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few types of cases are developed in the DO and referred to the NOO for adjudication (see FECA PM Chapter 1-0200c). Cases listed in FECA PM Chapter 1-0200a and b are to be sent without processing (other than notices of transfer) to the NOO, and inquiries about these cases should be referred to the NOO. 2-0400-3 Material Loaned from Other Agencies 3 Material Loaned from Other Agencies. This paragraph defines the responsibilities of Claims Examiners (CEs) with respect to material loaned by other Federal agencies or other sources to assist in adjudicating and managing claims. (PM Chapter 2-0402 explains the use of investigative reports.) a Inclusion in Case File. If the CE plans to base any decision or action on the loaned material , or if it will possibly aid in resolving an issue in the future, the CE must copy the material and place it in the file, then return the original as soon as possible. b. Refusal of Permission by Agency. An agency which initially refuses permission to copy will often grant it if the CE explains the need for documentation in a letter. If the agency does not allow its material to be copied, the CE may not use it, since the case file must contain full documentation for any decision. 2-0400-4 Filing Material in Cases 4. Filing Material in Cases. This paragraph describes the mechanics of maintaining material in case files. a Contents of Files. Each case file contains a Form CA-800, Non-Fatal Case Summary, or Form CA-105, Fatal Case Summary, which provides a concise record of case actions; a number of documents filed on a spindle which support those actions; and loose documents on which action is pending. b Filing Order. In general, documents are added to the file chronologically as they arrive. Claim forms and notices of injury and death are filed as follows: (1) In a disability case, Form CA-1 or CA-2 should be placed under the other documents in the case file. If a Form CA-7 is received, it is placed under Form CA-1 or CA-2. (2) In a death case, From CA-5b should be placed under the other documents. Form CA-5, the various certificates (birth, marriage, divorce and death), and Form CA-6 are then filed in order from bottom to top. (3) If a disability case becomes a death case, all material related to the death claim should be filed on a separate spindle, beginning with Forms CA-5b and CA-5, the certificates, and Form CA-6. Forms CA-24 and other documents relating to benefit payment changes may be placed on a separate
spindle. The Form CA-800 from the disability case may be added to the old spindle.
Page 1 and 2: LIST OF CHAPTERS PART 2 - CLAIMS (I
Page 3 and 4: eference materials, decisions, and
Page 5 and 6: d. Continuation of Pay. An employee
Page 7 and 8: o. Review of OWCP Decisions. Under
Page 10 and 11: 2-0300 COMMUNICATIONS TABLE OF CONT
Page 12 and 13: 2-0300-4 Regular Correspondence 4.R
Page 14 and 15: (1) Format. All letters should be p
Page 16 and 17: If the information requested cannot
Page 20 and 21: c Filing Down. After reviewing or c
Page 22 and 23: the automated system (see FECA PM 2
Page 24 and 25: i. Advising the Parties. When case
Page 26 and 27: (3) Mail and File staff will notify
Page 28 and 29: 2. Responsibilities. The CE has pri
Page 30 and 31: DO: Disallowed pending. D1: Denied
Page 32 and 33: through the system will be given at
Page 34 and 35: (1) Daily Roll. The codes for daily
Page 36 and 37: een issued. The pay status is UD. D
Page 38 and 39: 1. Worksheet for Investigation of F
Page 40 and 41: medical services received should be
Page 42 and 43: c. After Assignment for Investigati
Page 44 and 45: outside of ESA, whether a private c
Page 46 and 47: materials.
Page 48 and 49: 2-0500 CONFERENCES TABLE OF CONTENT
Page 50 and 51: (4) A formal follow-up or comment p
Page 52 and 53: e. Describe each party’s position
Page 54 and 55: 12. Conferences 13. Intervention St
Page 56 and 57: 2-600-2 Introduction 2. Introductio
Page 58 and 59: Authorizing medical treatment. Auth
Page 60 and 61: 2-600-4 Case Adjudication 4. Case A
Page 62 and 63: 2-600-6 Customer Service and Commun
Page 64 and 65: medical issues. In addition, the cl
Page 66 and 67: If the surgery is authorized, the C
Page 68 and 69:
address for submission of reports a
Page 70 and 71:
If the CN closes the case and the c
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��Assist in work
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permissible. The process for extend
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2-600-9 Vocational Rehabilitation S
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expected after completion of the pr
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2-600-10 Employing Agency Intervent
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2-600-11 Claimant Intervention 11.
