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2-0808 SCHEDULE AWARDS & PERMANENT DISABILITY CLAIMS TABLE OF CONTENTS Paragraph and Subject Date Trans. No. Table of Contents 01/10 10-04 1. Purpose and Scope 01/10 10-04 2. Impairment and Disability 01/10 10-04 3. Evaluating Potential Permanent Disability or Impairment 01/10 10-04 4. Permanent Total Disability 01/10 10-04 5. Entitlement to Schedule Awards 01/10 10-04 6. Evaluation of Schedule Awards 01/10 10-04 7. Payment of Schedule Awards 01/10 10-04 8. Disfigurement 01/10 10-04 *(ENTIRE CHAPTER REISSUED 01/10, TRANSMITTAL NO. 10-04) 2-0808-1 Purpose and Scope 1. Purpose and Scope. This chapter describes the procedures for developing claims which have resulted or may result in permanent disability or impairment. Entitlement may include awards for: a. Permanent total disability, as provided by 5 U.S.C. 8105; b. Permanent partial disability which results in loss of wage-earning capacity, as provided by 5 U.S.C. 8106; or c. Permanent impairment, either total or partial, for which a schedule award may be paid, as provided by 5 U.S.C. 8107. This chapter also includes procedures for making awards for disfigurement of the face, head or neck. 2-0808-2 Impairment and Disability 2. Impairment and Disability. Impairment is a medical concept, and any evaluation of impairment must rest on medical evidence. Disability, on the other hand, is an economic concept which reflects a claimant's inability to earn wages comparable to those received before the injury. The degree of impairment is a major factor in evaluating disability, but it is not the only one; others include age, education, and work history. The kinds of permanent disability and impairment are as follows: FECA-PT2 Printed: 06/08/2010 296
a. Permanent Total Disability (PTD). Claimants are rarely considered to have disability which is permanent and total in nature. Only in catastrophic injuries or long-standing chronic conditions should this course be considered, and then only after all attempts to reemploy and/or rehabilitate the claimant have been exhausted. b. Permanent Partial Disability (PPD). In disability which is permanent in nature but only partial, compensation is based on the difference between the wages earned at the time of injury, disability, or recurrence, and the wages the claimant is capable of earning after the injury. This difference is called loss of wage-earning capacity (LWEC). Reemploying injured workers and establishing LWEC are discussed in FECA PM 2-0813 and 2-0814. c. Permanent Impairment. This term is defined as the loss or loss of use of a part of the body, whether total or partial. The degree of impairment is established by medical evidence and expressed as a percentage of loss of the member involved. Permanent impairment may originate either within the affected member or in another part of the body. For instance, a back injury may result in impairment to a leg, for which a schedule award would be payable. A claimant may also receive an award for more than one part of the body in connection with a single injury. 2-0808-3 Evaluating Potential Permanent Disability or Impairment 3. Evaluating Potential Permanent Disability or Impairment. Case management procedures require that reminders be set at appropriate intervention points according to the medical evidence. The Claims Examiner (CE) should also monitor medical reports for the possibility of eventual impairment to a schedule member and the date by which maximum medical improvement is expected. If it appears that a schedule award may be payable, the CE should advise the claimant via Form CA-1053, or the equivalent, of his or her possible entitlement to such an award. 2-0808-4 Permanent Total Disability 4. Permanent Total Disability. The FECA provides that loss of both hands, arms, feet, or legs, or the loss of sight of both eyes is prima facie evidence of permanent total disability. See 5 U.S.C. 8105 (b). It does not necessarily follow, however, that a claimant in this medical condition should be declared permanently and totally disabled. Some individuals may be able to work despite such severe handicaps, and the possibility of rehabilitation and/or reemployment should be explored before any declaration is made. In very few other cases is it necessary or desirable to make a determination of permanent and total disability. Such an award confers no additional benefit on the claimant and it can result in forfeiture of other rights that a claimant may possess under other Federal laws. It is usually sufficient to continue payments for temporary total disability, even where efforts to reemploy and/or rehabilitate the claimant have failed. In the rare instance where such a finding is appropriate, it should be based on the evaluations of the attending physician, other physicians who have examined the claimant, and the opinion of the District Medical Advisor (DMA). Such an award does not supersede any award which may be payable for a schedule disability. Whenever a case involves both permanent total disability and schedule impairment, the CE should pay the schedule award and then continue compensation for permanent and total disability at the expiration of the schedule award. FECA-PT2 Printed: 06/08/2010 297
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LIST OF CHAPTERS PART 2 - CLAIMS (I
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which may be useful to the CE. b. C
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d. Continuation of Pay. An employee
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o. Review of OWCP Decisions. Under
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2-0300 COMMUNICATIONS TABLE OF CONT
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2-0300-4 Regular Correspondence 4.R
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(b) Formal Decision. If a formal de
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If the information requested cannot
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eferred to the NOO for adjudication
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2-0400-6 Requesting Files 6. Reques
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the file. This process should mainl
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2-0400-10 Case Transfers and Loans
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2-0401 AUTOMATED SYSTEM SUPPORT FOR
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names and addresses is optional. By
