to the control office or control point on the same day it is received from the employee
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ELM 544.112 Traumatic Injuries
In case of a traumatic injury, the supervisor must advise the employee of the following:
a. The right to select a physician of choice.
b. If the injury is disabling, the right to either of the following:
1. To elect COP for up to 45 calendar days.
2. To use annual or sick leave.
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Getting the bills paidThe CA-16
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We don’t have a CA-16!
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545.2 Authorizing Examination and ⁄ or Treatment With Form CA–16
545.21 Traumatic Injury
When an employee sustains a work–related traumatic injury that requires medical examination, medical treatment, or both, the control office or control point must authorize such examination and ⁄ or treatment by issuing a Form CA–16.
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What’s a Control Office or Control Point?
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Injury Compensation Control Office
Health Resource Management
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544.12 Control Office or Control Point Responsibility
The control office or control point is responsible for completing Forms CA–16 and CA–17 (see 545.21 and 545.53).
Control office and control point supervisors are responsible for reviewing all claims for accuracy and completeness and for forwarding claims and related documents to OWCP within prescribed FECA time frames.
The control office or control point must advise the employee whether COP will be controverted and whether pay will be interrupted.
The control office must provide the employee a copy of the completed CA–1 or CA–2 and all correspondence between the Postal Service and the treating physician.
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Why file a grievance?
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What The OIG FoundThe Postal Service did not appropriately handle claim forms to ensure accurate and timely submission to the DOL.
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OIG
In 102 of 471 (22 percent) case files reviewed, personnel made improper revisions to theemployee and supervisor sections ofthe claim forms.
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OIGSpecifically, in 77 of 102 case files, personnel in the Arizona, Capital, Suncoast, and Hawkeye districts improperly revised dates on forms in three places: 1. the date the employee completed the form2. the date the supervisor was notified, and3. the date the supervisor signed the form.
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OIG
In 25 of 102 case files, personnel in Arizona and Suncoast districts improperly revised, but revisions were not limited to:
1. the place and the date injury occurred2. the cause and the nature of injury3. the date stopped work4. the date pay stopped5. and the date returned to work.
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OIG
Revising information on the claim formswithout documenting the changes gave the appearance that claim forms were completed and submitted timely to the DOL.
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OIG
These conditions occurred because the Postal Service used a labor-intensive manual claims process for OWCP claim documents, which increased opportunities and the risk for personnel to alter the documents.
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OIG
In addition, district personnel were not always aware of policies and procedures for claim forms; and the Postal Service did not establish policies and procedures for revising pertinent dates on the CA-1 form, or revisingCA-2 and CA-7 forms, and date stamping outgoing claim documents.
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OIG
A more comprehensive electronic claims process could reduce
the risk of improper document revisions and improve the
timeliness of claim form submissions to the DOL. Insufficient
controls over the claims handling process and improper
alteration of pertinent dates on claims forms could harm the
Postal Service’s brand and integrity.
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542.31 Penalty for False Statement
Any employee, supervisor, or representative who knowingly makes a false statement with respect to a claim under FECA may be subject to a fine of not more than $10,000 or 5 years in prison, or both.
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542.33 Penalty for Refusal to Process Claim
Any employee or supervisor responsible for making reports in connection with an injury who willfully fails, neglects, or refuses to do so; induces, compels, or directs an injured employee to forego filing a claim; or willfully retains any notice, report, or paper required in connection with an injury may be subject to a fine of not more than $500 or 1 year in prison, or both.
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What you can do
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Request to see the Postal Service copy of your OWCP file
EL – 505 Chapter 12.10
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EL – 505 12-10 Granting On-Site Access to IC File InformationEstablish the identity of the requester.If the request is from the file subject or another authorized individual:– Inform the requester that:– Postal employees who wish to review any of their own records must do so on their own time, except
as provided for under current collective bargaining agreements.– Records are available for inspection and copying during normal ICCO business hours.– A complete official file can be obtained from the OWCP district office.– Schedule an appointment with the requester for the earliest possible date but not more than 10
working days from the date of request.– Before the scheduled appointment, review the file to ensure that the file is in proper order.– If the file subject is accompanied by another individual, have the file subject sign a statement that
he or she authorizes a representative to be present during his or her review of the specific record or records.
– Allow the file subject and/or his or her authorized representative to review the file in yourpresence or that of another ICCO staff person. The ICCO representative must maintaincontrol over the official record.
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If you find that a document has been altered without the consent of the injured worker, you should?
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File a grievance
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Contact you NBA office
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I am always doing that which I cannot do, in order that I may learn how to do it.
Pablo Picasso