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2-600-12 Conferences 12. Conference
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2-600-13 Intervention Strategies an
Page 88 and 89:
the various options, the CE needs t
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c. Return to modified work, with or
Page 92 and 93:
2-0601 Disability Management Tracki
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a. Return to Work. Returning the cl
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(2) COP Nurse Closure. In traumatic
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further entitlement to compensation
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esumes, the DM record should be reo
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DM Tracking, the status code TCQ is
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(2) RHI (Rehabilitation Plan in Pla
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specifics of the RTW, the RS enters
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codes should only be used if a FN o
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actually close out the DM record on
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(not CNC) so that the case continue
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new work stoppage should be reflect
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2-0700 DEATH CLAIMS TABLE OF CONTEN
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2-0700-1 Purpose and Scope 1. Purpo
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c. Notice to Survivors of Right to
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(a) Four-weekly and monthly compens
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(3) If the parties lived apart for
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(3) If the child does not begin pos
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Compensation was terminated effecti
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. Dependency Criteria. The test of
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(3) Proof of physical or mental inc
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parents would not be harmful). d. D
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payment regardless of whether the d
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2-0700-17 Periodic Roll Review 17.
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(2) If extenuating circumstances ex
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2-0800-21 FECA Death Gratuity 21. F
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2-0800 INITIAL DEVELOPMENT OF CLAIM
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not clearly identified, or the rela
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claim to the correct type and notif
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official duties (or an activity inc
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. Developing the Case. Development
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since expeditious treatment for the
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(a) The employing agency should be
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(4) The agency challenges the claim
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evidence. In general, medical repor
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Example: “You have opined that th
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(2) Cardiac and psychiatric conditi
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Exhibit 1: Nature of Injury Codes (
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V9 Virological/Infective/Parasitic,
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notice of injury or death any writt
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immediate superior had actual knowl
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(4) If a claim is not received by O
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(1) Disappearance During a Period o
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2-0802 CIVIL EMPLOYEE TABLE OF CONT
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Page 182 and 183:
2-0802-4 Proof that the Injured/Dec
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. Proof of Status. Any material dis
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2-0802-10 Volunteer Workers with th
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2-0802-15 Employees of the U.S. Pro
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2-0802-18 Cadets at State Maritime
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2-0802-22 Participants in Community
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2-0802-27 Student Volunteers, Inter
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2-0802-32 Federal Emergency Managem
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Establishing whether an injury, tra
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2-0803-5 Development of Medical Evi
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1. Purpose and Scope. This chapter
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(2) In disability cases an explanat
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(3) Workers having a fixed place of
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employment, who are injured while o
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is receiving transportation service
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and should show how they acquired t
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(2) Whether other employees were re
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Whether a fall at work is idiopathi
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performance of duty." Thus, under t
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(3) States how, when, and how often
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2-0804-14 Statutory Exclusions 14.