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PW: Entitled to payment on periodic
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AM/C1: Condition accepted. Up to $1
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full appeal rights, and the adjudic
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B Both A Aggravation 2-0402 SECURIT
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a. Signatures. The CE must review c
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(a) The particular issues about whi
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c. Review by DD. Upon receipt of th
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disposition, a report, enclosing th
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2-0500 CONFERENCING TABLE OF CONTEN
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necessary to identify the official(
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2-0500-6 Senior CE Actions 6. Senio
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2-0500-9 Due Process 9. Due Process
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This chapter outlines the major ste
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(d) Been notified that OWCP will pr
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2-0600-4 Initial Actions 4. Initial
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2-0600-5 Nurse Services 5. Nurse Se
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assess the claimant's environment a
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(4) Timely responses to telephone c
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for guidance in composing such ques
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(4) Only if the CE has taken these
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(1) RS Actions. If the claimant agr
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(3) Absent such a recovery, the OWC
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(c) After any training or other pre
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under way and the CE determines tha
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2-0600 Exhibit 1: Sample Letter to
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2-0600 Exhibit 3: Example of Letter
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2-0600 Exhibit 5: Planning Chart fo
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period, and each new recurrence. a.
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a. QCM Screen. When the QCM screen
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(c) Confirmation of Data. After ent
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(1) NFN*--Referred to Field Nurse.
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2-0601-6 Effect of RTW on QCM Statu
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2-0601 Exhibit 1: Disability Tracki
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SRE Referred to SrCE for Conference
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21. FECA Death Gratuity 4/10 10-06
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. Claimant. The claimant is respons
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2-0700-6 Adjudication 6. Adjudicati
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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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The CE should prepare a memorandum
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. Employee Status. The $200 payment
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(b) Form CA-1617 should be released
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2-0700-20 Gratuity 20. Gratuity fro
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2-0700 Exhibit 1: Percentages of En
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2-0800-2 Definitions 2. Definitions
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. Employing Agency. The FECA requir
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claimant, the CE should send a copy
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(3) The case must be coded as withd
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entire group of cases must be adjud
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2-0800-10 Investigation 10. Investi
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2-0800-13 Affirmative Defense 13. A
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2-0801 TIME TABLE OF CONTENTS Parag
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5 U.S.C. 8122 on the ground that no
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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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2-0802-1 Purpose and Scope 1. Purpo
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(1) The precise time when the worke
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2-0802-8 Contract Job Cleaners Used
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2-0802-13 Volunteer Workers with th
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(1) Whether, prior to the transfer
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. The pay rate for compensation pur
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2-0802-24 U.S. Park Police and Secr
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a participant or crew leader servin
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2-0803 FACT OF INJURY TABLE OF CONT
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2-0803-4 Development of Factual Evi
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2-0804 PERFORMANCE OF DUTY TABLE OF
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time before or after the end of the
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(a) A diagram showing the boundarie
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d. Workers in a Travel Status. (1)
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2-0804-6 To and From Work 6. To and
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(a) The reason the employee was req
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(1) At the time of the injury, the
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(1) Martha G. List, 26 ECAB 200. Em
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duty, the CE may approve the case.
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action taken; and (4) Statements fr
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2-0804-14 Statutory Exclusions 14.
