WWorkers’ orkers’ CCompensation ompensation

PProgramrogramModule 18Module 18

NNational ational GGuard uard

TTechnician echnician PPersonnel ersonnel MManagement anagement CCourseourse

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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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…continued

PROVISION 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/DOCUMENTATIONFor Traumatic Injury Cases (continued):

• CA 20- Attending Physician’s 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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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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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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IIndividualndividual EExercisesxercises

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SUPERVISOR’S OWCP GOALS

• To minimize workplace hazards

• To minimize worker injuries

& disease

• To minimize agency costs

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QQuestionuestionss