Printing - FECA-PT2 - National Association of Letter Carriers

a. Signatures. The CE must review claim forms and certified documents to ensure that original
signatures are present. Original signatures of those persons who certify the accuracy of the
information enable the Office to hold them accountable for any misinformation furnished. When
claims forms, claimant statements, form medical reports such as CA-20, and witness statements
are received without original signatures, they should be copied and returned for proper signature.
It is not usually necessary to copy both the face and reverse of a form. The original form should
not be returned.
Signatures should be reviewed to ensure that they have not been altered. If the signature has
been amended or if it appears to be different from other specimens in file, the CE should determine
whether the signature is genuine by contacting the person who ostensibly signed the form. If the
signature is invalid, the matter should be brought to the attention of the OIG.
b. Alteration of Documents. Alteration of forms is most likely on Forms CA-7 and CA-8 and on
medical forms such as CA-20, reporting dates of disability, leave or pay information, etc. It may
only be necessary to check with the person who prepared the form to ascertain whether the
alteration was made by a third party. If it appears that information submitted by the agency or
physician has been altered by a claimant in an attempt to significantly misrepresent the facts, the
case should be submitted to the OIG (see paragraph 4).
c. Inconsistent Information. The CE should review Form CA-1032 and other forms to ensure
that birth dates of children and earnings information are consistent from one report to the next. If
discrepancies are found which do not appear to accidental, the CE should develop the record to
determine the facts. If a discrepancy can be satisfactorily resolved by letter or telephone call, and
overpayment has not resulted, the CE should document the file with the correct information, but
not alter the erroneous form or document. If preliminary exploration indicates a pattern of
deception, and the exact facts cannot be established with certainty, an investigation may be
required. For example, if there are inconsistent reports of earnings and employment over a long
period during which compensation has been paid for total disability, investigative help should be
requested to establish the earnings record for that period.
d. Other Factors. The CE should be alert to any information which indicates that an improper
claim was filed or that a questionable activity, either within or outside the office, has occurred. The
best protections against fraud and abuse are careful and attentive case monitoring and intelligent
reading of documents. Maintaining current call-ups on all open cases, corresponding with the
attending physician, checking the official superior's allegations concerning the claim, and reviewing
compensation and medical history against approved payments will prevent fraud in the
compensation system.
2-0402-3 Payments
3. Payments.
a. Unexplained discrepancies between the Office's payments and the actual medical services
received should be explored when reported by the claimant. Discrepancies in dates may be due to
the claimant's lapse of memory, and unidentified providers may be Office consultants who
reviewed the file. If a significant discrepancy is reported, the case file and billing history should be
reviewed, and remaining problems referred to the OIG for investigation as explained in paragraph
5.
FECA-PT2 Printed: 06/08/2010 37