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2-0804-14 Statutory Exclusions (con
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(2) The official superior should al
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c. Development. (1) It is the CE's
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d. OWCP Policy. Employees performin
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However, the case of Brenda Getz, 3
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discussion with his supervisor conc
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ecause the employee's cardiac arres
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appellant attributes his emotional
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something the employee did while on
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j. Developing Factors of Employment
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When it has been determined that on
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2-0804-19 Deleterious Effects of Me
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Paragraph and Subject 2-0805 CAUSAL
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(1) Temporary aggravation involves
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(2) If examination or treatment was
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(6) Certain other kinds of cases re
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(2) A nurse becomes disabled by pul
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which includes an opinion concernin
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Chapter 2-0806, Initial Acceptances
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sent to the employing agency, and t
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The following sample language may b
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condition. When the claimant's inab
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period immediately following a job-
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2-0807-5 Employee Status 5. Employe
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c. End of Period. The claimant's en
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OWCP requires. g. Claim Forms. The
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2-0807-11 Regular Pay 11. Regular P
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2-0807-12 Delayed Disability 12. De
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(c) Census Enumerators--the date on
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2-0807-15 Relationships Between Lea
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(b) If the refusal is not found to
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d. Period of Payment. To determine
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2-0808 SCHEDULE AWARDS & PERMANENT
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and the opinion of the District Med
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those indicated in the FECA. See 5
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2-0808-7 Payment of Schedule Awards
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later date which is due to work-rel
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2-0809 STATEMENTS OF ACCEPTED FACTS
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elationship is not an issue would n
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For some types of claims, such as h
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modifications.) d. SOAF Footer. The
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a. Evidence. Raw evidence, such as
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September 10, 2008), in which the a
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The claim has been accepted for rig
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2. Several letter carriers were out
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14. Authorizing Medical Treatment a
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2-0810-2 Introduction 2. Introducti
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2-0810-4 Sources of Medical Evidenc
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under the FECA. See Dona M. Mahurin
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To be acceptable as medical evidenc
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not rationalized. The physician sho
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only once can weigh as heavily as,
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2-0810-7 Requesting Information fro
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or sufficient rationale, and the CE
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Also, where a referee examination i
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(5) The AP cannot or will not send
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other physician is supported by obj
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described. (d) As appropriate, an a
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attending the second opinion examin
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issue(s). While the referee’s rep
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of an excluded medical report were
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examination under 5 U.S.C. 8123(d).
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would require a more detailed expla
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2-0810-16 Functional Capacity Evalu
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the requested item, the CE should a
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the facility is fully suitable for
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above. e. Denial of Approval. If th
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2-0810-21 Attendant Allowance 21. A
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2-0811 Nurse Case Management Chapte
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A Staff Nurse assigned to each dist
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5. The Field Nurse (FN). A FN is as
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examples of these instances are: (1
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notification. (6) Release to return
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intervention, the CE and the FN wil
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collaboration between the CE and SN
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assigned, the FN should be notified
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clear goals or direction, as well a
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a. Conference Calls. During the nur
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FEDERAL (FECA) PROCEDURE MANUAL Cha
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Page 391 and 392:
Page 393 and 394:
Page 395 and 396:
Page 397 and 398:
Page 399 and 400:
Page 401 and 402:
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2-0813 Vocational Rehabilitation Se
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When it appears that the claimant
