Printing - FECA-PT2 - National Association of Letter Carriers

2-0800-13 Affirmative Defense
13. Affirmative Defense. The law states that an injury caused by the claimant's intoxication, willful
misconduct, or intent to injure self or another is not compensable. These factors are described and their
development discussed in FECA PM 2-804, Performance of Duty. Any finding that one of these factors
applies to a claim constitutes an affirmative defense which must be considered at the same time the five
basic requirements are examined, as the ECAB has stated that an affirmative defense cannot be raised for
the first time on appeal (see Hope Kahler, 39 ECAB 588). Therefore, whenever the file contains an
indication that an affirmative defense may apply, that issue must be developed prior to the initial
adjudication.
2-0800-14 Short-Form Closure Cases
14. Reopened Short-Form Closure Cases. The CE will need to adjudicate any reopened cases which
were originally closed by the system because they were uncontroverted traumatic injury claims, the
medical bills did not exceed $1500, or no wage loss claim was filed. Such reopened cases will usually
contain some medical evidence, and unless they involve a late controversion by the agency, they should
be adjudicated immediately. Extent and duration of injury-related disability do not have to be fully
developed before adjudication.
a. Automatic Reopening. Cases closed short form will be automatically reopened if the medical
bills exceed $1500, a wage loss claim is received or the CONTROVERTED INDICATOR in the CMF
record is changed to "Y". If the agency submits a late controversion, the supervisor should change
the CONTROVERTED INDICATOR from "N" to "Y".
b. Manual Reopening. Cases closed short form may also be reopened manually. The case
should be reopened when, for example, a request for surgery is received or a recurrence claim is
submitted. "
2-0800 Exhibit 1: Sample Letter to Claimant or Survivor Approving Withdrawn Claim
Dear _________________________:
SAMPLE LETTER TO BE SENT TO CLAIMANT OR SURVIVOR
WHEN APPROVING A WITHDRAWN CLAIM
I have received your written request to withdraw your claim under the Federal Employees’ Compensation
Act (FECA). As your case file has not been adjudicated, this request is granted. Pursuant to 20 C.F.R.
10.100(3), a claimant may withdraw his or her claim (but not the notice of injury) by so requesting in
writing to OWCP at any time before OWCP determines eligibility for benefits. Accordingly, the Office of
Workers’ Compensation Programs will take no further action in consideration of your claim.
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