Printing - FECA-PT2 - National Association of Letter Carriers

2-0800-10 Investigation
10. Investigation. As far as possible, the CE is expected to adjudicate claims on the basis of evidence
obtained by correspondence. However, in cases where fraud or other criminal wrongdoing is suspected,
the case must be referred for investigation to the Office of the Inspector General. Procedures for referring
cases for investigation are outlined in FECA PM 2-402. The primary purpose of investigation is to obtain
required evidence by personal contact with claimants, immediate superiors, co-workers, doctors, and
others.
a. When to Consider Investigation. The CE should consider requesting an investigation into
possible fraud where:
(1) Essential information about the employee's prior industrial and/or medical history is
unavailable from the employing agency or other sources.
(2) The employing establishment cannot adequately confirm or refute the employee's
allegations.
(3) Repeated requests for earnings or dependent information have not been fully
answered.
(4) Information has been received from witnesses, the employing agency or relatives
which bears on the level of compensation.
(5) The period of the claimant's disability is inconsistent with the type of injury sustained
and a new condition emerges.
(6) An unusual pattern of repeated claims filed by the claimant emerges.
b. Prima Facie Case. The CE should not request an investigation until the claimant has stated
the specific basis of the claim and established a prima facie case. Otherwise, the investigator is
effectively assuming the claimant's burden of proof. Moreover, the lack of specific information
concerning the claimant's allegations makes the investigator's work considerably more difficult.
FECA-PT2 Printed: 06/08/2010 133