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This chapter explains the procedure
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Lastly, this chapter explains the p
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2. Stautory, Regulatory and Program
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Section 8111 of the Act allows the
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Section 8151 of the Act provides re
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The Code of Federal Regulations dis
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The Vocational Rehabilitation (VR)
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(1) The RS’s responsibilities inc
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(3) The CE’s responsibilities inc
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a. Compensation for Wage Loss. Sect
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c. Schedule Awards. If a claimant r
Page 455:
4. Restoration Rights with the Fede
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a. OPM’s regulations on retention
Page 463:
c. When an injured worker resumes e
Page 468:
5. Referrals for Vocational Rehabil
Page 472:
If the attending physician cannot f
Page 476:
. The CE should ensure that the fil
Page 480:
Note - Prior to referral, the CE sh
Page 484:
(2) The claimant should be capable
Page 488:
(4) There should not be any outstan
Page 492:
d. The FN may recommend a vocationa
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The FN will focus on the medical as
Page 500:
g. To identify cases for early inte
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i. Making the Referral. The CE refe
Page 508:
(2) The name of the attending physi
Page 512:
(4) The date on which disability (o
Page 516:
(6) Whether or not the CE authorize
Page 520:
(8) When the case is being referred
Page 524:
(10) An indication as to whether or
Page 528:
j. Limited Referrals. If the claima
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(2) An Occupational Rehabilitation
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The CE should identify the non-empl
Page 539:
a. Roles and responsibilities. In o
Page 543:
(a) Refer the claimant to an RC to
Page 547:
(c) Advise the CE that the case has
Page 551:
(2) Role of the RC. Working under t
Page 554:
with the claimant so that all perti
Page 558:
(4) Role of the claimant. Claimants
Page 562:
(1) If the employer has shown no in
Page 566:
c. Interruptions. PPE may be interr
Page 570:
(1) If the claimant returns to work
Page 574:
(3) If the EA does not provide an o
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7. Plan Development. If efforts to
Page 579 and 580:
sufficient numbers to make successf
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to the claimant, and the RS will di
Page 583 and 584:
(3) On-the-job training is another
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a. Services offered during this pha
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c. Time Frames. The PNE phase usual
Page 589 and 590:
(c) It must support an LWEC rating,
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a. Various medical services can be
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(7) Reports. The ORP facility must
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Interrupt status is used when rehab
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esolve misunderstandings, or provid
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a. CE Responsibilities. The CE has
Page 601 and 602:
(3) The CE should appropriately dev
Page 603 and 604:
wage-earning capacity had he or she
Page 605 and 606:
days is calculated from the date pl
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ating of the claimant’s WEC has b
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a. A conference may be helpful any
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a. Return to Work with the Previous
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DFEC has adopted the following defi
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7. REPETITIVE MOVEMENTS OF WRISTS (
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2-0814 REEMPLOYMENT: DETERMINING WA
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Exhibits 1. Sample Letter to Claima
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. Preliminary Assessment of Positio
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(b) If the attending physician cont
Page 627 and 628:
employing agency, however, has an a
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e. Payment/Reimbursement of Relocat
Page 631 and 632:
income to the claimant. The CE will
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on June 5, 1997, returned to work o
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not equate to a finding that the po
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imprisonment. The implementing regu
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coworkers had treated him poorly wh
Page 641 and 642:
(2) If OWCP is seeking modification
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. LWEC Determination Not Made. When
Page 645 and 646:
2-0814 Exhibit 1: Sample Letter To
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SAMPLE LETTER TO CLAIMANT ADVISING
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2. Establishing a Pay Rate 3/11 11-
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letter, secure e-mail with the empl
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The salary for full-time rural carr
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(a) Full-time firefighters, such as
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(1) Career seasonal employment. Thi
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(which is discussed in further deta
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of the injury having regard to the
Page 663 and 664:
so supportive rationale should be i
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2-0900-5. Effective Date of Pay Rat
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date, would be used because it was
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. Administrative Inclusions. It has
Page 671 and 672:
hourly rate (computed using the 208
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an employee’s pay rate: (1) Overt
Page 675 and 676:
shifts (which is the most common si
Page 677 and 678:
6 days per week, for example. This
Page 679 and 680:
2-0900-11 Computing Monthly Pay Rat
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similar employment” under §8114
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When there is no disability, claima
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18. Other Payees 12/95 07/00 04/02
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(d) Death benefits, FECA PM 5-307.
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(2) The CE is responsible for notin
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(2) The amounts payable for funeral
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2-0901-8 Basic Computations 8. Basi
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c. Conversion from Daily to Weekly
Page 697 and 698:
Hourly wage X no. of hours per day
Page 699 and 700:
2-0901-11 Maximum Compensation 11.