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would justify such disobedience. (c
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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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such as soliciting new members or c
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c. Performance Ratings. The Board r
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Where an employee asserts that emot
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The Board noted that Cannon was unl
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Since both cases involve procedures
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Ashberry's disability was not compe
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no longer be considered so in light
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2-0804-18 Employing Agency Physical
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f. This matter was initially addres
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compensation would be payable for t
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limited to the period of work-relat
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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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the body originally injured is term
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2-0806 OCCUPATIONAL ILLNESS TABLE O
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the following steps, depending on w
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(4) Exposure to and Identification
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While records of past medical treat
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the medical connection between lift
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(b) The medical evidence presented
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2-080 Exhibit 2: Sample Letter to C
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TITLE _____________________________
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Page 245 and 246: eason, you should call or write to
Page 247 and 248: 2-0806 Exhibit 5: Sample Letter to
Page 249 and 250: 9. [FREE FLOW IF DESIRED] We may wr
Page 255 and 256: If you do not understand any part o
Page 261 and 262: stressful situations in your person
Page 263 and 264: TITLE FECA-PT2 Printed: 06/08/2010
Page 265 and 266: I am writing in reference to your c
Page 269 and 270: We may write directly to a physicia
Page 271 and 272: 2-0806 Exhibit 20: Sample Questions
Page 273 and 274: TA Amputation TB Back strain TC Con
Page 275 and 276: (D )Other Disability, Occupational
Page 277 and 278: a. Traumatic Injury. If an air traf
Page 279 and 280: 2-0807-6 Period of Entitlement 6. P
Page 281 and 282: d. Return to Duty. The injured empl
Page 283 and 284: f. The injury was not reported on a
Page 285 and 286: W = Total number weeks worked P/W =
Page 287 and 288: COP is paid for the entire period o
Page 289 and 290: (c) When the physician's report ind
Page 291 and 292: (a) Assign or detail the employee t
Page 293 and 294: . Monitoring the Claim. (1) If Form
Page 295: (4) If conflicting information appe
Page 299 and 300: (1) Prior to December 7, 1940. No p
Page 301 and 302: (2) Impairment due to amputation is
Page 303 and 304: . Claims for Increased Schedule Awa
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Page 307 and 308: Medical. 2-0809-2 Introduction 2. I
Page 309 and 310: CE is ready to evaluate the evidenc
Page 311 and 312: the physician with a complete pictu
Page 313 and 314: (3) Personal habits such as smoking
Page 315 and 316: games or operating a construction b
Page 317 and 318: Jane Doe, date of birth 04/06/1965,
Page 319 and 320: elated to the employee’s duties;
Page 321 and 322: 16. Physical Therapy 04/01 01-06 03
Page 323 and 324: evaluating the merits of medical re
Page 325 and 326: situation where ten days earlier th
Page 327 and 328: each opinion. The value of the evid
Page 329 and 330: manipulation of the body. They incl
Page 331 and 332: . The DMA's performance of these fu
Page 333 and 334: evidence from physicians who have n
Page 335 and 336: e. In cases involving a preexisting
Page 337 and 338: (1) The consultant should be asked
Page 339 and 340: value). Based on the results of thi
Page 341 and 342: However, if the impartial specialis
Page 343 and 344: 2-0810-13 Exclusion of Medical Evid
Page 345 and 346: Leanna Garlington, 37 ECAB 849). Re
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(d) A suggested supplier, if any. (
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need for further treatment as detai
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2-0810-18 Transfer of Medical Care
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2-0810 Exhibit 1: Information from
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Dear CLAIMANT NAME: We need the fol
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2-0810 Exhibit 3: General Guideline
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2-0810 Exhibit 5: Sample Paragraph
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2-0810 Exhibit 7: Letter of Warning
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In addition, a primary goal of case
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(3) Release Form CA-1008 and Pamphl
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a. Where disability is present, the
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f. If the evidence obtained as a re
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eligible for disability benefits. A
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f. Physician's estimate of the date
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2-0812 PERIODIC REVIEW OF DISABILIT
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determine the status of dependents
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whether disability is related to th
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earnings or activity is in question
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eferred to the Office of Inspector
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. Suspension of Compensation. OWCP
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certification clauses on the CA-103
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SI Payment/Entitlement Suspension i
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with the return to work effort. CFF
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should be placed in a PN status. OP
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force. 10. If the business has had
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I am writing in follow up to the Fo
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2-0812 Exhibit 6 - Periodic Entitle
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Service. On 03/14/2003, the claiman
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Authorized Medical Care for Substan
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a. OPM's regulations on retention r
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d. To identify cases for early inte
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2-0813-7 Communication Among the CE
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d. Cooperative Agreement. The title
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ehabilitation process. 2-0813-11 Fa
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(2) To reduce compensation in this
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The specificity of the reasons offe
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in conjunction with graded conditio
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(1) Where the claimant cannot perfo
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2-0813 Exhibit 2: Non-Cooperation W
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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
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(3) The employing agency will be as
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e. Payment/Reimbursement of Relocat
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have no appeal rights attached. c.
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were not reported to OWCP or were o
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(3) If the employee can work only p
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this instance the CE will need to e
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d. Unacceptable Reasons for Abandon
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closure of an installation, cessati
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Code, and returns to duty under ret
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If you receive an increase in pay o
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2-0814 Exhibit 3: Sample Letter To
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RATE DATE FOR SCHEDULE AWARDS 01/10
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(1) Kinds of Appointments. The Post
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year, in the teaching profession, w
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(b) Census enumerators; (c) Casual
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The CE should consider these factor
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The greatest of these pay rates wil
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the Department of Veterans Affairs
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degree of expense, hardship, and in
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(2) Basic bi-weekly pay x premium p
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2-0900-9 Computing Daily Pay Rate 9
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2-0900-11 Computing Monthly Pay Rat
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The salary for these employees may
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2-0901 COMPUTING COMPENSATION TABLE
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2-0901-2 Related Topics 2. Related
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(4) A GS-12 CE or designated CE may
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2-0901-4 Factors in Computing Compe
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(3) For schedule award payments, th
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(4) Compensation payable for less t
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2-0901-9 Special Determinations 9.
