Printing - FECA-PT2 - National Association of Letter Carriers

AM/C1: Condition accepted. Up to $1500 in medical payments can be
made without adjudication by the CE. No time lost.
AL/C2: Condition accepted. Some disability supported and covered
by leave. No further claim or bills expected.
Non-controverted no-time-lost cases will be closed without adjudication by the CE as soon
as they are created, and will not subsequently require the CE’s attention unless any of the
following apply:
(a)
(b)
The total amount of medical bills exceeds $1500;
Evidence is received to show that the injured employee was disabled for work
after the date of injury;
(c) Evidence is received to show that a schedule award may be payable for
permanent impairment.
Prior to releasing cases to the claims units, the District Office will identify the
non-controverted, no-time-lost traumatic injury cases.
COP cases should not be closed until a date of return to work is in file, on Form CA-1, Form
CA-3, or other documentation in the file. The appropriate closure code, if no further
disability is claimed, is AC/C4.
If COP is elected but disputed in an accepted case, the code should be AM/MC until closure.
The issuance of Form CA-1050 should not lead the CE to assign a “D” code. If the case as a
whole is denied, Form CA-1050 is not used and a formal notice of decision with appeal
rights is issued, with explicit reference to any COP claimed or paid.
b. Compensation Payment.
(1) Daily Roll. The codes for daily roll payments are AD/DR (accepted for daily roll
compensation; compensation payable). If continuing CA-7 Forms are expected, the case
should remain in that status and should not be placed
in a closed or medical pay status, since these will not permit payment through the
compensation management system.
Lump sum schedule awards must be in AP/LS status. Therefore, even if a one-time
payment of a schedule award is being made, the CE should not use
AD/DR. The appropriate status after the payment is made would be AP/C5 or, if medical
care continues, AM/MC.
When the claimant returns to work (or ceases to claim compensation) and medical bills are
still coming in, the codes should be AM/MC. If the claimant is discharged from treatment,
the case is closed AM/C5.
FECA-PT2 Printed: 06/08/2010 31