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2-0901-13 (RESERVED) 13. (Reserved)
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...wages received 2, 5 or 10 years
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decision is issued do not alter tha
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injury. The pay rate for the job he
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e. Representative Payee. When OWCP
Page 711 and 712:
For example, let us assume that the
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(3) If the child does not begin pos
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2 In disability cases, minimum is v
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01/04/87 31.20-46.80 156.00-234.00
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6 The amendments of 07/04/66 establ
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01/01/68 3.7 457 15 09/01/80 4.0 15
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2-0901 Exhibit 5: Percentage Table
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PERCENTAGE TABLE OF SCHEDULE AWARDS
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11 12 cost-of-living increases) 13
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compensation payable; (2) In disabi
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(1) Contact the appropriate person
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the retirement acts. (2) When an em
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(b) If there is accrued compensatio
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Offices (DVARO). In some places the
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(a) No reduction in a schedule awar
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d. Obtaining Elections--Educational
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(3) The CE must advise the claimant
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c. Injuries On and After September
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Based on information contained in t
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2-1000-16 Benefits for Judicial Off
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the CE should suspend compensation
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(See PM 2-0814.11.) (6) An employee
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2-1000 Exhibit 2: OPM Contact List
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When a third party is or may be leg
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attorney) (5) Form EN-1108, Long Fo
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7. Administration of Third Party Ca
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confirms receipt of the refund and
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On the written recommendation of th
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(3) Provide the claimant or attorne
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any SOR for which a refund check ha
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In any other case, where a judgment
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asserted for pain and suffering of
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h. Costs of Suit. The costs of suit
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(6) Section 8133(a) of the FECA pro
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(2) The initial demand letter in an
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efficiently and effectively accompl
Page 787 and 788:
procedures for regular third party
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10.700(b).
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a. Under 5 U.S.C. § 8127(b) and in
Page 793 and 794:
. Should an application be submitte
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(2) The Nature and Complexity of th
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notice of payment of compensation o
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(4) The claimant did contest the am
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2-1300-2 Authority 2. Authority. Se
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annuity adequate to meet living exp
Page 805 and 806:
2-1300 Exhibit 1: Sample of Initial
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FEDERAL EMPLOYEES' COMPENSATION ACT
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Case Number: Employee: APPEAL REQUE
Page 811 and 812:
Dear CLAIMANT NAME: I am writing in
Page 813 and 814:
2-1300 Exhibit 5: Information Neede
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Notice of Reduction 8. Sample Lette
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(1) Notification to Claimant. The C
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See FECA PM 2-0807.10. (2) Particul
Page 821 and 822:
2-1400-4 Notices of Decision Notice
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f. Conclusion. Where the decision i
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approach will assist readers at eve
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(3) A specific service which the cl
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2-1400-7 How to Issue Pre-Terminati
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the claimant for the CE's signature
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(a) Compensation is being terminate
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. Source of Advice. District office
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prior to imprisonment, payment for
Page 839 and 840:
Basis for Decision: While Dr. Smith
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2-1400 Exhibit 3: Sample Notice of
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2-1400 Exhibit 4: Sample Letter Con
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2-1400 Exhibit 6: Sample Notice of
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2-1400 Exhibit 8: Sample Letter Con
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2-1400 Exhibit 10: Sample Letter De
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2-1500 RECURRENCES TABLE OF CONTENT
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(e.g., "pipeline" grants); (c) True
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(3) The case was originally accepte
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c. Case Management. The CE should c
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determined in its November 24, 1999
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2-1600 REVIEW PROCESS TABLE OF CONT
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(2) Any file in which a complaint a
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1. Purpose and Scope. This chapter
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5. Review of the Written Record. Th
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Where it has been determined that a
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submit any comments and/or document
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2-1602 RECONSIDERATIONS TABLE OF CO
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inform the claimant that OWCP will
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discretion is not subject to review
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only evidence submitted is cumulati
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now at issue, the SrCE should prepa
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2-1603 APPEALS TABLE OF CONTENTS Pa
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d. Timeliness of Filing. A person r
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2-1603-6 Cases Returned to District
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2-1700 SPECIAL ACT CASES TABLE OF C
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2-1700-4 Peace Corps 4. Peace Corps
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(2) Staff Spouses. (a) The spouses
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the children born of such pregnanci
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(3) Return from Service Abroad. d.
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(3) Compensation for death will be
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(1)While at a Job Corps Center, an
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(1)Enrollees are required to report
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that observers on vessels that are
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2-1800 HOUSING & VEHICLE MODIFICATI
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the appropriate medical specialty.
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educed by the trade-in value of the
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available comes with extras (like a
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of living, due to personal preferen
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enrichment.” ECAB stated that wit
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such as increased durability or deg
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proposal, or review of a submitted
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