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2-0901-11 Maximum Compensation 11.
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payment. a. Beginning Date. Schedul
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(3) ( ) (a) is capable of earning (
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automatic pay increases. For exampl
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claimant to a higher pay rate under
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(a) the beneficiary's maintenance,
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Letter CA-1208 to the claimant, wit
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01/01/76 4.4 10/10/76 18.96-28.44 9
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01/02/2000 44.98-67.47 224.91-337.3
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10/07/79 144.56 722.78 - (2,891.12)
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*Calendar Days 01/01/2001 3.3 365 1
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PERCENTAGE TABLE OF SCHEDULE AWARDS
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2-0901 Exhibit 6: Activity Codes AC
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12. Tennessee Valley Authority 02/9
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. Death Benefits. When compensation
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(3) Certification. The CE should ha
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elected, refer the case to the inac
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(b) If there is accrued compensatio
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Centers, and DVA Hospitals. If the
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(b) The claimant may be entitled to
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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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(a) Calculate the number of weeks w
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I. Claimants must elect between Fed
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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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(6) Ltr. CA-1109, Authorization to
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7. Administration of Third Party Ca
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(3) If not accurate or complete, th
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the DCE, is urgent should be sent i
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(3) Provide the claimant or attorne
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for a course of action. All formal
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In any other case, where a judgment
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(b) 5 percent of the total to be al
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To determine the amount to be liste
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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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of the employee. The USPS cannot re
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not be referred to the FEEWC until
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FECA-PT2 Printed: 06/08/2010 581
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a. Under 5 U.S.C. § 8127(b) and in
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. Should an application be submitte
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and the requested fee is reduced du
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2-1200 Exhibit 1: Sample Formal Dec
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2-1300 LUMP SUM PAYMENTS TABLE OF C
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2-1300-3 Requests for Lump-Sum Paym
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2-1300-4 Calculating Lump-Sum Sched
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2-1300 Exhibit 2: Sample Appealable
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3. REVIEW BY THE EMPLOYEES' COMPENS
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SIGNATURE _________________________
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We have received your request for a
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2-1400 DISALLOWANCES TABLE OF CONTE
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2-1400-1 Purpose and Scope Purpose
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a. Initial Disallowances. Such disa
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(1) Failure to Appear for Medical A
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(1) The name and location of the em
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injury caused no disability for wor
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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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(a) The case is being referred beca
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(a) Compensation is being terminate
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. Source of Advice. District office
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usual rate, i.e., 75 percent of the
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objective findings to support your
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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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(d) Closure of a base or other faci
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(1) The medical evidence needed to
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c. Case Management. The CE should c
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emains the same regardless of wheth
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2-1600 REVIEW PROCESS TABLE OF CONT
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c. Formal Decision. Chapter 2-1400
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the request. H&R will acknowledge r
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spouse or child prevents his or her
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OWCP shall pay fees requested by wi
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2-1601-9 Cases Returned from H&R 9.
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2-1601 Exhibit 2: Sample Letters Ac
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Exhibit 3, page 1 of 3: Hearing Not
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Exhibit 3, page 3 of 3: Hearing Ins
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2-1601 Exhibit 5: Request for Comme
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2-1602 RECONSIDERATIONS TABLE OF CO
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2-1602-2 Policy 2. Policy. The foll
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d. Decision. An untimely applicatio
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percentage of the award under the S
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(2) The cover letter to the agency
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2-1602 Exhibit 1: Sample Letter Ret
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Dear CLAIMANT NAME: We have reviewe
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2-1602 Exhibit 5: Sample Compensati
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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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Compensation for loss of wages may
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(3) Return from Service Abroad. d.
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Section 5 U.S.C. 8101(4), which pro
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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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coverage under 5 U.S.C. 8101. b. Co
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2-1800-2 Authority 2. Authority. Ho
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determined by the type of vehicle,
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greatest current fair market value
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Such certification from an architec
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over $10,000, and that amount must
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2-1800-7 Housing Modifications for
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send an approval letter along with
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By signing this agreement, all part
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By signing this agreement, all part
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Memorandum of Agreement - Modificat
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Memorandum of Agreement - Housing M
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