Federal Worker’s Compensation, What You Don’t Know…

At InformedFed, we have encountered a number of employees injured while on duty, in connection with the performance of their assigned duties.  While that itself may not be unusual, we found these employees were either 1) not advised of their FECA benefits (Federal Employees Compensation Act at 5 U.S.C. 8101) or 2) they were inadequately or untimely advised of FECA rights and benefits in connection with federal employment.  The Agency failure to properly advise injured federal employees and otherwise timely and properly process claims for injuries, can adversely affect both the employee and family of the employee in the context of compensation and benefits, for the remainder of their lives.  The more serious or debilitating the injury, the greater and longer the adverse impact.

Unlike most appeal forums, the OWCP does not accept untimely applications or appeals based on an agency failure to timely or properly advise an employee.  Therefore, an agency who fails to advise an employee of such rights, or otherwise timely advise the employee, is largely impervious to claims against it on that basis.  Simply put, the employee loses in this scenario. Conceivably, an employee could pursue some type of appeal before the EEOC, agency grievance procedure, or negotiated grievance procedure.  However, any corrective remedy would require a transaction by the Office of Workman’s Compensation Program, which is not a party to the dispute and an agency cannot order the OWCP to take an action.

The Organizational Basics

As incredible as it sounds, one of the most frequent complaints we encounter is that federal employees cannot determine the contact information for the local OWCP agency specialist. For some reason, local agency OWCP specialists appear to not make their presence known generally.  Of course, there are exceptions to this, though it appears such exceptions are just that- exceptions. Therefore, it is important for federal employees to understand the basic structure of FECA administration, down to the local level of agency operations where the employee likely resides.

Please note, the local methods, organization, and processes of FECA administration among federal agencies is as varied (unfortunately) as the number of agencies that exist; much like you find with the federal EEO (Equal Employment Opportunity) program.  Agencies operate under a delegated authority in the administration of the FECA and they are not essentially prescribed an organizational model by the Department of Labor.

The Federal Employees Compensation Act (FECA) is administered nation-wide by the Office of Worker’s Compensation (OWCP) under the Department of Labor (DOL).  On the very best of days, navigating the OWCP bureaucracy is a nightmare.  Each federal agency is responsible for administering the program within the agency.  The federal agency model typically consists of an OWCP office at the headquarters level with subordinate OWCP agency offices at some level of regional organization.  From that organizational point, OWCP “Specialists” may be directly assigned to some level of local control or are otherwise responsible for covering the employees of the local level of the organization through some centralized (at regional level), or shared service center model.     Sometimes, these OWCP “assets” may be organizationally aligned under the local human resources section.  However, this is increasingly rare.  Most federal employees injured at work will only deal with the most local agency person representing the agency in FECA and OWCP matters as the agency operates under a delegated authority from the Department of Labor and has the authority to conduct intake and general day-to-day case administration.  The local agency OWCP Specialists also have the authority to controvert cases; specifically, they have the authority to argue your injury is not work related or that you in fact have work capacity, even if your medical provider indicates you do not.  Therefore, their role is not to specifically advocate for your situation.

The efficacy of local agency OWCP specialists can be questioned.  Some Specialists are extremely passive, if even known locally, whereas we have encountered a few otherwise.  The training is arguably questionable as is the dedicated career paths necessary to produce seasoned professionals who, in fact, actually specialize in FECA and OWCP matters to the extent necessary to properly advise injured employees.  Regardless, the local agency OWCP specialists should not be considered your advocate.  Their role is to transact and intake claims on behalf of the agency and most agencies are aggressive, if not reckless, in attempting to reduce both the short-term and long-term “rolls” of worker’s compensation cases.

What to do When Injured on Duty

Please note, this article is not intended to be a comprehensive treatise on how to initiate and manage your worker’s compensation case or claim of Continuation of Pay (COP).  It is only intended to provide brief information to ensure you make appropriate and timely contacts at the onset of a claim.

Upon a work connected injury, a federal employee has only thirty days to submit form CA-1 (see, 20 CFR 10.100).  Failure to do so within thirty days will bar the employee from any entitlement to Continuation of Pay (COP).  See, V.J. v. U.S. Postal Service, (ECAB 2017) and F.C. and Department of Veterans Affairs, (ECAB 2010). Therefore it is critical both the employee and supervisor engage the process timely.  In the event a supervisor is non-compliant, it is recommended the employee unilaterally file the CA-1 and obtain evidence of such submission (for example, an agency e-mail with attachment).  This will shift the burden of proof to the agency in the event of administrative or civil litigation in connection with the claim.  If the employee is unsure of where, or with whom, to submit a claim in such a situation, the employee should submit the CA-1 to the closest level of supervision possible.

We also recommend the affected employee immediately initiate efforts to identify the local agency OWCP Specialist. If such identification becomes difficult, contact your local human resources office.  Typically, Employee & Labor Relations Specialist are familiar with the local agency OWCP specialist.  Check your agency intranet site and more specifically, your local organization’s section.

The Immediate Obligations of the Agency

When an agency learns of an employee injury, it is required to-

  1. Provide form CA-1 and CA-16 to authorize medical care
  2. Advise the employee of COP
  3. Inform employee of any agency decision or effort to controvert the employee’s claim and the reason
  4. Complete and transmit form CA-1 within ten days of receipt from the employee

There are some differences in case management whether the employee is filing a claim of traumatic injury (CA-1) or a claim of occupational disease or illness (CA-2).  The key difference is that most traumatic injuries are connected to an event or incident whereas occupational diseases or illness are associated with prolonged exposure to elements of the work environment such as chemicals, ergonomic deficiencies, etc.

 

 

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